A total of 16 metatarsal bones were treated for ten with brachymetatarsia using two different methods: single staged lengthening by bone graft(2 cases) and gradual distraction lengthening using unilateral external fixator(14 cases). Three cases of first metatasal bone and thirteen cases of fourth metatarsal bone were operated. All of the cases of the brachymetatarsia were congenital. The average amount of lengthening was 16.1 mm in gradual distraction lengthening while 10.5mm in single staged lengthening. Average percentile increase was 38.8% in gradual distraction lengthening and 23% in single staged lengthening. The average healing index of gradual distraction lengthening was 1.7(months/cm). Although single staged lengthening has advantage of cosmetics, gradual distraction lengthening using unilateral external fixator was thought to be effective functionally for metatarsal lengthening.
External Fixators ; Metatarsal Bones

Neither the cause nor the correct treatment of Kienbocks disease has been clearly established, but its clinical and radiologic presentations have been distinctly defined. There are many controversies concerning therapeutic guidelines for the treatment of Kienbocks disease. The purpose of this study is to evaluate the clinical result of triscaphe fusion with radial styloidectomy of Kienbocks disease. Ten cases of stage III Kienbocks disease by Lichtmans classification were treated by triscaphe fusion with radial styloidectomy from September 1991 to March 1997. We followed up over 24 months and evaluated clinical results. In all cases, pain was relieved. The postoperative results according to Kuschners method revealed three excellent, six good and one fair. The triscaphe fusion and radial styloidectomy was considered as useful method of treatment which has clinical efficacy in Kienbocks disease.
Classification ; Osteonecrosis*

PURPOSE: To evaluate the accuracy and reliability of method for prediction of rotationally neutral state of the femur by comparing with contra-lateral lesser trochanter. MATERIALS AND METHODS: The rotationally neutral state of the femur was measured by comparing the shape of the opposite side of the lesser trochanter in a normal group of 100 adult. Each examination was performed independently by three observers. The observers predicted a position presumed to be neutral by comparing the shape of lesser trochanter with that of contra-lateral side previously recorded by the C-arm image intensifier. We evaluated the mean angular discrepancy that is different from the neutral point and assessed the inter-observer variations. RESULTS: The mean angular discrepancy (SD) was 3.4 degree(+/-2.4); 3.5 degree(+/-2.4) by observer-1,3.5 degree (+/-2.8) by observer-2, 3.2 degree(+/-2.2) by observer-3. There was no inter-observer variation (p=0.87). 77% of all observers indicated below 4 degree and no one over 15 degree. CONCLUSIONS: The method of comparing the shape of both lesser trochanters is considered to be effective in determining the rotational status of the femur. It could be used as a practical method in the operation of the femoral fracture for prevention of rotational deformity intra-operatively
Adult ; Congenital Abnormalities ; Femoral Fractures ; Femur* ; Humans ; Observer Variation

No Abstract Available.
Arthroplasty* ; Knee Joint* ; Knee*

This study was conducted to compare the validity of obese index among body mass index(BMI), waist to hip ratio(WHR), and waist circumference(WC) and to determine which is the best in relation to cardiovascular risk factors of middle aged Korean(40-64yr).Data from the 1998 Korean Health and Nutrition Survey were used(N=3380). Anthropometric indices and cardiovascular risk factors were measured. Chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator characteristic(ROC) curves were used in the analysis. There was a significant increasing trend in WHR, systolic blood pressure(SBP), high density lipoprotein cholesterol(HDL), and fasting blood sugar(FBS) with age categories of male and in BMI, WC, WHR, diastolic blood pressure(DBP), SBP, total cholesterol(TC), low density lipoprotein cholesterol(LDL), triglycerol(TG), and FBS with those of female. Specially female had the characteristics of upper body fat and systolic blood pressure risk(p<0.05). Proportions of subjects with lifestyle factors related to cardiovascular risk in overweight or upper body fat group were higher than that of normal group. Higher proportions of subjects were practiced exercise in upper body fat group of male than in other groups. Among 7 cardiovascular risk factors in partial correlation analysis, BMI had the highest correlation coefficient in 6 risk factors in male, whereas WC in 4 risk factors in female. Mean of each obese index according to cardiovascular risk groups except smoker was higher than that of normal(p<0.05). These trends were shown in upper body fat group and female. In ROC analysis of 12 risk factors and health conditions, the largest area under curve among obese indices for risk factors were BMI in male and WHR in female. The optimal cutoff values of each index(BMI: WHR: WC) for one or more cardiovascular risk factors were 23.13: 0.89: 85.35 in male and 23.57: 0.84: 78.35 in female. The results showed that cardiovascular risk factors were prevalent in middle aged Koreans within normal limits of obese indices like another Asians. For the identification of cardiovascular risk factors of middle aged Koreans, BMI for men and WHR for women are appropriate indices. But it is recommended that BMI, WHR, and WC, all three indices should be considered, when using these indices.
Adipose Tissue ; Area Under Curve ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index* ; Fasting ; Female ; Hip ; Humans ; Life Style ; Lipoproteins ; Male ; Middle Aged* ; Nutrition Surveys ; Overweight ; Risk Factors* ; ROC Curve ; Waist Circumference* ; Waist-Hip Ratio*

