It is generaly accepted that displaced phalangeal neck fractures in hands accelerate the onset of degenerative changes, with increasing pain and stiffness of the affected joint. However, reports on the results of surgical treatment in phalangeal neck fractures are relatively few. We have followed sixteen patients, who had operations for phalangeal neck fractures. The average length of follow up was 13 months. The interval between injury and operation ranged from three days to six years, whith a mean of 18 months. The second finger was the most frcquently injured. The phalangeal neck had been displaced with rotation in 9 cases and slightly displaced without rotation in 7 cases. The most common surgical approach was a mid-dorsal incision. Of 16 cases, thirteen required open reduction and internal fixation with a K-wire, either for dorsal displacement and volar angulation of the head or for a 180 degree proximal rotation of the head. The pull-out wire technique was the second most common fixation method. Excellent and good results were noted in 10 cases(62%). Complications were found in seven cases and loss of motion was the most frequent. Late malrotation with angulation occurred in one case.
Fingers ; Follow-Up Studies ; Hand ; Head ; Humans ; Joints ; Methods ; Neck

BACKGROUND: Pityriasis versicolor(PV) is a superficial mycosis, theoretically unusual in children. Epidemiologic and clinical data for children with PV under 14 years were collected. OBJECTIVE: The purpose of this study was to evaluate the clinical features of PV in the young. METHOD: We included all cases of PV in patients under 14 years of age observed in our department from 1981 to 1995. All cases were diagnosed on the basis of clinical criteria and were confirmed by microscopic examination. RESULTS: From 1981 to 1995 we encountered 32 cases of PV in children, compared with 637 cases in adults; thus children represented 4.7% of all cases. The ratio of male to female was l. 7:1. Among the age groups, the incidence was the highest in the 10-14 years(43%). The monthly prevalence was the highest in August. Distribution of the lesions were the face(40.9%), neck (25%), chest(13.6%), back(11.3%), extremities(6.8%) and abdomen(2.2%). The incidence of hypopigmented lesions was 70.4% and that of hyperpigmented lesions was 29.6%. CONCLUSION: This study confirms that the face is a predilectionl site for PV in children and all facial lesions are hypopigmented. Other clinical features are variable and similar to those of adults.
Adult ; Child ; Female ; Humans ; Incidence ; Male ; Neck ; Pityriasis* ; Prevalence ; Tinea Versicolor*

Radial nerve paralysis associated with humeral shaft fracture is the most common peripheral nerve lesion complicating fractures. The mechanism of injury, treatment, and prognosis of radial nerve paralysis associated with fracture of the humerus vary considerably, depending on when the nerve injury occured with respect to the humeral fracture and its subsequent treatment. A clinical study was performed on 243 patients with fractures of the humeral shaft. Especially fourty two cases of radial nerve paralysis associated with fracture of the humerus were analyzed at Department of Orthopedic Surgery, Yonsei University College of Medicine from January 1965 to December 1982. The results were summarized as follows: l. Among 243 humerus shaft fractures, the ratio of male to female was 2: 1. The common cause of radial nerve paralysis associated with humerus fracture were due to traffic accident and industrial machine injury. The closed fracture was 205 cases(84.4%) and the most common type of fracture was comminuted fracture(52.6%) 2. Among 243 humerus shaft fractures, 42 cases(17.3%) complicated the radial nerve paralysis. The radial nerve paralysis was the most vulnerable to injury at the distal third of the humerus, especially when there was open or comminuted fracture. The incidence of primary radial nerve paralysis was 8%(34 cases), and 19#g(8 cases) in secondary radial nerve paralysis. 3. Among 42 radial nerve paralysis associatd with humerus fractures, 15 cases were treated by conservative method. And 27 cases were treated by surgical exploration. By surgical exploration the practical cause of radial nerve paralysis were found: 13 cases negative, 5 cases contusion, 3 cases stretching. The recovery sign of radial nerve paralysis was noted from 2 weeks after treatment. Spontaneous neurological recovery was not noted beyond 6 months after treatment. Thirty two patients were available for follow up study. The overall recovery rate of radial nerve paralysis was 81.3. The practical causes of patient with no recovery of nerve function were cross section of nerve, severe stretching or entrapment of radial nerve between the sites of fracture. From a consideration of these series, it was concluded that satisfactory result was obtained from conservative management in humerus shaft fracture associated with radial nerve paralysis. Indication of early surgical exploration of radial nerve paralysis associated with humeral fractures are open fractures requiring debridement, spiral or oblique fractures with marked displacement, and progressive nerve paralysis.
Accidents, Traffic ; Clinical Study ; Contusions ; Debridement ; Female ; Follow-Up Studies ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Humeral Fractures ; Humerus ; Incidence ; Male ; Methods ; Orthopedics ; Paralysis ; Peripheral Nerves ; Prognosis ; Radial Nerve

