Post-traumatic kyphosis is generally recognized as the result of failure of initial treatment in injured spine. The purposes of this study are to find out the surgical indications in residual post-traumatic kyphosis and to analysis the result of operative correction in post-traumatic kyphosis. The authors analyzed 14 cases of post-traumatic kyphosis, operated from Jan. 1992 to Mar. 1996. Their injuries were estimated initially compression fracture in 12 cases, hurst fracture in 2 cases. Their initial treatments were conservative method in 12 cases, anterior fusion in 1case & laminectomy in 1 case. The results of this study are as follows: 1) By standard Cobb lateral measurement, the mean preoperative kyphosis of 32.9degrees was reduced to 14.2 degrees(56.8% correction ratio). 2) Symptomatic improvement was definite, stooping with fatigue pain, mid back pain and accompanied claudication were improved in all cases. And low hack pain due to compensatory lordosis was improved in 5 of 6 cases. 3) We acquired bone union in all cases. We concluded that some thoraco-lumhar fractures could be underestimated in supine X-ray and needed more meticulous evaluation and follow-up. In addition, preexisting symptomatic lumhar degeneration below fracture should be considered in initial surgical decision making of post-traumatic kyphosis.
Animals ; Back Pain ; Decision Making ; Fatigue ; Follow-Up Studies ; Fractures, Compression ; Kyphosis* ; Laminectomy ; Lordosis ; Spine

Transient synovitis is characterized by the development of pain arising from the hip and often felt in the thigh or knee in children between the ages of 2 and 12 years. The benign self-limiting nature of this condition has made it difficult to establish the caus'e. However, the condition is generally conceded to be the commonest cause of a painful hip in childhood. The disease is of interest, not because of its disabling condition, but because of the difficulty in differentiating it from more serious diseases of the hip, such as tuberculosis, osteomyelistis, or Legg-Perthes disease. The author had studied the clinical symptoms and signs, roentgenologic findings, and treatment of the 34 patients who had admitted to Severance Hospital Yonsei Medical Center in Seoul, Korea from January 1970 to December 1979, under the diagnosis of the transient synovitis of the hip and summerized the results as follows; 1. There was probably associated with predisposing factors such as infection and allergy. 2. Among the 34 patients, 28 cases(82.4%) were male and 6 cases(17.6%) were female. The most prevalent age were between 6 and 10 years old. 3. Pain and limitation of motion of the hip joint were the most common symptoms. In 56.5% of the patients, roentgenographic findings were positive. In 50% of the patients, the erythrocyte sedimentation rates were increased. 4. The treatment was conservative including bed rest, skin traction on the affected leg, non-weight bearing, antibiotics, and sedatives. Most of all patients had improved symtoms and signs within two weeks of treatment. 5. The course of this condition was short and benign with complete resolution. The occasional hip with chronic or recurrent symptoms could be distinguished from Legg-Perthes disease by the short history, normal radiographs, and the complete resolution.
Anti-Bacterial Agents ; Bed Rest ; Blood Sedimentation ; Causality ; Child ; Clinical Study ; Diagnosis ; Female ; Hip Joint ; Hip ; Humans ; Hypersensitivity ; Hypnotics and Sedatives ; Knee ; Korea ; Leg ; Legg-Calve-Perthes Disease ; Male ; Seoul ; Skin ; Synovitis ; Thigh ; Traction ; Tuberculosis

