Plaster of Paris is an effective ancillary treatment in the surgery of infected cavities in bone. It is well tolerated and spontaneously absorbed over the period of weeks to months, being replaced by bone of normal architecture. When the antibiotics incorporated into plaster of Paris, the antibiotics are capable of prolonged local release in bactericidal concentrations. Therefore it is proposed that antibiotics loaded plaster of Paris might be a simple adjuvant technique after good surgical debridement for the treatment of bone infection. The authors carried out an experiment to study the effect of plaster of Paris containing antibiotics for a prevention of experimental osteomyelitis, using 45 rats, which were divided into 3 groups. In the Group 1, a defect was made at the proximal metaphysis of the tibia, inoculated by Staphylococcus aureus sensitive to Cephradine and Tobramycin and then filled with plaster of Paris pellet. In the Group 2, a defect was filled with Cephradine loaded plaster of Paris pellet. In the Group 3, a defect was filled with Tobramycin loaded plaster of Paris pellet. Then we observed the healing process of the bone defect in the point of view of the gross findings, radiologic findings and histologic findings at 4th, 8th and 12th week after operation. The results of this study were as follows:l. In the control Group;all 30 cases were infected. 2. In the Group 2;only 4 of 30 cases were infected. 3. In the Group 3;all 30 cases were not infected. 4. The plaster of Paris filled into the defect was absorbed continuously and stimulated the new bone formation.
Animals ; Anti-Bacterial Agents ; Calcium Sulfate ; Cephradine ; Debridement ; Osteogenesis ; Osteomyelitis ; Rats ; Staphylococcus aureus ; Tibia ; Tobramycin

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

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

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

No abstract available.

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

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

All clinical studies reported in the literature have indicated that non-operative treatment is the treatment of choice for the diaphyseal fractures of the clavicle. It has also been suggested by some that open reduction may contribute the development of nonunion. From 1985 to 1989, 23 of 133 diaphyseal fractures of the clavicle were treated by open reduction and internal fixation with the intramedullary pinning with or without cerclage wiring, or prebent plate and screw fixation with supplementary iliac bone graft in each instance. All fractures healed without any complication such as the infection, pin migration, other fixation failure, neurovascular accident, and pseudarthrosis. Based on our experience and review of the literature, we concluded that the indications for open reduction and internal fixation should be: 1. The patient's inability to tolerate prolonged immobilization or recumbency in multiple injury. 2. Widely distracted or displaced fractures in adults. 3. Comminution with one or more large butterfly fragments. 4. Neuro-vascular compromise due to displacement and impingement of the bone fragment. 5. Symptomatic delayed union or nonunion. 6. Refracture. And early operative treatment is safe, reliable and provide excellent results comparable to the conservative treatments.
Adult ; Butterflies ; Clavicle ; Humans ; Immobilization ; Multiple Trauma ; Pseudarthrosis ; Transplants

In anterior dislocations of shoulder complicated by fracture of greater tuberosity, the prognosis of shoulder after reduction of dislocation depends upon associated injury of the rotator cuff. Early recognition and repair are thought to be essential if better functions is to be obtained. Among 40 patients with 41 dislocations, 28 cases with fracture of greater tuberosity were managed and treated at the Department of Orthopaedic Surgery, Hangang Sacredheart Hospital, Hallym University, from January, 1985 to December, 1988. The results obtained from this study were as follows: l. Among 40 patients with 41 cases of fracture-dislocation, 27 patients with 28 cases(68.3%) were complicated by fracture of greater tuberosity. Most of these were by traffic accident and occurred at the age of 40s and 50s. 2. According to the Depalma's classifcation, the most common type was type 2(15 cases, 53.5%). 3. Open reduction with repair of cuff was done in 2 cases of type 2 and 4 cases of type 3. 4. Rotator cuff injury was confirmed in eight operatively treated cases and in 3 cases by arthrography and ultrasonography. 5. Five operatively treated cases of fracture-dislocation with rotator cuff injury showed improved function especially in abduction. Therefore in anterior disloations with fracture of greater tuberosity, careful evaluation of anatomic reduction state of fragment after reduction and accompanying rotator cuff injury is necessary. If the fragment retracts under the acromion or still shows displacement more than 8-10mm after reduction, we may assume that a tear of rotator cuff is present and open reduction of fracture with repair of rotator cuff is essential for the better function of the shoulder.
Accidents, Traffic ; Acromion ; Arthrography ; Dislocations ; Humans ; Prognosis ; Rotator Cuff ; Shoulder ; Tears ; Ultrasonography

In children, the supracondylar fractures of the humerus are common in elbow region, and often associated with various complications and problems in treatment (ie,Volkmann's ischemic contracture, cubitus valgus or varus deformity, rotational deformity). The results of reduction can be measured by Baumann's angle, carrying angle, trochlea-capitellum angle, and displacement of distal radial styloid process on radiological study. So we have made experiments on the process which various three dimensional displacements reflected into two dimensional Baumann's angle and humerocapitellar angle. And we investigated the process of rotation, through various radiological studies by means of molded models of humerus. The results were as follows:l. In experiments, AP & lateral X-ray studies showed no change in rotation of proximal segment of fracture with fixed distal segment of fracture. 2. On the other hand, AP & lateral X-ray showed significant change, in rotation of proximal fracture segment with distal segment of fracture. 3. Supracondylar rotation angle(S.R.A.)depicted as the ratio of the length of proximal fracture width minus that of the distal fracture width in lateral view, to the length of distal fracture width in AP view minus that of the distal fracture width in lateral view. 4. According to the modified Mitchell result, S.R.A. to the result of treatment was average 7.6 degree in excellent group, 15.2 degree in good group and 29.3 degree in unsatisfactory group.
Child ; Congenital Abnormalities ; Elbow ; Fungi ; Hand ; Humans ; Humerus ; Ischemic Contracture