No abstract available.
Hand* ; Osteomyelitis*

The transfer of a sensory island of skin to an anesthetic area on the hand has been the most important development in hand surgery in the past decade. A neurovascular island flap transfer has proved useful for the treatment of finger injuries in primary cases and in secondary cases. The purpose of this paper is to describe the use of local composite tissue, isolated and transferred on a neurovascular pedicle graft for the secondary reconstruction procedures of finger injuries. Thirty two fingers had been operated on for "neurovascular island flap" coverage operation at the Department of Orthopedic Surgery, Yonsei University, Severance Hospital and Inchon Severance Hospital during the period from 1983 to 1992. The follow up study was carried out on twenty hands over a year period after an operation. The results obtained were as follows. 1. Among twenty hands the cases of thumb are ten. The index are eight, other fingers are two. 2. The ratio between male and female was about 4: 1 The most common procedures of primary treatment were abdominal distant flap (14cases). 3. All had better touch, pain and temperature sensibility in the flap than the surrounding recipient area. Thirteen patients reffered a pinprick in the flap to the donor finger, All had decreased two point discrimination corresponding to the pulp about 6 months after operation. 4. The use of neurovascular pedicle graft as a method of tissue transfer which permits a wide range of motion and comfortable appearance without jeopardizing either circulation or sensation.
Clinical Study ; Discrimination (Psychology) ; Female ; Finger Injuries ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Incheon ; Male ; Methods ; Orthopedics ; Range of Motion, Articular ; Sensation ; Skin ; Thumb ; Tissue Donors ; Transplants

No abstract available.
Knee* ; Rabbits* ; Tendons*

No abstract available.
Fingers*

No abstract available.

No abstract available.
Child* ; Hand* ; Humans

PURPOSE: Diverticular disease of the colon is relatively common in western population and rare in oriental population but in recent years the incidence is steadily increasing in oriental population including Korean, so more concerns and appropriate management are required. METHODS: We reviewed 111cases who had diverticular disease in the colon from January 1988 to May 1998 in the Soonchunhyang University Chunan Hospital. Of 111 cases, 87 cases were treated conservatively and 24 cases received a surgical treatment. RESULTS: The annual incidence increased progressively for the last 10 years. The mean age of the patients at the time of diagnosis was 49.6 years and the most common age-group was forth decades (25%). The diverticula were located in the right colon 89%, left colon 7% and both side 4%. Among 24 surgically treated cases, the most common preoperative diagnosis was acute appendicitis (75%) and the correct preoperative diagnosis was made only 3 cases (13%) who had previous appendectomy history, previous diagnosed history or received barium enema due to recurrent pain attack. The surgical procedures of the colonic diverticulosis were right hemicolectomy (6 cases), ileo-ascending colectomy (6 cases), diverticulectomy (2 cases), segmental resection of transverse colon (1 case), left hemicolectomy (1 case), appendectomy (2 cases), appendectomy with drainage (3 cases), appendectomy with drainage and diverticulectomy (3 cases). The postoperative complication was wound infection in all complicated cases. There was no postoperative mortality. CONCLUSIONS: The outcome of patients in our series is satisfactory despite of diagnostic inaccuracies. Preoperative barium study is recommended in those above the 40 years of age suspected the appendicitis. We recommend surgery for patients after two or three episodes of acute diverticulitis that resolves after medical treatment with antibiotics.
Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Barium ; Chungcheongnam-do ; Colectomy ; Colon* ; Colon, Transverse ; Diagnosis ; Diverticulitis ; Diverticulosis, Colonic ; Diverticulum ; Drainage ; Enema ; Humans ; Incidence ; Mortality ; Postoperative Complications ; Wound Infection