Recent advance in the field of microvacular surgery has popularized the reattachment of severed digit, with increasing success rate and improving functional regain. Reattachment surgery was performed in six digits, two thumbs and four fingers, which had been amputated at or distal to the level of DIP joint. Microvascular anastomosis of one digital artery was done and the venous drainage was reestablished with blood letting from the pulp of each digit. There was one failure in which hypersensitivity to heparin was present, while all other five showed success. Postoperatively considerable sensory recovery was present in all.
Arteries ; Drainage ; Fingers ; Heparin ; Hypersensitivity ; Joints ; Linear Energy Transfer ; Thumb

Kienbock's disease is a rare disease that is suspected to be caused by the circulatory impairment or/and trauma to the lunate. The various modes of etiology, progression and the treatment have been suggested without any definite ones. The authors report 13 cases of the Kienbock's disease and the results are as follows:1. The male(10 of 13 patients) and the dominate hand(10 of 13 hands) were the more prevalent. 2. Eight cases had a definite history of trauma and the 5 of them were injured by the hyperextension of the wrist. 3. Eight cases were stage III B according to the Lichtman's classification. 4. Nine cases(69%) showed ulna minus variant, which was thought to have certain significant relation with the cause of this disease.
Classification ; Clinical Study ; Osteonecrosis ; Rare Diseases ; Ulna ; Wrist

Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome that characterized by pain, especially in night, sensory disturbance in median nerve dermatome of the hand, and thenar muscle atrophy. Open decompression was a treatment of choice, when operative intervention is necessary. But, endoscopic or percutaneous decompression is introduced recently. Authors analyzed 21 cases of open decompression and 22 cases of percutaneous decompression and they could be follow up over 6 months at Dept. of Orthopedics, Chonnam University Hospital from June 1990 to January 1995. The results are as follows. 1. There were no difference in age, sex, lesion side, symptoms duration until operation, etiology and occupation between percutaneous and open decompression. 2. There were excellent or good results in clinical symptom in 19 cases(90%) of open procedures and 19 cases(86%) of percutaneous procedure and more rapid relief of the pain, and grip power in percutaneous procedure than open procedure. 3. The EMG, recorded at 1 week, 4 weeks, 3 months and 6 months after operation, revealed improvement in sensory than motor function. There was more rapid recovery in percutaneous procedure than open procedure especially latency and amplitude of sensory nerve. There were 2 cases in open procedure and 3 cases in percutaneous procedure who did not respond to treatment. As a result, percutaneous procedure was more simple and rapid recovery than open procedure in clinical progressions and EMG reports, but recovery rate of symptomatic relief was similar. Therefore percutaneous procedure is thought to be more reasonable method in the treatment of carpal tunnel syndrome if surgical intervention is indicated.
Carpal Tunnel Syndrome ; Decompression ; Follow-Up Studies ; Hand ; Hand Strength ; Jeollanam-do ; Median Nerve ; Methods ; Muscular Atrophy ; Occupations ; Orthopedics ; Peripheral Nerves

PURPOSE: To compare the functional and radiographic results of the treatment in unstable intra-articular fractures of distal radius by closed reduction and external fixation versus open reduction and internal fixation. MATERIALS AND METHODS: Forty cases of unstable intra-articular fractures of distal radius were treated either by application of closed reduction and external fixation (CREF) or by open reduction and internal fixation (ORIF) between March 1989 and June 1997. They were followed up for more than one year. To assess the functional results, we used Green and O' Brien' s score system and for the radiographic results, measured volar tilt, radial inclination and radial length. RESULT: In functional results, excellent to good results were obtained in 19 cases (76%) in the CREF group and 10 cases (80%) in the ORIF group, and the average score was 81.4 and 82.8 by the Green and O' Brien' s score system. In radiographic results, mean loss of volar tilt, radial inclination and radial length were 1.4 degree (13.4%), 2.0 degree (9.0%), 1.3 mm (10.3%) in the CREF group and 1.2 degree (10.8%), 1.6 degree (6.1%) and 1.2 mm (11.5%) in the ORIF group on last follow-up radiographs. There was no evidence of statistical difference between two groups in functional and radiographic results (P>0.05). CONCLUSIONS: If an appropriate operative method is selected according to the presence of several properties, including the pattern of fracture, the general condition and activity of patient and the degree of soft tissue injury, the two operative managements are considered useful to restoring articular congruity and alignment and to allow early postoperative range of motion exercise
Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Radius* ; Range of Motion, Articular ; Soft Tissue Injuries

