We studied the degenerative changes of acetabulum, examining the acetabular articular cartilage at weight bearing dome area from the hips of 25 avascular necrosis of femoral head cases. Histological- histochemical studies demonstrated 4 mild, 19 moderate and 2 severe grade of degenerative arthritic change. This has confirm that even in early stage of avascular necrosis of femoral head, there are degenerative arthritis in acetabular cartilage. This may influence the prognosis of bipolar hemiarthro- plasty in avascular necrosis of femoral head patient.
Acetabulum ; Cartilage ; Cartilage, Articular ; Head ; Hip ; Humans ; Necrosis ; Osteoarthritis ; Prognosis ; Weight-Bearing

A case of fibrolipomatous hamartoma of the median nerve in the palm and digits of the hand in a 14 year old man developed in the right hand is reported. This is rare disease characterized by fatty and fibrous tissue infiltration in themedian nerve of the palm and digits. This case was treated by limited debulking of the redundant tumor tissue and excision of the transverse carpal ligament. This case was performed with relief of the symptom.
Hamartoma ; Hand ; Ligaments ; Median Nerve ; Rare Diseases

Benign solitary osteochondroma are the most common benign bone tumor, and often arise in the long bone of the extremities about 80% of lesions, particulary about the knee and the upper extremity. In rare cases, the spine is involved. We describe a case in which a solitary sacral osteochondroma compressed the lumbosacral plexus, producing sensory disturbance. The tumor was removed through the anterior midline approach. The excised mass was round, lobulated, measuring 7. 5cm×6cm, pedunculated type and the cartilage cap is complete and is 4mm in thickness.
Cartilage ; Extremities ; Knee ; Lumbosacral Plexus ; Osteochondroma ; Sacrum ; Spine ; Upper Extremity

The authors clinically analyzed 53 cases of patients beyond 18 years of age with closed solitary femoral diaphyseal fractures, and 24 cases of patients with multiple long bone fractures including closed femoral diaphyseal fracture. All theses 77 cases were followed for more than 1 year, during 1988. 1
Clinical Study ; Femoral Fractures ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Fractures, Multiple ; Humans ; Methods ; Sex Distribution ; Transplants

In 1988, a new fascioutaneous flap, the Lateral supramalleolar flap, was introduced by Masquelet and Roman. The flap is designed on the lower third of the aspect of leg, and supplied by a cutaneous branch from the perforating branch of the peroneal artery. This perforating branch continues distally deep to the fascia along the anterior ankle and into the foot. This can be use as either proximally based rotation flap or distally based reversed pedicle island flap giving the flap an arc of rotation that allows coverage of the dorsal, lateral and plantar aspects of the foot, the posterior heel and the lower medial portion of the leg. The authors have recently used this flap for 13 cases of foot and ankle soft tissue defect reconstruction and all the cases, except two partial marginal necrosis, good postoperative course. In our opinion, this flap is useful for reconstruction of foot and ankle soft tissue defect which does not need nerve innervation. The main advantages of the flap are as follows 1. It may be a rather large flap(15× 9cm2 ). 2. The pedicle is long(8cm) and easy to dissect. 3. The pivot of the pedicle is distal(sinus tarsi) and allows great local possibilities of coverage. 4. It does not require the sacrifice of a main artery.
Ankle ; Arteries ; Fascia ; Foot ; Heel ; Leg ; Necrosis

To cover soft tissue defect, various types of flaps have been used. Although lateral supramalleolar flap has been used as rotation flaps or reversed island flaps to cover defects around the foot and ankle, there has been no report about its application as a free flap. The lateral supramalleolar island flap has proves to be supplied constantly by the terminal branch of the peroneal arterys perforating branch. The free lateral supramalleolar flap has the same skin territory. Its vascular pedicle can be extended to the main peroneal artery and vena comitans, which can be obtained by dissecting the peroneal vessels between the distal tibia and fibula through the interosseous membrane. We have successfully transferred this free flap in eight patients from April 1994 to February 1995. All of the patients had full thickness skin defects which were caused by contact thermal burn, electrical burn, flame burn or traffic accident. There were no complications. From our experience, we feel that this new free flap have some advantages, induding vascular anatomy and long pedicle with large diameter and a relatively thin flap with minimal morbidity of donor site.
Accidents, Traffic ; Ankle ; Arteries ; Burns ; Fibula ; Foot ; Free Tissue Flaps* ; Humans ; Membranes ; Skin ; Surgical Flaps ; Tibia ; Tissue Donors

No abstract available.

To evaluate the effect of preoperative treatment on proliferative activity and prognosis of the hepatocellular carcinomas(HCCs), fifty-three surgically resected HCCs were studied. Twenty cases were treated preoperatively and thirty-three were not treated before surgery. The proliferation index(PI, % of proliferating cell nuclear antigen positive cells) of the remaining cancer cases(35.41). Although PI was similar among gross types and among histologic grades, tumors of the expanding type and of the histologic grade I revealed distinctly low PI in pretreated cases. Two-year survival rate was not significantly different between pretreated and not-pretreated cases(67.4 vs 52.7). But the differences between gross types(p<0.05) and between histologic grades(p<0.01) were significant. Total necrosis of tumor occurred in five pretreated patients, all of whom were alive during two-year follow-up. Smaller HCCs showed better prognosis(p<0.01). Although PI appeared not correlated well with the two tear survival rate, the pretreated HCCs preoperative modalities induce tumor necrosis, but do not reduce the proliferative activity of tumor cells significantly, and that pretreatment does not affect the long-term prognosis of HCCs except for the accasions of total necrosis of tumor.
Carcinoma, Hepatocellular

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries