The management of chronic skin defect over the pretibial region, sacral pressure sore and other bony protuberant area is extremely difficult due to the presence of necrotic and infected bone, avascular and infected scar tissue, dead space and anatomical sparse of available adjacent structure. The present methods of management include versatile varieties and have left much to be revised, but they often despaired of both surgeon and patient, especially due to persistent chronic osteomyelitis and recurrent ulcer. From January, 1975 to April, 1979, we have had treated 20 such cases with application of muscle flap transposition and following has been observed. 1. The cause of lesion were 11 cases of the traffic accident, 4 cases of the industrial accident, 2 cases of the falling from a height, 2 cases of the pressure sore and 1 case of the chronic osteomyelitis. And 15 cases of them were physically active young adult between 2nd decade to 4th decade. 2. The muscles used for pretibial lesion were medial head of gastrocnemius m., soieus m., flexor digitorum longus m. and peroneus brevis m. Used abductor hallucis m. for medial malleolar defect, gluteus maximus m. for sacral pressure sores and sartorius m. for exposed knee joint. 3. There existed hematoma formation in 2 cases, partial necrosis of transposed muscle in 3 cases and persistent infected sinuses in 3 cases. Other cases except the last 3 cases, which needed another surgical procedure and antibiotic therapy, were controlled without difficulty and all of them did not develope any recurrence of ulcer during the follow up duration. 4. There did not appear to be any significant long term functional residua due to loss of original function of the transposed muscle except somewhat unacceptable cosmetic result. 5. It was 2 months average for the healing cases which did not need a bone graft and 5 months average for the cases needed a bone graft.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Cicatrix ; Follow-Up Studies ; Head ; Hematoma ; Humans ; Knee Joint ; Muscles ; Necrosis ; Osteomyelitis ; Pressure Ulcer ; Recurrence ; Sacrococcygeal Region ; Skin ; Transplants ; Ulcer ; Young Adult

Cubitus varus and valgus is one of late complication of elbow fracture, and this deformity is caused usually by malunion in supracondylar fracture or epiphysial injury of the elbow joint. 40 supracondylar closed wedge osteotomies (on cubitus varus 25, cubitus valgus 15) were performed at the supracondylar level and were fixed with two K-wires or French method. The following results were obtained: 1. The frequency of deformity of cubitus varus was higher than that of cubitus valgus: cubitus varus, 25 cases and cubitus valgus, 15 cases. 2. Injury of the supracondylar of the humerus frequentry occured between the age of 6 and 15 (65%). 3. In cubitus varus the degree of deformity ranging from −11° to −30° was the most common whereas in cubitus valgus that ranging from 30° to 40°, 4. Incomplete ulnar nerve palsy was revealed in 15 postoperative cases of cubitus varus of which 3 cases were treated by anterior transposition. In all cubitus valgus, tardy ulnar nerve symptom was disappeared after correction. 5. Nerve damage could be avoid by performing the closed wedge osteotomy and upper connection combind with posterolateral incision in cubitus varus and medial incision in cubitus valgue. 6. Internal fixation associated with cross pinning with two K-wires or French method were performed and good result was obtained without complication even though older case.
Congenital Abnormalities ; Elbow ; Elbow Joint ; Humerus ; Methods ; Osteotomy ; Ulnar Nerve ; Ulnar Neuropathies

We analysed forty-six cases of femoral neck fracture treated with internal fixation and followed for more than one year at Korea University Hospital from January 1979 to June 1986 and the following results were obtained. 1. Sex distribution was 23 cases(50%) male and 23 cases(50%) female, and average age was sixty years old (range from 21 to 91 years). 2. The most common cause of injury was slip down(76%). 3. The most common type of fracture was Garden's type III(46%) and Pauwels' type III (67%). 4. In cases of internal fixation, the most commonly used method was closed reduction and multiple pinning under the local aneshtesia(83%). 5. Bony union was established within 5.9 months in average. 6. Among forty six cases, 7 cases(15%) of avascular necrosis, 4 cases(9%) of malunion, and 2 cases(4%) of nonunion was occurred. 7. The clinical results were excellent in twenty cases(43%), good in sixteen cases(35%), fair in seven cases(15%), and poor in three cases(7%) according to Lunceford's assessment.
Clinical Study ; Female ; Femoral Neck Fractures ; Femur Neck ; Humans ; Korea ; Male ; Methods ; Necrosis ; Sex Distribution

The Enchondroma is a benign cartilage forming harmartoma arising chiefly from short tubular bones on hands and feet. If on a long tubular bone or flat bone such as femur or ilium, it is most likely to be a true neoplasm such as chondrosarcoma, not a harmartoma. A case of enchondroma was reported. It occurred over right ischium of 19 years old male and was found incidentally by roentgenogram. The lesion was biopsied and diagnos's was confirmed by histologic examination. It was treated by curretage with filling of cavity with bone chips. Post operative-course was uneventful.
Cartilage ; Chondroma ; Chondrosarcoma ; Femur ; Foot ; Hand ; Humans ; Ilium ; Ischium ; Male