The objective of this study was to investigate the differences in food intake patterns by the economic status. Data from the 1998 Korean National Health and Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, the subjects (n = 10400) were classified into high class (36.1%), middle class (40.7%) and low class (23.1%). Mean intakes for other food groups except grains, potatoes and vegetables became higher as the economic levels were going up. By the family size, it was found that intakes of grains and fishes were different (p < 0.05). By the economic status, intakes of fruits (p < 0.05), meats (p < 0.05) and fishes (p < 0.01) were different. There were no significant differences in consumed types of food by the economic status. Rice was the most prevalent food in all classes and its intakes increased as the economic status was going down. In the dietary patterns of main food group (GMDVF: Grain, Meats, Dairy, Vegetable and Fruit), the pattern except dairy (11011) revealed the highest proportion in high-middle class while the patterns without dairy and fruit food groups (11010) had the highest proportion in low class. The proportions of subjects with the low dietary diversity score (DDS) increased as economic status was going down (p < 0.01). The food groups that most people do not consume were the dairy and fruit group. Proportions of people who missed one or more groups increased as economic status was going down. The high dietary variety score (DVS) also was linked to a high score on the DDS and high class (p < 0.01). Thus the intakes of the dairy and fruits product should be increased in all classes. The low class especially had worse quality of food intakes pattern than that of the high or middle class. The nutrition policy and education programs need to be established according to the economic status.
Edible Grain ; Eating* ; Education ; Family Characteristics ; Fishes ; Fruit ; Meat ; Nutrition Policy ; Nutrition Surveys* ; Poverty ; Solanum tuberosum ; Vegetables

The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n = 1017). Anthropometric indices and cardiovascular risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p < 0.05). Among life style factors the current smokers were prevalent in obese male (p < 0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p < 0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p < 0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p < 0.05). Among 7 cardiovascular risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC > WHR > BMI in male and BMI > WHR > WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also cardiovascular risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of cardiovascular risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.
Adipose Tissue ; Aged* ; Area Under Curve ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index* ; Cardiovascular Diseases* ; Female ; Humans ; Life Style ; Male ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Risk Factors* ; ROC Curve ; Waist Circumference* ; Waist-Hip Ratio*

The purpose of this study was to investigate differences in the diet with the amount and the qualitative assessment of nutrient intakes by the economic level. Data from the 1998 Korean Health and Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, Subjects (n = 10400) were classified into high class (36.1%), middle class (40.7%) and low class (23.1%). Chi-square-test and Analysis of Variance following Duncan's multiple range test were used to test the difference in nutrient intake pattern among three groups (alpha = 0.05). The amount of nutrient intake and nutrient intake adequacy were statistically different by the economic level (p<0.01). The ratio of energy intake from carbohydrate is higher than the criteria of WHO recommendation in all economic levels. Especially people in the low class depended much on the carbohydrate for the energy intake. The ratio of energy from the protein and fat are lower in the middle and low class than that of the high class. The Intake level of calcium and vitamin B2 were lower than those of the Recommended Dietary intake level, regardless of economic status. It also showed differences in major food sources of nutrients by the economic level Consequently, it seems that the nutrition policy and program should be prepared according to their economic status. Also, there should more detailed studies to find out the nutrient intake pattern, their determinant, and health consequences.
Calcium ; Diet ; Energy Intake ; Nutrition Policy ; Nutrition Surveys* ; Poverty ; Riboflavin

The objective of this study was to investigate difference in the diet by the kind of meal and the economic status. Nutrient contents at each meals were compared and differences in food intake at different meal were analyzed by economic status. Data from the 1998 Korean National Health Examination Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, the subjects (n = 10400) were classified into high class (36.1%), middle class (40.7%) and low class (23.1%). Most nutrient intakes were obtained for main meals regardless of economic status. For high class, breakfast, lunch, dinner and snacks bring about 21, 29, 30 and 19 % of total energy intake, for middle class 22, 29, 30 and 19% and for low class 24, 30, 30 and 16%, respectively. The high-middle class people tend to get more food intakes and nutrients at dinner and snacks, while the low class at main meals. This result was associated with the consumption of a smaller number of meals and a greater number of snacks daily as the economic level was going up (p < 0.05). Meals contributed to energy, protein and fat intake, and snacks to water, retinol and vitamin C. The food intakes by food group were different at meals by economic class. Seaweed product were popular breakfast foods in both middle and low groups. Thus three meals such as breakfast, lunch and dinner still delivered most of the energy and most of the macro nutrients regardless of economic status.
Ascorbic Acid ; Breakfast ; Diet ; Eating* ; Energy Intake ; Lunch ; Meals* ; Nutrition Surveys* ; Poverty ; Seaweed ; Snacks ; Vitamin A ; Water

Freibergs disease is avascular necrosis of the second or third metatarsal bone. Since 1914, numerous causes and treatments have been proposed but no definite single cause and treatment method were developed. The simple method, joint debridement could not recover the pathophysiologic condition of Freibergs disease and the destructive method, metatarsal head resection and prosthetic replacement arthroplasty had many postoperative problems. Recently, dorsiflexion osteotomy, which was described by Gauthier and Elbaz for the first time, and joint debridement and reshaping of the metatarsal head, which was described by Mann, were very effective method to manage Freibergs disease. This paper was aimed to evaluate the result of joint debridement and reshaping of the metatarsal head which were relatively simple, less destructive and safe method in treatment of the advanced Freibergs disease. We treated 7 cases of Freibergs disease from August 1993 to March 1997. The results were as follows: 1. All the patients of the last follow-up improved pain. 2. The passive range of motion was increased from 39.1 preoperatively to 57.6 postoperatively. 3. Follow-up X-rays showed no loose body and further metatarsal head destruction. The above results suggested that the joint debridement and reshaping of metatarsal head provided good result in the treatment of advanced Freibergs disease.
Arthroplasty, Replacement ; Debridement* ; Follow-Up Studies ; Head* ; Humans ; Joints* ; Metatarsal Bones* ; Necrosis ; Osteotomy ; Range of Motion, Articular