Six. patients with clavicular nonunion were treated at the Daegu Catholic Hospital from Aug. 1980 to Jun, 1986. Five patients were male and one was female, and their ages ranged from 35 to 52 years. There were hypertrophic nonunion in four patients and atrophic nonunion in two patients; all six patients had symptoms due to nonunion. Factors that might have influenced the development of nonunion in our cases seem to be inadequate operative treatment, severe trauma and inadequate external fixation due to combined injuries. Five patients were treated with semitubular plating and iliac graft, and one was treated with intramedullary K-wire fixation and iliac graft. All patients achieved good union by average 10 weeks postoperatively and symptoms disappeared. It was concluded that symptomatic nonunion of the mid-clavicle could be treated by operation, and the procedure of choice seemed to be rigid internal fixation with plating applied in compression and bone graft.
Clavicle ; Clinical Study ; Daegu ; Female ; Humans ; Male ; Transplants

In 38 patients with femorsl neck fracture trested at Cstholic Hospital from Aug. 1980 to Jun. 1985, 24 patients were followed for more thsn 2 years. Preoperative bone scanning with 99m Tc MDP was performed in those 24 patients and postoperative follow-up bone scan assesment of the femorsl vascularity was done in 9 patients of them. Following results were obtained. 1 . Tc 99m methylenediphosphonate bone scanning was effective in assesing the femoral head vascularity in the femoral neck fracture patients. 2. The femoral head activity could be changed in the postoperative scanning : there could be further injury to the blood supply during operation or femoral head revascularization after operation 3. Some information about the possibility of future avascular necrosis could be obtained by comparing preoperative and postoperative bone scan in order that early preventive measures might be applied against the late head collapse. 4. It was conculuded that internal fixation should be considered first in the treatment of fresh femoral neck fracture : the indication of head replaement surgery could not be rnade by preoperative bone scan only.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Neck ; Necrosis ; Prognosis

No abstract available.
Arm*

No abstract available.
Clonidine* ; Depression* ; Growth Hormone* ; Humans ; Panic Disorder* ; Panic*

The methods of treatment of discoid meniscus have been in controversy and there are so many reports which represent different results. We analyzed the results of the 91 knees with discoid menisci of 84 patients who had been treated with arthroscopic partial or total meniscectomy, open partial or total meniscectomy, semi-arthroscopic total menisceetomy form June 1982 to Dec. 1987. The puropse of this paper is to present the indication and prognosis of the each method of treatment. There were 45 cases of male, 46 cases of female, and 10 patients were affected both knee. 2 patients who had served arthroscopic partial meniscectomy were reoperated by arthroscopic total meniscectomy due to recurrence of symptom. We classified the types of tear into 7 classes and observed the clinical characteristics and results. The methods we applied were arthroscopic total meniscectomy 40 cases, semi-arthroscopic total meniscectomy 25 cases, arthroscipic partial meniscectomy 16 cases, open partial meniscectomy 3 cases, open total meniscectomy 2 cases, and conservative treatment after arthroscopic diagnosis 5 cases. The follow up cases were 56, and period of follow up was ranged form 11 months to 5 years and 4 months (av. 2 years and 8 months). The results were followings : l. 71.4% of the patients were placed between 11 years and 30 years old, and there was no sexual difference. 2. 11.9% of the patients were affected bilaterally. 3. The commonest clinical symptom and physical sign was clik (67%) and quadriceps muscle atrophy (48.4%) 4. Diagnostic accuracy of knee arthrogram was 88%, but it could not demonstrate the type of tear. In arthrographic finding, the older the patient, the thinner the meniscus was. 5. The commonest type of tear was type V(34.1%) and it was followed by type II (19.8%). 6. There was no difference between the long term results of arthroscopic and semi-arthroscopic total meniscectomy. 7. The results of total meniscectomy is better than partial meniscectomy.8. The method of treatment should be chosen according to the type of terar, so partial meniscectorny is recommended for type II, IV and total meniscictomy is recommended for type III, IV, V and VI. 9. Less hospitalization, earlier recovery, and better result were obtained by the arthroscopic or semi-arthroscopic total meniscectomy.
Atrophy ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Knee ; Male ; Methods ; Prognosis ; Quadriceps Muscle ; Recurrence ; Tears

The treatment of acutely torn anterior cruciate ligament(A.C.L) remains a controversial subject. The purpose of this paper is to show the arthroscopic technique of A.C.L. primary repair with or without augmentation with semitendinosus tendon. Twenty-one patients with acute A.C.L. tear were treated with repair or augmented repair under arthroscopic control from April 1989 to August 1993. Five A.C.L. torn at femoral attachment with intact distal stump were treated with arthoscopic repair alone & 16 A.C.L. torn at substance near the femoral attachment with arthroscopic repair & augmentation with semitendinosus tendon. The patient population included of 16 males and 5 females with an average age 28.3 years. Fifteen patients injuried during sports activity. Postoperative results were evaluated by Lysholm knee score & Hospital for Special Surgery knee scale in average 26 months (range from 12 months to 64 months). All patients were rated as good or excellent result except one patient who had fair result. At follow-up study, testing with KT1000 arthrometer revealed 17 patients had less than 3mm of side to side difference. Second look arthroscopy was performed in 15 patients from 4 to 29 months after repair or augmented repair. Eleven out of these 15 A.C.L. were well healed with good tension 8r. revascularization of graft. Remaining 4 A.C.L. were healed with scar tissue. On the based of this study, arthroscopic repair or augmented repair is very effective treatment for acutely torn A.C.L. near the femoral attachment.
Anterior Cruciate Ligament ; Arthroscopy ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Knee ; Lysholm Knee Score ; Male ; Sports ; Tears ; Tendons ; Transplants

