No abstract available.
Cold Injury*

In the operative treatment of an indirect rupture of tendo calcaneus, we should consider difficult repair and postoperative adhesion with surrounding tissues. In this paper, the new surgical technique for indirectly ruptured tendo calcaneus was introduced and evaluated. From July 1994 to Sep. 1995, we experienced 10 cases of closed rupture of Achilles tendon which was treated with reversed tendon sheath wrapping of juncture site after direct repair. This technique consists of conventional core suture with strong suture material followed by fine tide up sutures around the ragged outer margin of the ruptured end. Then, we made a delicate incision on the synovial sheath of the tendon two inch proximal to the tendon juncture site and elevated it carefully and rolled it back reverse direction to wrap around the juncture site, then hooked it up with the synovial sheath of distal part of ruptured tendon. It was very helpful to prevent adhesion by lowering the endotendon cellular ingrowth between tendon proper and tendon sheath by wrapping the ragged end of rupture site. Their least follow-up period was 12 months. The clinical outcome of the patients was assessed according to the criteria of Hooker, and there were eight cases of excellent (80%), and two cases of satisfactory results. We report good results with the reversed tendon sheath wrapping around juncture site after direct repair of Achilles tendon, as a new technique the treatment of indirectly ruptured tendo calcaneus.
Achilles Tendon ; Calcaneus* ; Follow-Up Studies ; Humans ; Rupture* ; Sutures ; Tendons*

To identify whether acromial shape, osteophyte, and acromio-humeral interval have effects on impingement syndrome or rotator cuff tear, we reviewed 40 cases of normal group (F:M=22:18), and 30 cases of impingement syndrome(F:M=16:14). Forty cases of normal group aged from 40 to 69 who had no pain, no abrasion sign, no limitation of motion, and normal function of shoulder joint were selected. Thirty cases of impingement syndrome were managed by acromioplasty of direct repair from October, 1993 to May, 1994. Twenty-five cases of 30 were identified rotator cuff tear(RCT), and the others were turned out subacromial abrasion. We reviewed the acromial thickness, the acromial shape, the anterior protuberance, the presence of osteophyte, and the acromio-humeral interval to compare the difference between two groups. Forty-seven point five per cent of normal group had a flat, type I acromion, 47.5% had a curved, type II acromion and 5% were identified by a hooked, type III acromion. However, in subjects with impingement syndrome and RCT, 37% had type I, 20% had type II, and 43% displayed type III. Type III was considerably noticed in the massive tear. In regarding to acromial thickness, normal group had type A(less than 8mm)-37.5%, type B(8-12mm)-62.5%, and the impingement syndrome or RCT group had type A-53%, type B-47%. We couldn’t find any significant difference with each group in type III(more than 8mm)-15% in normal, and type I-17%, type II-33%, type III-50% in the impingement syndrome or RCT. It was suggested that the anterior protuberance was related with the evidence of RCT. A-H interval was 10.25mm±1.46mm in normal, and 9.44mm±1.70mm in the impingement syndrome or RCT. There was on significance in A-H interval except rotator cuff arthropathy. Thirty three percent of normal group had osteophytes and 40% of impingement syndrome or RCT had osteophytes on the undersurface of acromion.
Acromion ; Osteophyte ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears

A retrospective analysis was conducted on ski injury collected in past 12 years, from 1982 to 1995, exception of 1986 and 1987 at the Young Pyeong Ski Resort in Korea. A total of 3,093,667 skiers during the 12 years period are cohort of this investigation. Of 3,093,667 skiers, 7,172 injuries were indexed by anatomic region and severity according to diagnosis on initial evaluation. The frequency of injury changes from 3.4 to 1.5 per 1,000 skier-days during the 12 years. The rate of upper extremity to lower extremity injury increased from 1:1.33 to 1:0.89 during the study period(P<0.005). The most common upper extremity injury pattern was simple injury including laceration and contusion(74.2%). The ulnar collateral ligament injury of thumb make up of 6.5% of all injuries. In conclusion, upper extremity skiing injury was related to 1) Skiers activity level, 2) Skiers skill, 3) Degree of fatigue, 4) Slope condition, 5) Improvement of ski equipment, and 6) Increased skiing population density.
Cohort Studies ; Collateral Ligaments ; Diagnosis ; Fatigue ; Health Resorts ; Korea* ; Lacerations ; Lower Extremity ; Population Density ; Retrospective Studies ; Skiing ; Snow* ; Thumb ; Upper Extremity*

Fracture-Dislocation of the the body of the hamate is rare in carpal bone fractures. Recently, we experienced two patients with coronal fracture of the dorsal aspect of the hamate with dorsal subluxation of metacarpal bases of the ring and little fingers. The mechanism of injury was by indirect blow with c1enched fist in two patients. Two patients were treated with closed reduction and plaster immobilization for 6 weeks and physical theraphy. At 13 and 14 weeks follow-up respectively, two patients had no funtional limitation, no complaints referable to hand, and nearly solid union on radiographs. We report two cases of fracture of the the body of the hamate bone, associated with dorsal subluxation of hamatometacarpal joint treated by conservative methods and review of literatures.
Carpal Bones ; Dislocations* ; Fingers ; Follow-Up Studies ; Hamate Bone ; Hand ; Humans ; Immobilization ; Joints

