The fractures which develop from a already structually damaged or weakened bones are called pathologic fracture and it can be caused by many different diseases. The way of treatment and prognosis of these pathologic fractures differ in many ways according to causative factors. So, regarding frature that developes without definite history of trauma, one shoud approach them with concepts of pathologic fracture. In the cases of pathologic fracture caused by metastatic bone tumors, physicians are employing more aggressive methods of treatment these days. Authors have analysed 87 cases of pathologic fracture who were admitted to department of orthopedic surgery, Severance Hospital during the period of 10 years(from Jan. 1976 to Dec. 1985). Those cases of osteoporosis were all excluded from the study. The conclusion were as follows : 1. There were no discrepancies regarding sexes but 69% of patients were over forty years of age. 2. Fifty percent of pathologic fracture were fractures of femur. 3. Most common causes were metastatic bone tumors(55%), and 36% of these were with unknown primary lesions. 4. In the cases that were caused by metastatic bone tumor, sugical treatment was performed on 46% of these cases. And most cases of patients who were treated with surgical methods improved in pain and ambulation state, especially in patients with use of bone cement.
Femur ; Fractures, Spontaneous ; Humans ; Orthopedics ; Osteoporosis ; Prognosis ; Walking

In transtrochanteric rotational osteotomy to treat osteonecrosis of the femoral head, the necrotic superior anterior femoral head is rotated anteriorly around the longitudinal neck axis so that the weight bearing force is transferred to the intact posterior surface. The ratio of transposed intact articular surface of the femoral head to the weight-bearing surface of the acetabulum on postoperative anteroposterior view of the hip roentgenograph is the most important indicator of the prognosis. During the period from December 1992 to June 1994, we treated 31 hips in 28 patients who were indicated for the anterior rotational osteotomy among the patients of osteoncrosis of the femoral head. Among the patients, male were 27 and female was one. Age distribution was from 13 to 62 years old and mean age was 44.3. According to the Ficat and Arlet classification, II A was most in number as 16 II B was 7 and III was 8. As their etiolgic factors, alcohol was most in number as 18, steroid was 3, idiopathic was 5 and trauma was 2. The mean rate of the intact area of the posterior part of the femoral head to the total articular surface on the preoperative lateral view of the hip roentgenograph was 41.8%. The mean ratio of transposed intact articular surface of the femoral head to the weight bearing surface of the acetabulum was 53.8% Fixation devices were screws or dynamic hip screw.
Acetabulum ; Age Distribution ; Classification ; Female ; Head* ; Hip ; Humans ; Male ; Neck ; Osteonecrosis* ; Osteotomy* ; Prognosis ; Weight-Bearing

A doctor's certificate is a statement from a doctor that attests to the results of a medical examination of a patient. It is based on the professional judgment of a doctor who has examined the state of a patient's healthBiased doctor's certificates, which can vary widely in their nature, would lead to the loss of the public's trust in the medical profession. Although the Korean Medical Association has set guidelines for issuing doctor's certificates, separate guidelines are necessary that address various issues, including, among others, the definition of doctor's certificates, the ethical duties of doctors, the purpose and issuance of doctor's certificates, the doctor-patient relationship, and the responsibilities of doctors and patients. Furthermore, hospitals should be required to conduct a review of the doctor's certificates that have critical importance, such as those that impact court hearings or suspension of sentences, by a committee of doctors, to ensure the accuracy and professional integrity of such doctor's certificates.
Humans ; Judgment ; Social Problems*

As the arthroscopic surgery of the knee joint has taken rapid strides recently, the knowledge of the structure and deveIopment of the joint are getting needed more and more. An embryological study about the development of the human knee joint was carried out using a total of 23 knees of human embryos. Serial sections of 23 embryos aged 5-8 postovulatory weeks (12-31 mm C.R.) and 3-dimensional reconstruction were examined. The embryos have been staged according to Carnegie's 'developmental stages'. The femur, tibia and fibula had begun to undergo chondrification by stage 18. The patella had commenced chondrification at stages 23. As the mesenchymal model began to chondrify, concomitant changes occurred in the region of the presumptive knee joint to create the interzone (stage 19-20). The following structures became condensed successively: patellar tendon (18-19), lateral collateral ligament and popliteus tendon (19-20), cruciate ligaments (20-22), meniscus (21-22). In summary, the differentiation from a generalized cellular blastema to a joint resembling the adult in form and arrangement occurred in only a relatively few days. By the end of the embryonic period proper (stage 23, 8 postovulatory weeks), all the elements of the knee joint were present in a form and arrangement closely resembling those of the adult. It seems that the embryological studies are more required to clarify the structures having many variants such as synovial plica, meniscus, and the development of the joint cavity through this study.
Adult ; Arthroscopy ; Embryonic Structures ; Femur ; Fibula ; Humans* ; Joints ; Knee Joint* ; Knee* ; Lateral Ligament, Ankle ; Ligaments ; Patella ; Patellar Ligament ; Tendons ; Tibia

Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their enumerous complications. 21 patients with fracture of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to September 1988. The result was sumarized as follows :1. The average age was 37.3 and the number of male was three times of the female. The most common cause was traffic accident. 2. 14 cases out of 22 were closed fracture and the remsining 5 were open. The comminuted and segmental fractures were 17(77.3%) and the most common fracture site was middle one third. 3. Aversge interval from injury to operation was 6.5 days and in 15 cases show the associated injurues. 4. The mean duration of the bone union was 17.6 weeks and in 2 cases show the delayd union. 5. 10 complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
Accidents, Traffic ; Ankle ; Congenital Abnormalities ; Female ; Fractures, Bone ; Fractures, Closed ; Humans ; Male ; Orthopedics ; Soft Tissue Infections ; Tibia

During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result,, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safty, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an exellent reduction.
Anesthesia, General ; Child* ; Elbow Joint ; Follow-Up Studies ; Hospitalization ; Humans ; Humerus* ; Length of Stay

The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative -patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better
Child ; Continental Population Groups ; Diagnosis ; Dislocations* ; Early Diagnosis ; Head ; Hip* ; Humans ; Necrosis ; Walking*

The posterior cruciate ligament is the primary static restraint to posterior translation of the tibia and provides proprioception within the knee. The goals of treatment in the injuries of PCL are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to cornpare functional outcome, muscle power, and posterior stability between conservative treatment and reconstruction with autogenous RPTB augmented with Kennedy LAD in PCL injuries. Twenty-seven patients with PCL rupture who have been treated from November 1990 to May 1996 were reviewed. The patiens were divided into conservative group and reconstruction group. Conservative treatment was done in 15 patients and reconstruction by autogenous bone patellar tendon bone with Kennedy LAD was performed in 12 patients. All patients were evaluated with posterior stress x-ray films, KT-2000 knee ligament arthrometer, Cybex 340 isokinetic dynamometer, subjective Cincinnati symptom rating scale and Lysholm knee score, complication. The results were as follows; 1. Mild and moderate posterior instability was remained in spite of BPTB graft and need more stable fixation technique and vigorous rehabilitation program. 2. At the angular velocity of 90 degree/sec and 180 degree/sec, the muscle strenth of quadriceps was decreased after PCL injury in both group in the test of Cybex 340 isokinetic exercises. The power of hamstrings were not changed after PCL injuries. 3. Average Lysholm knee score was 89 points in reconstruction group and 78 points in conservative group and average Cincinnati symptom-rating scale was 8.4 points in reconstruction group and 7.1 points in conservative group. More satisfied functional results and subjective symptoms were revealed in the reconstruction group and statiscal significancy (p<0.05) was showed when comparing conservative group with reconstruction poup. 4. Good clinical results did not always coincidence with lesser posterior instability and clinical results were influenced by associated injury of the knee. The more combined ligament injury of the knee, the worse clinical results.
Exercise ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Patellar Ligament ; Posterior Cruciate Ligament ; Proprioception ; Rehabilitation ; Rupture ; Tibia ; Transplants ; X-Ray Film

No abstract available.
Melanoma* ; Spine*

This study observed the changes of the glycogen content in extensor digitorum and soleus by electrical stimulation on the sciatic nerve with various frequencies, and the result were compared with those of treadmill running exercise. The results are summarized as follows ; The glycogen content of extensor digitorum longus was greater than that of the soleus in the normal group, and the reducing amount of glycogen content of extensor digitorum longus was greater than that of the soleus by overnight fasting. As the frepuency of electrical stimulation was increased by 2, 5 and 10Hz., the glycogen content of the extensor digitorum longus was slightly reduced or changed minimally. As the loading period of clectrical stimulation was increased to 30 and 90minutes, the glycogen content of extensor digitorum longus was much reduced from early stage, and that of the soleus was the same tendency as the frepuency increased. The glycogen content of the extensor digitorum longus was proportionally reduced by treadmill running excercise, and that of the soleus was much reduced from the early stage. In summary, based on the experimental evidence of this investigation, it showed the different physio-chemical responses of th fast and slow twitch muscle fibers by electrical stimulation, and also not the equal responses of muscle fibers by electrical stimulation and treadmill running exercise.
Animals ; Electric Stimulation ; Fasting ; Glycogen ; Muscles ; Rats ; Running ; Sciatic Nerve