Based on our experience with 23 frontotemporal reconstructions performed, this paper attempts to provide guidelines for appropriate selection among the four most commonly employed materials (e.g., autogenous parietal bone, silicone rubber, methylmethacrylate, and porous polyethylene) so that optimal results can be achieved. Clinical follow-up ranged from 6 to 91 months (mean 32 months). Every patient was analyzed clinically by ordinary scale method. The mean defect size was 134.8 cm2 in the silicone rubber, 36.5 cm2 in the methylmethacrylate, 17.4 cm2 in the autogenous bone graft and 7.3 cm2 in the porous polyethylene. The clinical assessment was excellent (mean, 29.3 points) in silicone rubber, excellent (mean, 28.6 points) in autogenous bone, excellent (mean, 26.8 points) in methylmethacrylate, and good (mean, 24.8 points) in polyethylene. To sum up, a large bony defect of congenital calvarial anomaly produced an excellent result using custom-made silicone implant. A relatively small bony defect with a scarred bed produced an excellent result using autogenous parietal bone grafting. Unexpected and medium-sized defect was reconstructed successfully through a simple procedure using methylmethacrylate. Porous Polyethylene was used at an incidental small defect because of its expensiveness.
Cicatrix ; Follow-Up Studies ; Humans ; Methylmethacrylate ; Parietal Bone ; Polyethylene ; Silicone Elastomers ; Transplants

No abstract available.
Child* ; Femur Neck* ; Humans

Because clinical course of the Legg-Calve'-Perthes disease (LCPD) is varied and unpredictable, it is important that pediatric orthopedists have to know prognostic factors of LCPD in order to choose proper method of treatment. The most universally accepted prognostic factor is the patient's age at the onset of the disease, and most patient's who are less than 5 years old have been treated non-operatively. However, we believe that the extent of involvement of the femoral head is more important in this age group and that operative treatment can get good results in cases of servere head involvement. The purpose of this study is to evaluate the efficacy of femoral varus osteotomy in patients before the age of 5 years with severe involvement. We reviewed 18 patients (23 hips) who were less than 5 years old with Catterall group III (5 patients, 7 hips) or IV (13 patients, 16 hips) involvement from June 1984 to June 1994. Femoral varus osteotomies were performed in all cases. We followed up more than 2 years (range, from 24 to 130 months) and analysed clinical and radiological results. The results were as follows: 1. The mean duration from onset of the disease to the stage of repair was 16 months (range, from 8 to 27 months). 2. 2 hips (28.6%) in group III and 12 hips (75%) in group IV showed radiographic head at-risk signs. 3. Clinically all hips in group III showed good result. However, among the 16 hips in group IV, 13 hips were rated good and 3 hips were fair. Overall, 20 hips (86.9%) showed good result. 4. Radiologically all hips in group III showed good result, whereas in group IV, 10 hips were rated good and 6 hips were fair. Overall, 17 hips (78.9%) showed good result. We concluded that femoral varus osteotomy in patients less than 5 years old with severe involvement might shorten the course of disease and might be effective method.
Child* ; Child, Preschool* ; Fibrinogen ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease* ; Osteotomy*

