No abstract available.
Tibia*

Segmental fracture of the femoral shaft is known as an unusual injury, usually caused by severe force and associated with marked damage to the soft tissue, and is difficult to treat due to these causes it is a controversal topic in regard to the treatment. Authors analysed 14 cases of segmental fracture of the femoral shaft, except cases associated with hip fracture, which had received operative treatment at Dept. of Orthopaedic Surgery, College of Medicine, Chosun University, from Jan. 1985 to Dec. 1990. The results are summarized as follows; 1. Of 14 cases, there were 12 cases of male and 2 cases of female: male was predominant. Most cases were at their 3rd and 6th decades of age. 2. Traffic accidents were the main causes of injury(11 out of 14 cases.) 3. There were 13 closed fracture and 1 open fracture. 4. In most cases, they accompanied injuries to other vital organ. Among 14 cases, 5 cases accompanied head injury. 5. We treated these fracture by flexible intramedullary nailing in 7 cases, open reduction and internal fixation with plate in 5 cases, locked intramedullary nailing in 2 cases. Bony union was more rapid in the distal fracture than in the proximal fracture. 6. Among 14 cases, primary bone grafting was done in 2 cases. In the group where primary bone grafting had not been done, dealyed union appeared but nonunion was not seen. 7. We could obtain rapid bony union and decreased operation time in the cases which were treated with intramedullary fixation, and thought that intramedullary fixation was a relatively good method in type of this fracture.
Accidents, Traffic ; Bone Transplantation ; Craniocerebral Trauma ; Female ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hip ; Humans ; Male ; Methods

Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears

No abstract available.
Posterior Cruciate Ligament*

The most commonly used graft source for anterior cruciate ligament reconstruction is the autogenous bone- patellar tendon-bone graft unit. Despite a good success record, intraoperative technical errors and postoperative complications have been known. Author analyzed intraoperative technical errors and postoperative complications, in 44 patients who were treated at the department of orthopaedic surgery, chosun university hospital from Jan. 1994 to Jun. 1996. The most common intraoperative technical errors was screw graft divergency in 5 cases. Other intraoperative technical errors were too anteriorly location of femoral tunnel in 1 case, too anteriorly location of tibial k femora) tunne.l both in 1 case, graft tunnel mismatching in 1 case, graft pullout in 1 case and partial destruction of posterior cortex of femoral tunnel in 1 case, fracture of the bone plug in 1 case. The most common postoperative complication was patellar tendinitis in 20 cases (45.5%). Other postoperative complications were anterior knee pain in 14 case. (31.8%), patellar crepitation in 12 cases (27.3%), quadriceps atrophy in 9 cases (20.5%), arthrofibrosis in 3 cases and graft failure in 2 cases. Author concluded the causes of intraoperative complications were technical errors, and anteriorly location of graft tunnel is most influenced factor to final fuctional results. To eliminate the postoperative complications, intraoperative technical errors should be avoided and also accelerated rehabilitation should be done.
Anterior Cruciate Ligament Reconstruction ; Atrophy ; Humans ; Intraoperative Complications ; Knee ; Patellar Ligament* ; Postoperative Complications* ; Rehabilitation ; Tendinopathy ; Transplants

Arthroscopic anterior cruciate ligament reconstruction with bone-patella tendon-bone has been commonly using for ACL insufficient patients. Bone-patellar tendon-bone graft is a strong intra-articular substitute, which allows, by means of its bony end, a rigid fixation with early bone to hone healing. As a counterpart, potentially serious cornplications & donor site morbidity has been reported, such as patella fracture & patella tendon avulsion, anterior knee pain, patella tendinitis, dcmor site pain and bone defect. We suppose tightly packing the donor site bony defect with hetrograft (Lubboc) may be also useful. So, we analyzed the morphological change in bony defect and donor site morbidity between the group of non-replaced bony defect and the group of replaced bony defect using by heterograft (Lubboc). We replaceJ hetrograft into the patellar side bony defect in 15 knees and left alone in l5 knees. The average follow up period was 17 months. The results werc as follows: 1. Nearly norma1 appearance on the bony defect showed at the long tenn follow up roentgenogram in the group of replaced hetrograft, but scalloping on the pateltar bomp defect was seen in non-replaced group. 2. Donor site morbidity (pain or patellai tendinitis) was developed 8 knees in the replaced group, and 7 knees in the non-rep)aced group. 3. We conclude that the filled in the bony defect hy hone graft (heterografl:) can not decrease the donor site morbidi ty.
Anterior Cruciate Ligament Reconstruction ; Bone-Patellar Tendon-Bone Grafts ; Follow-Up Studies ; Heterografts* ; Humans ; Knee ; Patella ; Patellar Ligament* ; Pectinidae ; Tendinopathy ; Tissue Donors* ; Transplants

