Supracondylar fracture of the humerus is the most common fracture about the elbow in children, and frequently accompanies neurovascular complications. It is one of the most difficult to manage and is frequently associated with significant residual complications. In the treatment of supracondylar fracture of the humerus, prompt and accurate reduction without additional trauma is mandatory. 114 patients with supracondylar fracture of the humerus who were admitted and treated at the Department of Orthopedic Surgery of Hanyang University Hospital from May, 1972 to May, 1981 have been reviewed. The results obtained are as follows: 1. Supracondylar fractures of the humerus frequently occurred between the ages of 5 and 12 years (77.2%), and the sex ratio was 2.5:1 in male to female. 2. Of all fractures, 96.5% were the extension type and 3.5% were the flexion type. According to the Holmberg classification, type IV fractures were most common. 3. In the injuries associated with fracture, there were 6 ipsilateral forearm fractures, 6 neural injuries, 4 vascular injuries, and 2 neurovascular injuries. In 8 traumatic neuropathies, median nerve was involved most commonly, and they were recovered spontaneously within 6 week except 1 case, which was repaired surgically. 4. Most cases were treated successfully by early manipulative reduction, but in the presence of neurovascuiar signs and symptoms, continuous traction or open reduction was indicated. 5. The result of treatment of the conservative treatment group was better than that of the operative treatment group.
Child ; Classification ; Clinical Study ; Elbow ; Female ; Forearm ; Humans ; Humerus ; Male ; Median Neuropathy ; Orthopedics ; Sex Ratio ; Traction ; Vascular System Injuries

Thumb reconstruction with a free neurovasculsr wrap around flap from the great toe by microsurgery had been first reported by O'Brien, Macleod and Morrison in 1980. We have performed one case of thumb reconstruction with psrtial first metstarsus for loss of thumb except pulp and one digital vessel by microsurgery. The results were summerized as followings ; 1. This one stage procedure has the unique advantage to reconstruct a thumb almost identical to the origin. 2. This technique allows preservstion of the toe and the secondary defect results in no significant morbidity.
Free Tissue Flaps ; Microsurgery ; Thumb ; Toes

No abstract available in English.
Transplants

No abstract available in English.
Amputation

Although the primary repair has been recognized so far, the tendon graft is reported as a primary treatment method for tendon injury in no man's land of Bunnel, judging from the state of injured hand, the ability of operator and the environment of medical operation. The 27 cases of tendon graft that were operated for 11 years from June, 1973 to June, 1984 in the Department of Orthopedic Surgery, Hanyang University College of Medicine have been followed up for clinical study. The results were as follows: 1. The Material of this study was composed of 13 males (21 cases) and 5 females (6 cases) whose age were from 8 to 39 years old. 2. The injured fingers were classified with 3 thumbs, 6 index fingers, 7 middle fingers, 8 ring fingers and and 3 little fingers out of 27 cases and all injured parts of fingers were Zone II except that of thumb which was Zone IV of Bunnel. 6 patients were injured more than 2 fingers. 3. The duration from tendon injury to tendon graft which scattered from 1 month to 9 years and averaged out to 28.2 months is supposed to have little relation to post-operative results. 4. The post-operative results showed up 9 excellent, 7 good and 1 fair out of 17 cases in good gmup, 3 good and 6 fair out of 9 cases in cicatrix group, 1 fair out of 1 case in nerve damage group at pre-operative state. 5. The post-operative results of thumb which show up 2 excellent, 1 good out of 3 cases were most successful among those of all fingers. 6. The pre-operative state is supposed to have great relation to post-operative state judging from 94% satisfactory results of good group at pre-operative state. 7. As multiple injury makes little difference from single injury, the injured state of each hand is supposed to an important effect on post-operative results. 8. As all electric bumed injury show up fair except that of thumb, they are supposed to have unsatisfactory results.
Cicatrix ; Clinical Study ; Female ; Fingers ; Hand ; Humans ; Male ; Methods ; Multiple Trauma ; Orthopedics ; Tendon Injuries ; Tendons ; Thumb ; Transplants

