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

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

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

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*

No abstract available.
Animals ; Cautery* ; Cryosurgery* ; Dogs* ; Femur* ; Phenol*

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

The anterior decompression and anterior interbody fusion have been the choice of surgical treatment for spinal tuberculosis since 1960. But, multi-level spinal tuberculosis involved more than three vertebrae resulted in large post-debridement defect and spinal instability. So, failure of the graft was very common & postoperative maintenance of the kyphotic angle correction was very difficult. In part of such cases as multi-level spinal tuberculosis, we performed supplementary anterior instrumentation in a single-stage procedure. The authors analyzed total 39 surgical cases of multi-level tuberculosis of the thoracolumbar spine from January 1985 to June 1992. The patients treated only with a strut graft were designated as group I(n=23) and the patients added by anterior instrumentation as group II(n=16). Mean age of 39 cases was 33.1 years, and mean follow-up period was 31.6 months. The purpose of this study was to compare the postoperative results of group I with those of group II by measuring the angular kyphosis on serial lateral roentgenograms, and to provide an aid in selecting method of surgery before treatment of multi-level spinal tuberculosis with high risk of progression of kyphosis. The results were as follows: 1. There were 16 cases of thoracolumbar, 14 cases of thoracic, 9 cases of lower lumbar lesions, and numbers of vertebrae involved were 4.2 in mean. 2. By standard Cobb lateral measurement, mean preoperative angle of segmental kyphosis was 32.5° in group I, and 45.1° in group II, and group II proved as more kyphotic. After operation, mean angle of segmental kyphosis was 24.7° in group I and 32.4° in group II. 3. On final F/U, mean angle of segmental kyphos was 32.7° in group I, and 37.3° in group II, and final loss of correction was 8.0° in group I, 4.9° in group II. 4. There were 8 patients(34.8%) of graft-related complications in Group I, and 2(12.5%) in group II. And graft failure in group I resulted in severe loss of correction of segmental kyphosis, but graft failure in group II did not, through graft protection by anterior instrumentation. 5. There were 3 patients(18.8%) of implant-related problems in group II; two during and one after union. In these former two cases, bony union was obtained without loss of correction by prolonged application of brace. No cases of group II was associated with persistence or recurrence of infection after instrumentation. In our opinion, anterior interbody fusion and combined anterior instrumentation can be effective and safe one of methods in surgical treatment for multi-level tuberculosis of the spine which has been considered as the most important determinant of the result by its extensive vertebral involvement with resulting large post-debridement defect to be struted.
Braces ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Methods ; Recurrence ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Vertebral stabilization using transpedicular screw fixation device is widely used in the surgical treatment of degenerative lumber diseases such as spinal stenosis, pseudospondylolisthesis, and spinal instability. The use of transpedicular screw fixation devices provides substantial advantages with regard to an increase of the rate of solid arthrodesis, early rehabilitation, short segment spinal fusion, and restoration of sagittal lumbar lordosis. The authors analyzed 11 patients showing definite postoperative loss of the lumbar sagittal lordosis in a total of 110 surgical cases of degenerative lumbar diseases who underwent segmental spinal fusion using transpedicular screws from January 1981 to December 1993. The purpose of this study was to analyze the causes of loss of lumbar sagittal lordosis in the instrumented segments and to present some precautions in transpedicular screw fixation for surgical patients with degenerative lumbar spines to maintain corrected lumbar sagittal lordosis. The results from this study were as follows: 1. By standard Cobb lateral measurements, eleven cases in a total of 110 patients showed definite loss of lumbar sagittal lordosis more than 4 degrees. 2. The period reflecting loss of lordosis was roughly within postoperative four months which were critical fusion time of the grafted bone mass, which lasted an average of 4.8 months in this study. 3. The implants led to loss of lordosis consisted of 6 cases in 53 Diapasons, 4 cases in 32 Wiltses, and a case in 15 Steffee plate systems. Diapason & Steffee plate systems were classified as a rigid type and Wiltse system as a flexible one. 4. The causes of postoperative loss of lordosis were recognized as 2 cases of screw toggling, 5 cases of screw-rod locking failure and 4 cases of rod bending. 5. The group resulted in more loss of lordosis in degrees was related to significant change between preoperative and postoperative lordosis, distraction of disc space during operation, extensive discectomy, and reduction of degenerative spondylolisthesis which were the cases of the anterior column deficiency.
Animals ; Arthrodesis ; Diskectomy ; Humans ; Lordosis ; Rehabilitation ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants