Beyond the usual age of walking, the dysplasia of dislocated hip has become severe and its reversivility limited so that the reduced hip cannot maintained in stable position. The innominate osteotomy redirect cartilage of the hip and provide stability in the functional position of walking. The author have experienced 45 cases out of 42 patients with congenital dislocation of the hip who were treated by innominate osteotomy at Department of Orthopedic Surgery College of Medicine Yonsei University from Jan. 1979 to Dec. 1986. The analysis of result of operation has been Jan. 1979 at least 18 months follw-up study. 1. The mean age was 4.2 years ranging fron 18 months to 14 years.2. The mean value of parameters in preoperative evaluation, acetabular index was 37°, neck shaft angle 146°, CE angle −64° and leg length discrepency 1.5cm. After operation, actabular index was 20°, neck shaft angle 137° and CE angle 39° in average. And operated limb was longer as 0.5cm in average. 3. By anatomical assessment of NcKay, 17 cases were graded excellent, 19 cases good, 7 cases fair and 2 cases poor. Especially among the patients above 6 years old, only 6 cases were graded excellent or good. 4. As to the post-operative complication, limitation of motion was noted in 4 cases, redislocation in 2 cases, subluxation in 1 cases, avascular necrosis of femoral head in 1 case and infection in 1 case.
Acetabulum ; Cartilage ; Dislocations ; Extremities ; Head ; Hip ; Humans ; Leg ; Neck ; Necrosis ; Orthopedics ; Osteotomy ; Walking

No abstract available.
Aorta, Thoracic* ; Blood Flow Velocity* ; Pregnancy*

The term “ganglion” was given by Hippocrates to designate a knot of tissue filled with mucin. A ganglion may be defined as a cystic benign tumor filled with a mucoid material usually surrounded by a thin wall and occurring in the region of the capsule and connective tissue of joints and tendon sheaths. The regions of the wrist, ankle, and knee and the volar regions of the fingers and hand are most frequently affected. The authors experienced a case of ganglion which had occurred at anteromedial aspect of right hip joint and had been connected with hip joint by cord like band.
Ankle ; Connective Tissue ; Fingers ; Ganglion Cysts ; Hand ; Hip Joint ; Hip ; Joints ; Knee ; Mucins ; Tendons ; Wrist

The ankle is a complex, weight-bearing joint and has an important role in walking. The injuries to the ankle joint complex include not only injuries that cause disruption of the bony architecture of the ankle joint but often significant ligamentous and soft tissue components. The literature on ankle fractures have divergence of opinion on treatment. However, the method used to obtain a good end result of treatment is a matter of differing opinion. One hundred and seventy six patients with one hundred and eighty cases of ankle fractures treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analized in clinical and radiological aspect. The results obtained from this study were as followings: 1. Among the 176 patients, male was 126 patients and female 50 patients (M:F=2.5:1). The average age was 29. 2. Of the 180 cases, the main cause of fractures was traffic accident, 74 cases (41.1%) and the other causes were falling from a height (16.1%), slipping down (15.0%) and sports injuries (12.8%) in order. 3. The fractures were almost closed fractures (84.4%). 4. According to the classification of Lague-Mansen, the pronation-external rotation type (40.6%) was the commonest type. 5. One hundred and twelve cases (62.2%) were treated by open reduction and 68 cases (37.8%) by closed reduction. 6. The average period of the cast immoblization after the open reduction was 8 weeks but the closed reduction was 10 weeks. 7. According to clinical and radioiogical assessment of the result of the treatment, the open reduction was better than closed reduction. 8. The fibular fracture involving lateral malleolus and the diastasis of the distal tibiofibular syndesmosis were very important in ankle stability and were treated by internal fixation for accurate anatomical reduction.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Ligaments ; Male ; Methods ; Walking ; Weight-Bearing

No abstract available.
Teratoma*

A primary infection of the intervertebral disc in adult is an uncommon entity. Usually these patients are not actually ill and their symptoms have been present for some months. Pyogenic infection of the intervertebral disc in children was well documented by a number of authors,but this condition was less well recognized in the adult. We analysed 12 cases of discitis in adults which were treated at the Department of Orthopedic Surgery of Severance Hospital for 10 years from January 1975 to March 1984 by curettage and autogenous iliac bone graft through anterior approach. The results obtained from this study were as follows: 1. The average duration of symptoms before diagnosis was 9.6 months. 2. The lumbar spine was involved in 83% and next in thoracic spine. 3. The most prominent symptoms and signs are backache and local tenderness at the site of the lesion. 4. Ten patients had the preceding disease or definile past history of previous back surgery, myelogram, abscess, urinary tract infection, heavy lifting and back trauma. 5. The white cell count was of little value in the initial investigation, but the E.S.R. was raised in 67%. 6. Positive cultures from the intervertebral disc were obtained in 8 cases(67%). The causative organisms were 5 Staphylococcus, 2 E-coli, and 1 Pseudomonas aeruginosa. 7. The most common radiological finding on admission was narrowing of the intervertebral disc space, and the tomogram showed the most reliable finding for the preoperative diagnosis. 8. In the treatment, focal curettage or diskectomy and anterior fusion with autogenous iliac bone graft was done in all cases. Antibiotics were administrated for 4 to 10 weeks (average 5.5 weeks) after operation and the cast or brace was applied for immobilization. 9. Over-all clinical result were as follows; eight patients (67%) excellent, 3 patients good, 1 patient fair, and no recurrence.
Abscess ; Adult ; Anti-Bacterial Agents ; Back Pain ; Braces ; Cell Count ; Child ; Clinical Study ; Curettage ; Diagnosis ; Discitis ; Diskectomy ; Humans ; Immobilization ; Intervertebral Disc ; Lifting ; Orthopedics ; Pseudomonas aeruginosa ; Recurrence ; Spine ; Staphylococcus ; Transplants ; Urinary Tract Infections