With the increasing number of the occupational accidents proportionate to the rapid development of modern culture, fractures of the hand have become one of the commonest fractures of the human body. The authors have reviewed 211 cases of injured hand in industry which were treated in the department of orthopedic surgery, InCheon Severance hospital from Jan. to Dec. in 1989. The following results were obtained; 1. The peak incidence was in the age group from 21 to 30 years in 87 cases (41.2%). Injured males outnumbered females predominantly by 92.9% vs 7.1%. 2. The hand injuries happened most commonly in the day time (from 8 oclock A.M. to 6 oclock P.M.) but there were no differences between month in the year. 3. Most of patients injured hand (73.9%) arrived at hospital within 1 hour after accidents. 4. The commonest cause of the injury was due to electric saw (21.9% ). 5. Of the 98 fracture cases left hand was more frequently involved than right hand and 64 cases monodigit and remained were polydigits. 6. 43 (32.6%) of total 132 fractured sites were index finger and 74 (56.1%) were distal phalanx. 7. The index finger was also most vulnerable to amputation (56.8% out of 44 amputation cases) and the most distal part was more vulnerable to amputation. 8. The most common method was primary closure and splint. The method of treatment was affected in part by the economic and social status of the patients. 9. In order to prevent hand injuries in industry, preventive policy should be established by improvement of working environments, machines and education.
Accidents, Occupational ; Amputation ; Education ; Female ; Fingers ; Hand Injuries ; Hand ; Human Body ; Humans ; Incheon ; Incidence ; Male ; Methods ; Orthopedics ; Splints

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually, the joints are destroyed, ankylosed and deformed. Therefore, the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving joint motion, maintaining the health of muscle supplying motor power about the joint, and preventing secondary joint stiffness and deformity. Surgical treatment in rheumatoid arthritis has progressed and there have been advances in the relief of pain and increase in the range of motion. For the period of 15 years from January 1973 to December 1987, 55 cases of rheumatoid arthritis who received surgical treatment were reviewed and the results of clinical observation were as follows : 1. Among 977 patients of rheumatoid arthritis, 76 sites in 55 patients were operated on. 2. Sites of operation were the knee in 33 cases, hip in 20 cases, wrist and finger in 12 cases, ankle in 5 cases, elbow in 5 cases, and cervial spine in 1 case. 3. Operative methods were 40 cases of joint replacement, 27 cases of synovectomy, 4 cases of fusion, and 2 cases of tenotomy and capsulectomy. 4. Postoperative results were good in 19 patients, satisfactory in 16 patients, unsatisfactory in 5 patients, and poor in 2 patients. 5. The clinical stage at the time of joint replacement was not related to the end results of the operations. 6. Causes of unsatisfactory and poor results were preoperative flexion contracture and Felty's syndrome.
Adult ; Ankle ; Arthritis, Rheumatoid ; Congenital Abnormalities ; Contracture ; Elbow ; Felty Syndrome ; Fingers ; Hip ; Humans ; Joints ; Knee ; Middle Aged ; Muscle, Skeletal ; Range of Motion, Articular ; Spine ; Synovial Membrane ; Tenotomy ; Wrist

No abstract available.
Osseointegration*

No abstract available.
Cystadenoma, Mucinous* ; Mucins* ; Pancreas*

The hand is a part of the human body, which has a complex structure, various functions and is one of the parts of the body most susceptible to trauma. With the increasing number of the traffic and occupational accidents proportionate to the rapld development of modern culture, fracture of the hand have become one of the commonest fracture of the human body. The object of treatment of fracture of the hand is to restore function the greatest degree possible with exact diagnosis and proper treatment based on the knowledge of anatomical structure and function. The authors have reviewed 228 cases of fractures of the hand (fracture with severe soft tissue injury were excluded) which were treated in the department of orthopedic surgery, Severance hospital from 1969 to 1978. The following results were obtained; 1. Fractures occured more commonly In man (80.3%) than woman. 2. Fractures occured more commonly in the second decade and the group between 10 and 30 years of age accounted for 73.7% of all fractures. 3. There was no significant differnnce between the left and right side. (105:123) 4. The commonest cause of the fracture was traffic accident (38.6%), machinary injury was the second (21.1%). 5. Most of the patients were brought to our hospital within 12 hours after injury (61.8%). 6. The most frequently fractured bone was the metacarpal (34.4%), then the proximal phalanx (28.1%), distal phalanx (16.9%), middle phalanx (10.5%) in decreasing frequency. 7. The average time for clinical union was 4.2 weeks in the case of the distal phalanx, 6.8 weeks in middle phalanx, 7.3 weeks in proximal phalanx and 6.5 weeks in metacarpal. 8. Complications were found in 8.3% of all cases and angulation deformlty was the most frequent.
Accidents, Occupational ; Accidents, Traffic ; Clinical Study ; Diagnosis ; Female ; Hand ; Human Body ; Humans ; Orthopedics ; Soft Tissue Injuries