Segmental fractures of the femoral shaft result from high energy trauma such as a traffic accident or falls, and it is frequently accompanied by multiple fractures and severe injuries to other organs. Thus it is very difficult to treat these fractures satisfactorily and several complications can be caused. Early operative intervention and rigid fixation is important to mobilize the patient and to ensure early rehabilitation. Nineteen cases of segmental fractures of the femoral shaft were treated with operative intervention(intramedullary nailing) and followed up between May 1989 and Nov. 1993.; minimal follow-up period was more than one year. Results were obtained as follows: 1. The methods of treatment were interlocking intramedullary nailing in 16 cases(colsed nailing in 7 cases, open nailing in 9 cases) and Kiintscher nailing in 3 cases. Bone grafts were done in 11 cases among 19 cases(8 cases in the interlocking nail group). 2. The closed interlocking intramedullary nailing could be obtained in more shortened operation time than in the open method. 3. There was earlier bone union time in the closed intramedullary nailing than in the open method with bone graft, but there was no statistical significance(SPSS/pc+progam). 4. There was a tendency of earlier bone union time in the proximal fracture site than in the distal fracture site.
Accidental Falls ; Accidents, Traffic ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Multiple ; Humans ; Methods ; Rehabilitation ; Transplants

We reviewed 24 patients who had performed arthroscopic meniscal repair for the treatment off discoid lateral meniscal tear between january 1989 and December 1992. The follow up ranged from 1 year 6 month to 4 year 6 month(average 32month). The mean age was 17.9(range,8-50)years, the patients under 20 years old were 17(cases,71%).Common preoperative clinical symptom was pain on the knee joint(21 cases,87.5%) and click(19 cases,79%).Positive McMurry test was the most common physical examination finding(19 cases, 79%). All the lateral discoid meniscal tears were confirmed by arthroscopy. The mean interval between symptom onset and operation was 18.7 months(range 1 month to 10 year). The types of tear were peripheral (14cases, 58%), complex tear(4cases), longitudinal tear(2cases), transverse tear(2cases), horizontal tear(2cases)and the most common location of tear was posterior horn(1 1cases, 45%). The mean number of suture was four. In operative method, Scases(33%) were performed only meniscorrhaphy and meniscorrhaphy combined with partial meniscectomy was done in 16 cases(67%). According to Ikeuchi's grading system, the result was satisfactory in 21cases, fair in three cases. Second look arthroscopy was done in eleven cases(46%) between post operative 4 months to 2 years(mean, 8.3 months). The arthroscopic examination revealed complete healing of repaired meniscus in eight cases(73%). The remained three cases which were not completely healed was fair result.
Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Methods ; Physical Examination ; Sutures ; Tears

It is generally accepted that fractures should be treated by closed methods, however for certain femoral fractures in adults, closed methods yields an unacceptable high incidence of nounlon, malunion, delayed unlon, and disability. For these fractures various methods of open reduction and internal fixation have been recommended, but unfortunately, there are frequent reports of complications and failures. The recently developed association for study of Internal fixation (ASIF) compression plating apparatus, seems to satisfy the basic objectives of internal flxatlons: namely
Adult ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Walking

Author take off the pelvic bone from the cadaver and made the accruate reconstructed the pelvic bone as well as normal bone. Then author setted the pelvic bone into the specialized acrylic globe as the normal person erect position. For the acetabular posterior wall, projected the radiologic beam from the 0°to 45°cephalad direction and then pelvic bone rotated internally 0°~45°, each section is 5°. For acetabular anterior wall, projected the radiologic beam from 0° to 45° caudal direction and pelvic bone rotated externally 0°~45°, each section is 5° too. From the pelvic bone experiments, author get on the good radiologic angle for acetabular anterior and posterior wall. Ane then make the radiologic projection for normal person as the pelvic experiment. In pelvic bone model experiment, For acetabular anterior wall and anterior colum, external rotation 20°~30° caudal tilting 30°~45° angle projection has good visualization. For acetabular posterior wall and posterior column (including anterior column partially), internal rotation 15°~20° cephalad tilting 15°~30°angle projection has the good visualization. In normal person experiment, For acetabular anterior wall and anterior column, external rotation 20°caudal tilting 30°angle projection shows the good visualization. For acetabular posterior wall and column (including anterior column partially) internal rotation 20°cephalad tilting 30°angle projection shows good visualization. From the pelvic bone model and normal person experiments, the following conclusion are obtained. 1. For posterior wall and posterior column(including anterior column partially), internal rotation 20°, cephalad tilting 30°view is good. 2. For anterior wall and anterior column, external rotation 20°, caudal tilting 30°view is good.
Acetabulum ; Cadaver ; Humans ; Pelvic Bones