Subcutaneous angiolymphoid hyperplasia is an uncommon disease characterized by eosinophilia, proliferation of the capillary vessels and lymphoid tissue and infiltration of the inflammatory cell, especially eosinophils. The etiology of the disease are obscure, but probably trauma, lower grade infection, nervous factor & hormonal status etc. The predilection sites are face, ears, scalf & neck, but rarely reported in the extremities. We experienced a case of subcutaneous angiolymphoid hyperplasia of the inguinal region and anteromedial side of the proximal thigh in a 10 year-old man who complained pain and tenderness on the above region. The patient was treated by excision with satisfactory result.
Capillaries ; Ear ; Eosinophilia ; Eosinophils ; Extremities ; Humans ; Hyperplasia ; Lymphoid Tissue ; Neck ; Thigh

Malignant lymphoma of the bone is a rare, but involves the shaft or metaphysis of the bone, producing destruction, frequently pelvis, spine, skull and femur. Most of the patients are over thirty years old and equal sex distribution. The authors experienced one case of lymphoma involving the left ilium.
Femur ; Humans ; Ilium ; Lymphoma ; Pelvis ; Sex Distribution ; Skull ; Spine

In femorsl neck fracture, viability of the femoral head depends on the revascularization of the femoral head. The purpose of this study is to observe the effect of early fixation and anatomical reduction by measuring the Tc-99m-MDP uptake ratio of the femoral head in experimental animsls. Femoral neck region of 20 mature rabbits were osteotomized completely and divided into 2 groups ; each group consisted of 10 rsbbits. Group 1 had two Kirschner wire fixation after osteotomy and anatomic reduction. Group 2 had no fixation after osteotomy. The uptake ratio of Tc-99m-MDP of the femoral head in each group were measured st the intervals of 24 hours, 48 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks, respectively. The results obtained were as follows ; 1. In experimental group 1, the mean uptake ratio of the femoral head was 0.72±0.13 at 1 day after operation, increased to a level of 1.44±0.14 at 1 week, increased to a maximal value of 2. 90±0.36 at 3 weeks and decreased to a level of 1.10+0.12 at 4 weeks. 2. In experimental group 2, the mean uptake ratio of the femoral head was 0.70±0.10 at 1 day, 0.64±0.13 at 1 week, decreased to a maximal value of 0.33±0.05 at 3 weeks and 0.47±0.05 at 4 weeks, showing decreased level below 1.0. The results suggest that early anatomicsl reduction and rigid fixation of femoral neck fracture is helpful for revascularization of the femoral head and prevention of non union.
Femoral Neck Fractures ; Femur Neck ; Head ; Neck ; Osteotomy ; Rabbits

The fibrous dysplasia, divided into 3 categories of the monostotic, polyostotic and extraskeletal forms, is a relatively rare disease which was first reported by Well in 1922 and shows a characteristic findings replacing the medullary cavity of noe or more bones by the pathologically proliferating fibrous connective tissues. In a consequence, the structural integrity of the diseased bone becomes weakened and suffers frequent episodes of pathologic fracture and deformities of the bone, which are most common around the hip. Various operative methods and instruments have been tried to manage the pathologic fracture around the hip recently. The authors report a satisfactory resnlt of total hip replacement for the pathologic fracture in a patient of the fibrous dysplasia involving the proximal half of the right femur.
Arthroplasty, Replacement, Hip ; Congenital Abnormalities ; Connective Tissue ; Femur ; Fractures, Spontaneous ; Hip ; Humans ; Rare Diseases

The authors had experienced 24 cases of aeromioclavicular dislocation from 1980 to 1988 at Korea university Haehwa hospital with at least 6 months follow up. They were treated by modified Phemister method. Ther were twenty-three males and one female. The ages ranged from eighteen to fifty-eight, the average was 31.6 years. The following results were obtained. 1. The most common cause of injuries was sports injury, followed by fall down and traffic accident. 2. There were twenty-two type III and type IV according to Rockwood and Green classification. 3. Duration between injury and operation were less than 1 week in 21 cases, between 1 to 2 weeks in 2 cases and more than 2 weeks in 1 case. 4. Clinical results according to Ejeskar classification were excellent in 16 cases(66.7%), good in 6 cases(25%), and acceptable in 2 cases(8.3%). 5. There were five complications : two K-wire breakage, two recurrent dislocation and one lateral end fracture of right clavicle.
Accidents, Traffic ; Athletic Injuries ; Classification ; Clavicle ; Clinical Study ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Methods

No abstract available.
Muscle, Smooth* ; Relaxation*