Recently, there were many cases which was associated with bone defect in the limb and skin defect. We had performed vascularized osteocutaneous fibular transfer with microsurgical technique and experienced early bone union and simutsneous external wound healing. So we, authers, reviewed 12 cases of vascularized osteocutaneous fibular transfer which were performed to the extensive bone defect of the tibia and associated soft tissue injury. And the following remarkable results were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed and there was no non-union. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In the cases which the fibula were grafted to the defect after the segmental and partial excision of the tibia, in general, the partial weight bearing was able to be started from 3 months to 5 months after the operation, In the cases with segmental and complete excision of the tibia, the partial weight bearing was able to be started from 5 months to 7 month after the operation. 4. In adult, free fibula can be obtained and grafted as 20cm as long and the fibula was a good donor for extensive long bone defect as a compact bone; the skin flap with fibula can be obtained and grafted as 17 × 9cm as large in our experience. 5. In the vascularized osteocutaneous fibula transfer, the skin flap could be confirmed wheather the vascular anastomosis is patent or not as a monitor.
Adult ; Clinical Study ; Extremities ; Fibula ; Follow-Up Studies ; Humans ; Microsurgery ; Skin ; Soft Tissue Injuries ; Tibia ; Tissue Donors ; Transplants ; Weight-Bearing ; Wound Healing

Hand injuries in the industries have been steadily increasing in this country in recent years. All structures are damaged when a hand is caught in punch presses, gears or under falling objects. Irreversible loss of blood supply to the part is only real indication for primary amputation. Statistical observations were carried out on 240 patients of hand injuries who were treated at the Deparement of Orthopedic Surgery, College of Medicine, Hanyang University from May, 1972 to April, 1977 and following results were obtained. 1. The peak incidence was in the age group from 11 to 20 years in 83 cases(38.4%) and of the 226 patients, 204(85.0%) were male and 36(15.0%) were female. 2. In general, the incidence of hand injuries per year was annually increased and was much more occurred on April than other months of year. 3. The injured ratio of both hands was almost equal and main causes of hand injury were industrial accident (72.1%), traffic accident(12.9%) and electric accident(6.3%). 4 Most of hand injured patients(81.7%) arrived at our hospital within 6 hours after accidents 5. Of 240 injuries, 78(32.5%) were crushing injury with open comminuted fracture, 39(16.2%) were open fracture and 30(12.5%) were closed fracture. 6. Of injured fingers, 126(51.2%) were mondigit and the remained were polydigits. 7. The most frequency of monodigit injury was index finger(32.5%) and of polydigits injury was middle finger(28.2%) 8. In mondigit amputation, index finger were generally amputated at metacarpo-phalangeal joint and middle finger at proximal phalangeal level. 9. Of 457 injuries with facture, 213(46.6%) were treated by debridement and primary suture, and 94 (20.6%) by debridement and open reduction with Kirschner wire fixation. 10. Of 240 patients, 46 cases(19.2%) were infected and the main causative organisms were pseudomonas aeruginosa (41.3%), Staphylococcus aureus(17.3%) and Alkaligenus fecalis(10.9%).
Accidental Falls ; Accidents, Occupational ; Amputation ; Clinical Study ; Debridement ; Female ; Fingers ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hand Injuries ; Hand ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Pseudomonas aeruginosa ; Staphylococcus ; Sutures

The altered hemodynamics of arteriovenous fistul lead to overvascularization with trophic hypertrophy of a part or ulceration and tissue necrosis following local circulatory decompensation. A twenty years old female had been suffered from chronic ulcerative dermatitis on the dorsal aspect of left foot and multiple hemangioma on ber left great toe. The ligation of main communicating vessel and excision of fistula masses were performed in the surgical treatment. The ulceration on the dorsal aspect of left foot was healed completely and the size of hemangioma was reduced.
Arteriovenous Fistula ; Dermatitis ; Female ; Fistula ; Foot ; Hemangioma ; Hemodynamics ; Humans ; Hypertrophy ; Ligation ; Necrosis ; Toes ; Ulcer

A microvascular osteocutaneous free flap is totally detached from its origin and reattached at a distant site, in one stage, by the use of microvascular anastomosis to maintain its viability. The advantages of microvascular osteocutaneous free flap trsnsfer are more rapid healing, greater resistance to infection, less risk of absorption than conventional bone grafts, and shortened hospitalization. Two cases of microvascular osteocutaaeous free flap transfer were performed at the department of Orthopaedic surgery of Hanyang University Hospital, and satisfactory results were obtained.
Absorption ; Free Tissue Flaps ; Hospitalization ; Transplants

No abstract available in English.
Radionuclide Imaging ; Transplants