No abstract available.
Spinal Stenosis*

Recently spondylolysis and spondylolisthesis have become major causes of low back pain in the orthopaedic field and numerous methods have been designed for its treatment. The authors used the LSDS with posterolateral fusion for 12 cases of spondylolisthesis and spondylolysis having low back pain and tenderness, which were operated on during the 4 years from Jan. 1983 to Jan. 1986 at Wallace Memorial Baptist Hospital. The advantages of LSDS with posterolateral fusion are as follows. l. In the case of distraction spondylodesis of interspinous process between L4 and Sl; A. the diameter of intervertebral formaina as well as of the whole spinal canal is widened. B. decompression is accomplished. C. the mechanical stress on the posterior columns of vertebral arch is lessened because the plumb line is anteriorly transferred. 2. Technique of LSDS; the knee-elbow position has the advantages of maximal kyphosis together with expansion of the space between the vertebral arches, as well as a reduction in the tendency to bleed because the blood collects in the abdominal vessels. 3. Internal fixation of grafted bone is not necessary. 4. A large surface area for unit mass of graft is in contact with blood supply. 5. Hypertrophy or displacement of graft can not encroach upon the epidural space; as may occur in certain circumstances following posterior fusion. The results of treatment are follows; l. In the case of improvement of symptoms after facet infiltration and knee-elbow position, satisfa- ctory results after LSDS were obtained. 2. The progression of slipping was not occurred after LSDS. 3. In increased lumbar lordosis, we have noted the instability especially with the changes from the mean values in Fergusons angles. 4. In the slip angle, there is some tendency to the lumbosacral instability correlating with the in- crease in the body weight. 5. We have also noted that the functional result was not closely related with degree of displacement.
Animals ; Body Weight ; Decompression ; Epidural Space ; Hypertrophy ; Kyphosis ; Lordosis ; Low Back Pain ; Lysergic Acid Diethylamide ; Protestantism ; Spinal Canal ; Spinal Fusion ; Spondylolisthesis ; Spondylolysis ; Stress, Mechanical ; Transplants

STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

No abstract available.
Spine*

We have treated the open tibia shaft fractures, especially Gustilo type II, with unreamed interlocking intramedullary nail. In cases combined with soft tissue damage around fracture site, maintaining rigid internal fixation and preserving endoosteal blood supply is important in union of fracture and soft tissue healing. We have analyzed 18 cases of Gustilo type II open tibial shaft fractures managed with intramedullary nailing without reaming since 1991, the follow-up period was average 22 months. Most of the fractures were the result of moderate to high-energy trauma. In all 18 cases, nails were inserted via closed method. Static interlocking nailing was used in all cases. In 16 cases, union of the fracture was achieved from 16 to 25 weeks(average 23 weeks). In the other 2 cases, union was achieved in 7 months. There was no serious postoperative complication except one skin infection with skin defect managed by skin flap and one failure of the interlocking screw. These results are comparable with those obtained from other forms of fixation, including immobilization with a cast, reamed intramedullary nailing, and external fixation.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Immobilization ; Methods ; Postoperative Complications ; Skin ; Tibia

It had been reported by many authors that the incidence of delayed or nonunion in fracture of clavicle was higher in open reduction and internal fixation than conservative treatment. The purpose of this study is to verify the gratification of the reconstruction plate in fracture of clavicle which needed internal fixation. From March 1993 to September 1995, 32 clavicular fractures were underwent open reduction and internal fixation with reconstruction plate for the wide gap, soft tissue interposition and comminuted fracture etc. The results were as follows 1. The range of motion of the shoulder was returned to normal range within 1.5 weeks except one case who had brachial plexus injury. 2. All cases had bony union. Average time to clinical union was 2.9 weeks and the bony union 7.8 weeks. 3. By functional evaluation of shoulder by Weitzman, final results were excellent in 27, good in 4 and fair in l. 4.Fixation and maintenance of clavicular fragment by reconstruction plate was recommendable for wide separated, soft tissue interposed, comminuted fracture of the clavicle. We concluded that reconstruction plate in fracture of clavicle could be recommended as one of the device for internal fixation.
Brachial Plexus ; Clavicle ; Fractures, Comminuted ; Incidence ; Range of Motion, Articular ; Reference Values ; Shoulder

Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, of the anterolateral thigh caused by entrapment or metabolic neuropathy of the lateral femoral cutaneous nerve. Many cases of meralgia paresthetica have been presented for a century. We have experienced a case of meralgia paresthetica which was misdiagnosed as lumbar radicu- lopathy at other hospital, of a 53-year-old man who had developed painful paresthesia and dysesthe- sia of the anterolateral thigh caused by soft tissue tuberculosis of oblique abdominal muscles just proximal to the lateral inguinal ligament where the lateral femoral cutaneous nerve passes. We report a case of unilateral meralgia paresthetica secondary to soft tissue tuberculosis with review of literatures because it has not previously been reported.
Abdominal Muscles ; Humans ; Ligaments ; Middle Aged ; Paresthesia ; Thigh ; Tuberculosis*

No abstract available.
Electrolytes* ; Lung*

Clavicle fractures are frequently seen with the recent increase in traffic and industrial accidents. Recently, in adults, open reduction and internal fixation techniques are commonly performed for the patient to return earlier to their jobs. But internsl fixation technique for clavicle fractures has been a subject of controversy. We operated on 78 cases of fractures of the middle third of clavicle by the technique of intramedullary threaded Steinmann pin fixation from March 1985 to Nov. 1988. The following results were obtained. 1. The funtional results were excellent; 32 cases(41%), good; 41 cases(53%), fair ; 5 cases (6%). 2. The complications include motion limitation ; 5 cases(6%), pin tract infection ; 5 cases (6%), delayed union ; 1 case(1%) 3. The advantages of intramedullary threaded Steinmann pim fixation are as follows. 1) Early active range of motion is possible. 2) The operation procedure is simple to perform. 3) Removal of the pin is easy without anesthesia. Therefore, intramedullary threaded Steinmann pin fixation is thought to be a good operative technique for the clavicle fracture.
Accidents, Occupational ; Adult ; Anesthesia ; Clavicle ; Humans ; Range of Motion, Articular

Gaucher's disease is an uncommon metabolic disorder, which was first described by Gaucher in 1882, characterized by accumulation of distinctive Gaucher's cells in the reticuloendothelial system such as spleen, liver, and bone marrow. The great majority of cases have been reported in Jews, and others in negros and orientals. We are presenting two cases in homozygous twins in Korea, whose clinical manifestations are hepatosplenomegaly and bone lesions due to expansion of involved bones.
African Continental Ancestry Group ; Bone Marrow ; Gaucher Disease ; Humans ; Jews ; Korea ; Liver ; Mononuclear Phagocyte System ; Spleen ; Twins