BACKGROUND: The differentiation between hemorrhagic(HS) and norhemorrhagic(NHS) stroke is the most important first step in the management of acute stroke because clinical management of the two disorders differs substantially. Neuroimaging studies are useful in diagnosing and distinctioning between HS and NHS. The use of clinical variables, such as Siriraj stroke scores(SSS), has led to good sensitivity, specificity and predictive values. The aim of our study was to evaluate the use of the SSS in the Korean population and assess whether it could aid to expedite treatment decisions. METHODS: We reviewed 111 cases of stroke patients admitted to our hospital via the emergency department over a 6 months period from July to December 1998. Levels of consciousness, vomiting, headache, and atheroma markers used in the SSS were applied to these patients who met the criteria for a stroke. RESULTS: Of the 111 patients, the SSS classified 83 with sensitivities of 81.1%(NHS) and 73.3%(HS) and positive predictive values of 84.3% and 68.8%, respectively. The overall accuracy rate was 78.3%. CONCLUSION: Our results suggest that the SSS is not reliable in distinguishing stroke types in the Korean population. Definite neuroimaging studies are needed prior to thrombolytic therapy.
Consciousness ; Emergency Service, Hospital ; Headache ; Humans ; Neuroimaging ; Plaque, Atherosclerotic ; Sensitivity and Specificity ; Stroke* ; Thrombolytic Therapy ; Vomiting

PURPOSE: The diagnosis of hypertrophic pyloric stenosis(HPS) can be made by clinical manifestations and upper gastrointestinal(UGI) series in most cases. Recently, the ultrasonogram(US) is a more accurate and reliable method for the diagnosis of HPS in early stage. METHODS: We retrospectively studied 27 HPS patients confirmed surgically from January 1999 to March 2000. We reviewed clinical histories and physical and laboratory findings. Among these patients, ultrasonograms were carried out in 23 cases preoperatively. Therefore, we analyzed pyloric muscle thickness(PT), pyloric diameters(PD), and pyloric canal lengths(PL), and calculated pyloric volume(PV) by the equation of 'PV=pie(1/2PV)2xPL'. RESULTS: The mean age on admission was 39.0+/-20.4 days and 70.4% of the patients were under 6 weeks of age. The mean age at onset was 26.9+/-20.4 days and the duration of symptoms was 12.7+/-11.6 days. On physical examination, the pyloric tumors were palpated in 14 cases(51.9%) and the gastric peristalses were noted in 8 cases(29.6%). UGI series were carried out in 21 cases, and all of them had the characteristic findings of HPS. The mean PT was 5.23+/-1.05mm, the mean PD wase 13.56+/-2.25mm, the mean PL was 21.42+/-3.85mm, and the calculated PV was 3.23+/-1.35 mL. According to the criteria by Stunden, et al., PT(>=4mm), PD(>=12mm) and PL(>=15mm) were satisfied in 91.3, 73.9 and 91.3% respectively. The PV(>=1.4mL) was satisfied in 95.7% according to the criterion by Westra, et al. CONCLUSION: The US in the diagnosis of HPS is safe and useful. With measurements of PV parameter, the diagnosis by US will be more reliable and more accurate.
Diagnosis ; Humans ; Peristalsis ; Physical Examination ; Pyloric Stenosis, Hypertrophic* ; Retrospective Studies ; Ultrasonography

BACKGROUND: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. METHODS: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. RESULTS: Mean age of the patients was 40.0 years and the ratio of male to female was 1 : 0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea. except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1%). CONCLUSION: The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are discharged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.
Abdominal Pain ; Agaricales* ; Amanita ; Diarrhea ; Eating ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver Failure, Acute ; Male ; Mushroom Poisoning* ; Nausea ; Seasons ; Vomiting

Open fractures of the tibial shaft have a high incidence of complication and often result in poor outcomes. The most common method of stabilization is the external fixation by way of the Ilizarov method but the small diameter interlocking intramedullary nailing has also been introduced. The purpose of this study is to analyze the result of Ilizarov method and to compare its results with those of delayed intramedullary nailing used in the treatment of open tibial shaft fractures. We analyzed 81 patients with open tibial shaft fractures, treated using Ilizarov external fixator, or by delayed locked intramedullary nailing between January 1987 and December 1994. The follow-up period was an average 14.5 months. Out of the 81 patients, 58 patients were treated by nails and 23 patients by Ilizarov external fixators. Both groups were given the same initial management but the operation of the nailing group was delayed until proper soft tissue coverage and healing of the wound were evident. In the Ilizarov method group, 58 fractures obtained union within 26 to 53 weeks (average of 32.8 weeks) and in the nailing group, 23 fractures showed union within 14 to 51 weeks (average of 21.2 weeks). There was a significant difference between the two groups (P<0.05). Complications in the Ilizarov group included 4 nonunions, 12 delayed unions, 3 malalignments, 14 wound infections and 13 stiff ankles. There were no nonunion, 10 delayed unions, 8 malalignments, 6 wound infections and 11 stiff ankles in the nailing group. In this study, the Ilizarov group had more delayed unions and nonunions took a longer period of time to obtain the union, and had a more limited range of motion in the ankle, than the nailing group. The nailing group was easier to manage, especially in the soft tis-sue procedure, and it did not require a high level of compliance while having a relatively low risk of malunion.
Ankle ; Compliance ; External Fixators* ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Ilizarov Technique ; Incidence ; Range of Motion, Articular ; Wound Infection ; Wounds and Injuries