No abstract available.
Child* ; Femoral Fractures* ; Humans

No abstract available.
Humans

We experienced the 17 hands of 11 patients with Dupuytren disease, which was known as relatively rare in orientals. Retrospectively, we analyse it and the results were followings; l. Among 11 patients, 10 patients were male and average age was 62.5 years (49 to 77 years) 2. Most (15 hands, 88%) of patients had symptoms of flexion contracture, nodule and contracted cord, simultaneously. 3. Occupation of patients was agricultural laborer in 9 patients (82%). 4. In 9 patients(82%); individual habit of alcoholic drinking, more than 3 times per week, and smoking, 1 package per day, over 20 years more, was observed. 5. In 15 hands (88%), ulnar side of fingers (4th+5th, 5th only or 3rd+4th+5th)was involved. 6. Surgical treatment was performed in 9 hands of 7 patients, with results of excellent in 6 hands (67%) and no recurrence, in average follow up 2.6 years (1.5 year to 3.7 year)
Alcoholics ; Clinical Study ; Contracture ; Drinking ; Dupuytren Contracture ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Male ; Occupations ; Recurrence ; Retrospective Studies ; Smoke ; Smoking

We studied thirteen, all male, patients who had trans-scaphoid perilunar dislocation(stage I, 5 cases) and dislocation of lunate(stage IV, 8 cases). Age of patient was ranged from 25 years to 49 years(avr. 36 years)and the most common cause of injury was fall down(6 cases, 46%). Seven acute cases, diagnosed and treated within 3 weeks from injury, were treated by open reduction and K-wire fixation(5 cases), and K-wire fixation and bone graft(1 case) and Herbert screw for fracture of scaphoid(1 case). Six chronic cases diagnosed and treated after 3 weeks from injury were treated by open reduction and K-wire fixation(1 case), K-wire fixation and bone graft(1 case), removal of lunate(2 cases), and arthroplasty using muscle after removal of lunate(2 cases). Thirteen cases were followed up for average 33 months(from 13 months to 81 months). Grip power was evaluated as excellent or good in 8 cases and fair in 5 cases. Range of motion of wrist joint was decreased 21 degrees in flexion, 22 degrees in extension, 4 degrees in ulnar deviation, and 5 degrees in radial deviation of wrist joint, compared with uninjured side. Carpal height and carpal height ratio were decreased to 33.1 and 0.51, compared with normal 35.8(p=0.001) and 0.55(P < 0.001), respectively. Between 2 groups of acute and chronic cases, no significant differences were noted in carpal height or carpal height ratio. The surgical treatment of perilunar fracture-dislocation has not simple option, therefore, we would recommend the early diagnosis and exact anatomical reduction.
Arthroplasty ; Dislocations ; Early Diagnosis ; Hand Strength ; Humans ; Male ; Range of Motion, Articular ; Wrist Joint

For the nonunion of humeral shaft, there have been many methods of treatment. We are aimed to analyse the causes of nonunion of humeral shaft fracture and present the direction of treatment. We reviewed total 21 cases which were diagnosed as delayed or nonunion of humeral shaft and analysed the causes. l. Initial method of treatment was surgical in 19 out of 21 cases. Among these 19 cases, 14 cases were operated with internal fixation with plate and screw. 2. The most common cause of nonunion was inadequate internal fixation in 26 cases(81%) in which were unstable fixation in 13 cases, choice of inadequate internal fixator in 11 cases, and failure of operative technique in 2 cases. Other causes were distraction between fracture fragments in 4 cases(13%) and open comminuted fracture in 2 cases. 3. Eighteen cases of established nonunion due to inadequate internal fixation were treated by rigid fixation with longer and broader plate and bone graft, and 1 case interlocking IM nailing, 1 case Ender nailing and 1 case bone graft only. 4. Union was obtained in all cases at least in 5 months. And there were no specific complications. In conclusion, surgeons should contemplate the operative indication and principles in primary treatment. In treatment of nonunion, surgeons should treat by more longer and broder internal fixator and additional bone graft.
Fractures, Comminuted ; Humerus ; Internal Fixators ; Methods ; Surgeons ; Transplants

Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome due to compression of the median nerve at the wrist. Division of the transverse carpal ligament for median nerve compression in patients with carpal tunnel syndrome is a common and successful procedure. A variety procedures exist to release the transverse carpal ligament the classic open release, limmited open or percutaneous release, and endoscopic release. From February 1994 to January 1996, 39 carpal tunnel releases were performed by percutaneous method in 30 patients (3 males and 27 females) at the Chonnam University Hospital. The patients age ranged from 42 to 67 years (average 54.8 years). The duration of the symptoms ranged from 3 months to 10 years. According to Brown's outcome analysis, results were as follows. 1. Persistent pain and paresthesia were noted in only 3 cases (7.7%) at 24 week postoperatively. 2. Two-Point discrimination on the index finger was improved significantly at 12 week postoperatively (p<0.05). In electromyographic study, conduction delay of motor and sensory fibers was diminished significantly at 4 week postoperatively (p<0.05). 3. Functional outcomes (grip strength, pinch strength, scar tenderness and return to work) were showed good and excellent result. We concluded that percutaneous decompression is one of the less morbid method for decompressing the carpal canal and relief of symptoms for the patient.
Carpal Tunnel Syndrome* ; Cicatrix ; Decompression* ; Discrimination (Psychology) ; Fingers ; Humans ; Jeollanam-do ; Ligaments ; Male ; Median Nerve ; Paresthesia ; Peripheral Nerves ; Pinch Strength ; Wrist