In 1960 Jacobson and Suarez introduced the operating microscope to vascular surgery and demonstrated the superiority of small vessel repair using magnification. The first clinical replantation of an arm in the western world was performed by Malt in 1962, and Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. To perform a digit or hand replantation, microsurgical anastomosis of blood vessels is absolutely essential to revascularize the severed part. Without accurate repair of bone, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or hand. This is a difficult task because all structures must be reconstructed at the same level and time. Even if the repair of some structures has been postponed, the secondary reconstruction may also be troublesome due to circular scarring at the replantation level. Since replantation surgery has been popularized throughout the world in recent years, the replantation sucess rate has increased and the surgeons interest in functional reconstruction of replanted digits or hands has been stimulated. The authors have seen and studied 6 cases of upper Jimb and 20 cases of finger replantation from May, 1980 through January, 1982 at the department of orthopedic surgery, Yonsei University College of Medicine. The results were as follows: I. The average age was 20 years and the male to female sex ratio was 4.5:1. 2, The causes of injury are detailed as follows: electric saw(6); cutting machine(5); roller(4}; presser(2); stone(2); others(3). 3. The level of amputation in 26 replantations was as follows: thumb, 3 cases; index finger, 4 cases; middle finger, 9 cases; ring finger, 4 cases; palm, I case, wrist, 3 cases; forearm, 1 case; upper arm, 1 case. 4. The maximum ischemic times for successtul results were 16 hours in limb replantation and 22 hours in finger replantation. 5. Six limbs, with four complete and two incomplete amputations, have been replanted and all six limbs survived: Twenty digits, with nine complete and eleven incomplete amputations, have also been replanted and 6.5 cases of nine complete amputations and 10 cases ot eleven incomplete amputations survived. A total of 22.5 cases(86.5%) of replanted limbs and digits survived. 6. The results of joint motion, two point discrimination, sensory recovery and status of sweating due to recovery ot sympathetic nervous function following replantation were satisfactory. 7. In the early stage of our series, postoperative systemic heparinization was used in some cases, but recently we have achieved good recults without it. 8. Main causes of reattachment failure were tissue crushing and secondary thrombosis of the anstomosed vessels.
Amputation ; Arm ; Blood Vessels ; Cicatrix ; Clinical Study ; Discrimination (Psychology) ; Extremities ; Female ; Fingers ; Forearm ; Hand ; Heparin ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sex Ratio ; Surgeons ; Sweat ; Sweating ; Tendons ; Thrombosis ; Thumb ; Western World ; Wrist

No abstract available in English.
Clinical Study ; Spondylolisthesis

The purpose of this study is to investigate the effect of plasma sprayed hydroxyapatite(HA) coating on bone ingrowth into fiber-mesh coated titanium implant. The shear strength of the HA coatings on interface attachment, the degree of osseointegration of HA coated implants and bone ingrowth of fiber-mesh coated titanium implants were evaluated. The implants were placed transcortically in the femora of mature dogs and evaluated after six weeks. The pushout test showed 33.58±10.87 MPa in HA-coated fiber meshed implants and 20.53±4.91 MPa in fiber-mesh coated implants. In histologic observations, similar quantitative results in the amount of bone ingrowth and osseointegration on both systems. The HA coatings showed direct osseointegration and bone ingrowth on its surface and fiber-mesh without fibrous layer, but the fiber-mesh only coatings showed thin fibrous layer between the ingrown bone and titanium surface. In conclusion, HA-coating on fiber-mesh coated implant provided earlier and stronger osseointegration and bone ingrowth than fiber-mesh only coated implant.
Animals ; Dogs ; Durapatite ; Osseointegration ; Plasma ; Shear Strength ; Titanium