The cases of 82 humeral shaft fractures were evaluated at the Department of Orthopedic Surgery, Chosun University Hospital, during the ten years period from January 1978 to December 1987 and the following results were obtained. 1. The most common type was transverse fracture (59.8%) and the most common site was middle one third (61.0%). 2. The average time of bone union were about 9.6 weeks in non-operative cases and 9 weeks in operative cases. 3. The radial nerve palsy was more common in transverse fracture of humerus at the middle one third level. 4. Among the 28 radial nerve palsy associated with humerus fracture, 19 cases were treated by conservatively, and 9 cases were treated by surigical exploration. 73.7% of conservatively treated cases and 77.0% of operatively treated cases regained most of the functional lost of the radial nerve.
Clinical Study ; Humerus ; Orthopedics ; Paralysis ; Radial Nerve

Synovial sarcoma is a distinct and generally recognized soft tissue tumor that it’s origin still raises controversy. The synovial origin of synovial sarcoma has not been determined despite the accepted terminology implying synovium as stem cell. Three cases of primary synovial sarcoma (2 fibrous monophasic, 1 biphasic type) were studied with a panel of antibodies against different types of cytokeratin and other markers (EMA, CEA, vimentin, S-100 protein, lysozyme, 1-antichymotrypsin). Spindle shaped-cell in monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin. Epithelial cells lining of glands in biphasic synovial sarcoma reactive for CK7, pancytokeratin, EMA, and focally CEA but spindle cells only positive for vimentin. By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal destiny and discontinuous basal lamina. These results indicate that synovial sarcoma showes epithelial differentiation. We believe that synovial sarcoma arises in pluripotential connective tissue cells that is able to be differentiated into both mesenchymal and epithelial components. So, synovial sarcoma have been considered carcinosarcoma of soft tissues depending on the type of differentiation.
Antibodies ; Basement Membrane ; Carcinosarcoma ; Connective Tissue Cells ; Epithelial Cells ; Immunohistochemistry ; Intercellular Junctions ; Keratins ; Microscopy, Electron ; Muramidase ; S100 Proteins ; Sarcoma, Synovial ; Stem Cells ; Synovial Membrane ; Vimentin

No abstract available.
Adult* ; Humans

Thirty-three cases of the fracture of the femur and tibia on the same limb were treated at the Orthopedic Department of the Chosun University Hospital during the period from January 1977 to December 1983. The following results were obtained. 1. The incidence of trauma was high in the young man, most frequent in the third decade (45.4%). 2. The most common cause of the fracture was traffic accident (81;8%). 3. The most common shape of the fracture was comminuted in both femur and tibia. 4. The common fracture site were middle one-third in both femur and tibia. 5. Eight patients were treated by conservative means on both femxr and tibia. The patients were treated by internal fixation on femur and by conservative means on tibia. Internal fixation was .done in ten patients on both femur and tibia. Two patients were treated by inteinal fixation on tibia and by conservative means on femur. Three patients were amputated. 6. Average healing time of fracture was 21 weeks in femur and 24.2 weeks in tibia. 7. Functional end results were assessed and rated with satisfactory results in rigid internal fixation of the femur and tibia.
Accidents, Traffic ; Clinical Study ; Extremities ; Femur ; Humans ; Incidence ; Inteins ; Orthopedics ; Tibia