Recent advances in surgical techniques and equipment have made bone lengthening by callotasis both easier and safer, and many successful clinical cases have been reported. The callus formation, however, has often been very poor, and prolonged applied of the external jixator increases the risk of serious complications, such as pin tract infection. We reviewed 68 cases of limb lengthenings performed with callus distraction in 48 patients at Kang Nam St. Mary' s Hospital between January 1989 and May 1994. There were 29 female and 19 male patients, with an average age of 19 (6-50) years. Causes of limb shortening were short stature (14), poliomyelitis (8), fracture and physeal damage (6), osteomyelitis (6), Legg-Calve-Perthe's disease (4), bone tumor (3), congenital dislocation of the hip (3), leg length discrepancy (3), achondroplasia (2) and hip dysplasia (1). Sixty eight calluses were classified radiographically into 6 types: external, straight, attenuated, opposite, pillar, and scattered. The healing indexes and complications following the procedure were evaluated. The mean femoral lengthening was 6.2 (2-10) cm, the tibial 6.5 (3.3-15.7) cm, the forearm 1.8 (1.6- 2.2) cm and the humerus 10 cm. Fifteen cases classified as external type, 5 femur, 7 tibiae, 2 forearm and 1 humerus, with healing index of 34 days/cm and no major complications. Thirty one cases classified as straight type, 7 femur, 22 tibiae, 1 forearm and 1 humerus with healing index of 38 days/cm and 2 obstacles. Fourteen cases classified as attenuated type, 4 femur and 10 tibiae with healing index of 47 days/cm and 2 obstacles. Six cases classified as opposite type, 4 femur and 2 tibiae with healing index of 65 days/cm and 3 obstacles and 1 residual complications. Two cases classified as scattered type, 2 tibiae with healing index of 116 days/cm and 5 obstacles. The scattered type of the callus in two cases was suspected to be a result of poor callus formation due to K-wire breakage conditions that autogenous bone marrow transplantations were performed. This classification enabled us to estimate the intrinsic conditions, predict the healing index, incidence of complications, and decide to apply early bone marrow injection to the callus.
Achondroplasia ; Bone Lengthening ; Bone Marrow ; Bony Callus* ; Classification* ; Dislocations ; Extremities* ; Female ; Femur ; Forearm ; Hip ; Hip Dislocation ; Humans ; Humerus ; Incidence ; Leg ; Male ; Osteogenesis, Distraction ; Osteomyelitis ; Poliomyelitis ; Tibia

PURPOSE: To report the results of acetabular revisions performed with the cementless, hemi-spherical porous coated component supported by viable host bone and minimal allobone graft for acetabular deficiencies. MATERIALS AND METHODS: A retrospective study was completed for 22-revision acetabular components, using the cementless hemispherical porous coated prosthesis and minimal femoral head allograft. There was an average follow up of 48 months, with a range of 24 to 84 months. Radiographic measurements were performed in several aspects; cup-allograft contact, inclination, vertical and horizontal migration of acetabular cup, and acetabular zone by modified zone of DeLee and Charnley, in which location, size and progression or non-progression of radiolucent zone were recorded. The acetabular deficiencies were classified by the American Academy of Orthopaedic Surgeons Committee and were type I in 2 hips (9%), type II in 12 hips (55%), and type III in 8 hips (36%). Twenty acetabular cup cases of Harris-Galante II were used in this study, 1 case of Harris- Galante I, and 1 case of Duraloc. The average size of the cup was 57(44-66) mm. RESULTS: The average cup-allograft contact was 72.5% in 19 cases and we could not differentiate the margin between the host bone and the allograft in 3 cases. There was no significant vertical or horizontal migration of acetabular cup. Radiolucent zones in follow-up radiographs were 8 cases in zone IA, 4 cases in zone IB, 4 cases in zone IIB, 9 cases in zone IIC, 8 cases in zone IIIA, and 7 cases in zone IIIB. One case showed 2 mm radiolucent area in zone IIC and another case showed 3 mm radiolucent area in zone IIB, but the radiolucencies were not progressive. The remaining cases showed less than 0.5 mm radiolucent area or no radiolucent zone. The average period of bony incorporation was 13.1 months. CONCLUSIONS: We suppose that acetabular revision with the cementless hemispherical porous coated cup supported by viable host bone and minimal bone graft produces good results.
Acetabulum* ; Allografts ; Follow-Up Studies ; Head ; Hip ; Prostheses and Implants* ; Retrospective Studies ; Transplants

Peritendinous adhesions which develop in the flexor tendons of the digits after injury or operation are still a major problem in the surgery of the hand. The adhesions that are part of the healing process constitute an almost inevitable functional disability during the biological response of the tissue to injury. To achive better gliding function of flexor tendons, continuous efforts are being made to reduce peritendinous adhesions without adversely affecting the healing process itself. To reduce peritendinous adhesions, an aqueous solution of beta-aminopropionitrile (BAPN) was added to a solution of enriched native collagen (E.C.S.) and applied to the cut tendons of one group: untreated controls and controls treated with collagen solution alone comprised the other groups. Chickens from each group were sacrificed one, three and five weeks after operation. Tn he results were evaluated grossly and pathologically. The results of this experiment were as follows. 1. The collagen solution alone had the same lathylogenic effect as the beta-aminopropionitrile. 2. There were no systemic complications with beta-aminopropionitrile. 3. The beta-aminopropionitrile collagen solutions had the adverse effect on the tendon healings.
Aminopropionitrile ; Chickens ; Collagen ; Hand ; Tendons

