We reviewed the knee radiographs of 68 cases of arthroscopically-proven discoid lateral meniscus to evaluate usefulness of plain radiographs in diagnosing discoid lateral meniscus. The subject included 42 cases of complete type and 26 cases of incomplete type discoid lateral meniscus. Knee radiographs of 70 cases which had no pathology of the meniscus in knee arthroscopy were used as controls. We excluded patients who had a significant history of trauma and who were under 16 years of age or over 60 to avoid measuring radiographs of skeletally immature or degenerative knees. The absolute values and relative normalized values of specific knee dimensions such as a squared-off appearance of the lateral femoral condyle, widened femorotibial joint space, cupping of the lateral tibial plateau, obliquity of the lateral tibial plateau articular surface, high fibular head and hypoplasia of the Iateral intercondylar spine in discoid lateral meniscus and normal controls were compared. Among these dimensions, high fibular head and widened lateral tibiofemoral joint space showed statistically significant difference between the discoid lateral meniscus group and normal control group. We suggest that these findings could be useful in screening lateral discoid meniscus in plain radiographs.
Arthroscopy ; Head ; Humans ; Joints ; Knee* ; Mass Screening ; Menisci, Tibial* ; Pathology ; Spine

Fractures of the proximal humerus in children are rare and according to Neer and Horwitz, fractures of the proximal humeral epiphysis constitute 3% of all epiphyseal injury. The most frequently reported complications are humeral shortening, varus angulation, and neurovascular complications. Closed anatomic reduction in frscture of the proximsl humerus is very difficult, so reported modes of treatment have ranged from aggressive attempts at reduction to simple neglect. Twenty nine fractures of the proximal humerus in children which were treated at Seve- rance Hospital, Yonsei University, College of Medicine from July 1982 to December 1986 were snalyzed both clinically and radiologically and the following results were obtained. 1. The age of the patients in this series ranged from 3 years to 18 years and the most frequently between the age of 12 years to maturity. And the oldest age was 18 years in male and 17 years in female. 2. Among the 29 frsctures, 21 cases were involving the proximal humeral epiphysis and all the injuries were Salter-Harris type Il epiphyse14 fracture. And 8 cases were fracture through the proximal humeral metaphysis not involving epiphysis. 3. Sixteen cases(55%) hsd associated injuries and the common associated injuries were fracture of the lower extremity, and fracture of same upper extremity were 5 cases(17%). 4. The fracture were graded according to their initial displacement(Neer snd Horwitz) and grade I, 6 cases, grade II, 3 csses, grade , 5 cases and grade IV were 15 cases. 5. Eight cases of grade I and II fractures were treated by simple immobilization. And among the twenty cases of grade III and 1V fractures, 12 cases were trested by closed reduction and immobilization and 9 cases, by open reduction. 6. Regardless of displacement of fractures and modes of treatment, all cases were united between six weeks to twelve weeks with full range of motion and no pain. 7. There were two cases of K-wire loosening, two cases of transient nerve palsy and one case of varus angulation.
Child ; Clinical Study ; Epiphyses ; Female ; Humans ; Humerus ; Immobilization ; Lower Extremity ; Male ; Paralysis ; Range of Motion, Articular ; Upper Extremity

No abstract available.

The endoscopic variceal ligation(EVL) has been adopted as a new treatment for acute hemorrhage from esophageal varices that ranks the highest mortality rate in upper gastrointestinal tract bleedings. This treatment method has good effects for the urgent treatment and eradication of varices from acute variceal bleeding in repeated sessions. We enrolled 34 patients with an acute or chronic variceal bleeding episode at the time of admission in this study from Apr. 8, 1992 to June. 2, 1994. Among 34 patients, there were 31 males and 3 females, at ages between 45-66(mean: 52 years). The incidence of symptoms on admission was 10 in tarry stool, 9 in hematemesis 8 in ascites, 4 in hepatic encephalopathy and 3 in nonspecific symptoms. Varices were eradicated or reduced to grade I in 30(88.2%) of the 34 patients by 4-25 bands (mean: 10.8 bands) in 1-7 EVL sessions(mean: 3.1 sessions). After EVL, there are complicated by active bleeding in 3 patients, dysphagia in 3 patienta and transient chest discomfort in 5 patients but subsided during 24 hours. These results indicated that EVL is a safe method for treatment of bleeding from esophageal varices.
Ascites ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Incidence ; Ligation* ; Male ; Mortality ; Thorax ; Upper Gastrointestinal Tract ; Varicose Veins

No abstract available.
Humans ; Mass Screening* ; Parents* ; Psychopathology*

Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture in itself were noted, but we have analyzed 18 femur neck fracture of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slipdown accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. Undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with preexisting disease in the same hip joint (total hip replacement).
Aged* ; Arthroplasty ; Cause of Death ; Classification ; Female ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Hemiarthroplasty ; Hip ; Hip Joint ; Humans ; Methods ; Mortality ; Necrosis ; Osteoporosis ; Preexisting Condition Coverage ; Prognosis

No abstract available.
Tibia*

No abstract available.
Drainage*

The authors present a case of intussusception of the vermiform appendix with ade nocarcinoma. A 35-year-old male with lower abdominal pain and anemia was found to have an intussusception of the appendix associated with an adenocarcino-ma. The preoperative diagnosis was cecal cancer but we detected the iutussuscept-ion of the appendix with an adenocarcinoma during operation. Patient was managed with right hemicolectomy and has been followed up.
Abdominal Pain ; Adenocarcinoma* ; Adult ; Anemia ; Appendix* ; Cecal Neoplasms ; Diagnosis ; Humans ; Intussusception* ; Male

The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fraction site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analyzed these cases and out own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4.3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.
Clinical Study ; Early Ambulation ; Hospitalization ; Joints ; Muscular Atrophy ; Orthopedics ; Walking