The aim in arthrodesis of ankle is to gain a painless, normal walking gait of destroyed ankle joint caused by various origins. Despite more than 30 different fusion techniques have been described in the literature, but the results were not always satisfactory. Blair introduced tibial sliding graft, rectangular hone block donated at distal tibia, to the neck of talus. His method has advantages of a normal apperance of the foot, no shortening, and the weight bearing thrust on normal tissue. The purpose of this study was to compare the ankle arthrodesis according to surgical procedures & introduce the method which could produce excellent results for ankle arthrodesis. We reviewed 23 patients(24 cases) undergone ankle arthrodesis from Jan. 1989 to Dec. 1996 in Kyung Hee Medical Center. Male were twelve(13 cases) and female were eleven. Mean age was 42.6(l8-75)years. The Blair fusion method was used in ten cases. Iliac bone graft followed by internal fixation using Steinmann pin in 4 cases, using cancellous screw in I case, and using both Steinmann pin and staple in 1 case, while tibiotalar coaptation without bone graft followed by internal fixation using Steinmann pin in 3 cases, using staple in 1 case, and using cancellous screw in 1 case. In 3 cases, arthroscopic abrasion and cancellous screw was used. The mean duration of follow-up was 46(6-99) inonths. Time to union was average l4.6(8-23) weeks in Blair fusion and 17.5(8-40) weeks in other methods. Delayed union was observed in three cases, but no case was found in Blair fusion. Pain was ohserved in 5 cases, 3 in Blair fusion and 2 in other methods. Nonunion or pseudoarthrosis was not ohserved. On the clinical criteria for Boston Childrens Hospital ankle-scoring system, we ohserved nineteen excellent and five good cases. The difference in results according to fusion method was not ohserved. The results in tibiopedal motion using cineroentgenography were seven good and three fair cases in Blair, while two good, ten fair and two poor in other methods. By using Blair fusion, we expect early bony union and better clinical results.
Ankle Joint ; Ankle* ; Arthrodesis* ; Child ; Female ; Follow-Up Studies ; Foot ; Gait ; Humans ; Male ; Neck ; Pseudarthrosis ; Talus ; Tibia ; Transplants ; Walking ; Weight-Bearing

No abstract available in English.

Kuntscher introduced the interlocking nail as the name of Detensionsnagel at 1968. Klemm, Kaessman, Hempel used it clinically through transverse hole. Authors tried to make the sagittal hole at the dorsum of the Kiintscher nail, which was interlocked- from the slot to the hole by bone screw. The direction of the sagittal hole crossed right angle to the transverse hole. Analysis of 35 cases conducted following conclusion. 1. Transfixing the screw at the sagittal hole of the nail can be done easily when transfixing through the transverse hole is difficult. 2. There was no difference in stability between transverse hole and sagittal hole transfixation. Lateral movement of the nail was disappeared after transfixation of the screw at the sagittal hole. Interlocking system is very similar to Harrington distraction rod system. 3. One case of nail breakage had occured at the transverse hole. Nail breakage easily occurs if the hole is situated near the fracture site. For prevent nail breakage larger nail insertion is desirable. (More than 14mm in femur and more than 12mm in tibia.) 5. Indication of the I-M nailing is widened by screw interlocking: from the subtrochanteric fracture to the supracondylar fracture of the femur. It is also useful in arthrodesis of the knee joint. 6. Addition of the Interlocking in ordinary I-M nailing patient could walk 3 to 10 days after operation and radiologic union achieved 12 to 20 week after opeation.
Arthrodesis ; Bone Screws ; Femur ; Humans ; Knee Joint

We performed the partial or total meniscestomy in 143 cases with the meniscal injury by the arthroscopy or arthrotomy during the period from May, 1978. to November, 1987. There were 89 cases treated with arthroscopic partial, 11 csses treated with arthroscopic total, 16 cases with open partisl and 27 cases with open total meniscectomy. We did not include the cases of the discoid meniscus in the study. The statistic analyses were as follow ;1. The ratio of male to female was 106 to 37, and right to left was 79 to 64. 2. There were 82 cases in medial meniscus, and 61 cases in lateral meniscus. 3. The most common chief complaint and physical finding was pain, tenderness & McMurray(+). 4. The average period of hospitalization were 5 days in arthroscopic and 20 days in open meniscectomy. 5. The most cornmon associsted injury was the ACL injury in 36 cases. 6. The most common site and type of tear was the longitudinal tear at posterior horn. 7. In the preoperative arthrogram, the diagnostic accuracy was 78.3%. 8. The satisfactory results were 79.2% in arthroscopic and 64.7% in open meniscectomy.
Animals ; Arthroscopy ; Female ; Horns ; Hospitalization ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears

A tumor of the neuromyoarterial apparatus, the glomus, was described by Masson : the epitheloid cell of glomus was derived from the pericyte of Ziemmermann and these cells were widely distributed in the body. From Jan. 1987 to Oct. 1993, six patients (male 1, female 5), who were diagnosed as a glomus tumor in the hand were operated. The lesions were distributed in the distal phalanges of thumb (3 cases), index (1 case), ring finger (1 case) and little finger (1 case). The average duration of clinical manifestation was 6.3 year. Nail extraction was performed because of pain in 2 cases, but symptom was not improved. The clinial symptoms were severe lancinating pain, tenderness and cold induced pain in all 6 cases, palpable mass in 2 cases, bluish purple discoloration of skin in 4 cases, subcutaneous hemorrhage in 1 case, swelling in 2 case. On the reontgenography, bone changes were detected in 2 cases, soft tissue change was detected in 1 case and 3 cases showed unremarkable findings. The treatments were simple excision in 5 cases,curettage and bone graft in 1 case and symptoms were improved in the 6 case with the remnant mild pain and there was no recurrence. The aim of this study was to report the rare cases of glomus tumor in the hand.
Female ; Fingers ; Glomus Tumor ; Hand ; Hemorrhage ; Humans ; Pericytes ; Recurrence ; Skin ; Thumb ; Transplants