No abstract available.
Extremities* ; Hemangioma*

Wiskott-Aldrich syndrome is an X-linked combined immunodeficiency disorder characterized by severely decreased number of platelets which are small in size, eczema resembling atopic dermatitis and recurrent infection. The serum of the patient contains elevated concentrations of IgA and IgE, whereas the IgG level is usually normal and IgM level is decreased. The patients also shows skin test anergy and progressive T-lymphocytopenia. Bleedings and recurrent infections are the main causes of death and the patients usually die before age 10. Bone marrow transplantation is accepted to be the only radical therapy. We experienced a case compatible with Wiskott-Aldrich syndrome in a 5 year old male child who accompanied above clinical manifestations and laboratory findings.
Bone Marrow Transplantation ; Cause of Death ; Child ; Child, Preschool ; Dermatitis, Atopic ; Eczema ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Male ; Skin Tests ; Thrombocytopenia ; Wiskott-Aldrich Syndrome* ; X-Linked Combined Immunodeficiency Diseases

Survey of causes of blindness on 23,249 eye patients who visited to department of Ophthalmology, Han Kang Sacret Heart Hospital, College of Medicine, Hallym University from Jan. 1982 to July 1986 were clinically evaluated. Blindness is defined as visual acuity for distance of 0.1(20/200) or less in the better eye with best correction. Standard Classification of Causes of Blindness recommended from the International Association for the Prevention of Blindness is applied. Estimated number of blindness is 882 persons(1057 blind eyes, 3.80%). For the evaluation of the site of blind eye, 175 persons(19.85%) were binocular and 707 persons(80.15%) were monocular, 375 persons(42.50%) were blind in the right and 332 persons(37.65%) in the left. Distribution of blindness causes by age group is; in male-under 10(3.41%), 11~20(6.06%), 21~30(12.78%), 31~40(10.32%), 41~50(8.42%), 51~60(6.72%), 61~70(5.78%), over 71(4.36%), and in female-under 10(1.80%), 11~20(1.90%), 21~30(4.45%), 31~40(2.65%), 41~50(3.88%), 51~60(5.49%), 61~70(10.13%), over 71(11.92%). Proportion of blindness by causes indicates; Injury and poisoning(31.60%), Senile cataract(28.11%), Infectious disease(9.28%), Others(5.78%), Glaucoma(5.50%), Systemic disease(4.78%), etc. Rate of blindness by site and type of affection is shown as; lens disease(cataract, 37.95%), Corneal disease(10.5%), Glaucoma(5.97%), Phthisis bulbi(5.87%), Anophthalmos(4.93%), Retinal detachment(4.17), etc. Evaluation of result and problems for better reliable survey in future are briefly discussion in comment.
Blindness ; Classification ; Heart ; Humans ; Ophthalmology ; Retinaldehyde ; Telescopes ; Visual Acuity

The wrist, or carpus, is a deformable anatomic entity composed of 8 small carpal bones (scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezium and trapezoid) and the surrounding soft-tissue structures. We should get radiological knowledge of normal wrist in order to identify pathology of that. So we measured the several values on AP, PA and lateral roentgenograms of 228 normal wrist(male : 124 cases, femal: 104 cases). The following results were obtained: 1. Scapholunate gap : 1.4±0.5mm 2. Ulnar variance : 1.3 ±1.7mm, Positive variance … 59.7%, Neutral variance … 25.4% 3. Carpal height ratio : 0.543 ±0.078 4. Carpal ulner distance ratio : 0.32 ±0.04 5. Scapholunate angle : 45.8 ± 8.7° 6. Capitatolunate angle : 19.3 ± 8.2° 7. Radiolunate angle : 8.9 ± 4.7° 8. Ulnar tilt: 23.5 ± 3.3° 9. Volar tilt: 12.0 ± 4.7°
Carpal Bones ; Pathology ; Wrist