Supracondylar fracture of the humerus is the most common fracture about the elbow in children and much has been written about its treatment and the prevention of both Volkmann's ischemia with contracture and the nerve injuries associated with these fractures. However, it is still one of the most difficult fractures to manage and is frequently associated with significant residual complications. Among these complications, the change in carrying angle is the most common one. In a retrospective survey of 102 children with supracondylar fractures of the humerus treated at the Department of Orthopedic Surgery of Kyungpook National University Hospital, 68 cases were found to have sufficient clinical and roentgenographic data to classify the fractures and to determine the carrying angles at end result. The results are as follows: 1. The mean age of the 102 patients at the time of fracture was 7.3 years (range, 2 to 17 years), and the fractures were on the left side in 67.6%, and male comprised 70.1%. 2, Of all fractures, 98% were the extension type, and the most common direction of initial displacement of the distal fragment was postero-medial. 3. According to Arnold et al classification, fractures with moderate varus or valgus displacement were the most common types in our series. 4. In the associated injuries with fractures, there were 5 nerve palsies and 5 fractures at the other sites. 5. In our series, the carrying angle of the opposite side of the fractured elbow ranged from 2 to 23 degrees of valgus angulation, with a mean of 9.2 degrees. 6. The decrease in carrying angle was most common in fractures with postero-medial displacement. 7, As far as the position of immobilization after reduction of the fracture is concerned, there was less tendency of decreasing the carrying angle in pronated group. 8. Most cases were treated by conservative method. There was no significant difference in change of carrying angle between the cases treated by closed reduction and those by skeletal traction.
Child ; Classification ; Clinical Study ; Contracture ; Elbow ; Gyeongsangbuk-do ; Humans ; Humerus ; Immobilization ; Ischemia ; Male ; Methods ; Orthopedics ; Paralysis ; Retrospective Studies ; Traction

Flexor tendon grafting is a well-proved procedure for the restoration of tendon defects in the hand. The results are not entirely predictable, it offers a good expectation of successful outcome. Authors have performed the tendon graft in thirteen cases of flexor tendon injury of the hand during the period from September '79 to January '82 and evaluated the results. The followings were the results obtained. 1. Male was eleven, female was two. Age distribution is from 4 to 38 years. 2. Injured fingers were thumb 6, index 2, middle finger 4 and little finger 1 cases. The site of the primary injury was on area of Bunnell's Zone II in all cases. 3. Time interval from tendon injury to flexor tendon graft was 6 weeks to 19 months (average 5.6 months). 4. The results of tendon grafts rated as excellent 2 cases and good 3 cases in preoperative Good group; excellent 1, good 3 and fair 1 in “Scar” group; fair 1 and 1 poor in “Joint” group; fair 1 in “Salvage” group. In the thumbs, the results were better than in the fingers. 5. Degrading the postoperative results were flexion contracture in 3 cases, lack of flexion ROM in 2 cases and bowstringing in 2 cases. 6. Pinch power of the finger where tendon graft was performed was 52% of that of the opposite healthy finger. 7. As complication, bowstringing was observed in 2 cases and recurvatum deformity of the PIP joint in one case.
Age Distribution ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Hand ; Humans ; Joints ; Male ; Tendon Injuries ; Tendons ; Thumb ; Transplants

The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

Chronic osteomyelitis is refractory because of the characteristics of bone. The soft tissues of bone are surrounded by hard walls, and inflammation of the contained tissues causes circulatory disturbances which can readily read to necrosis of various parts of the bone. Since it is impractical to deliver antibiotics to the target tissue at a sufficiently high concentration by the intravenous route, local administration is considered to be essential. There are many materials for drug delivery system. Antibiotic-containing cement beads qualify as a drug delivery system. The distance to which the effective concentration of an antibiotic extends from the carrier material is of clinical importance in evaluating a drug delivery system. We evaluated the concentration of gentamicin released from gentamicin mixed bone cement in bone marrow and bactericidal activity of released gentamicin according to time. Female albino rats weighing approximately 350 grams were used. Beads were made to gentamicin mixed Palacos PMMA bone cement. Three rats in each group were killed on 1st, 3rd day and 1st, 2nd, 3rd, 4th, 5th and 6th week. Extracted bone marrow was homogenized with 5ml of phosphate buffer saline (PBS) and removed beads with 5ml of PBS were incubated for 24 hours in 37degrees C. Gentamicin concentration from bone marrow and elution fluid from removed bead was measured using TDX machine and bactericidal activity of released gentamicin was measured by bactericidal broth dilution method using Bacillus subtilis ATCC 21008. Gentamicin sulfate gave a maximum concentration within the 1st week, which gradually decreased but was still effective at 6th week. Gentamicin concentration from removed bead gave a maximum concentration at 1st day, which gradually decreased to 6th week.
Animals ; Anti-Bacterial Agents ; Bacillus subtilis ; Bone Marrow ; Drug Delivery Systems ; Female ; Gentamicins* ; Humans ; Inflammation ; Necrosis ; Osteomyelitis ; Polymethyl Methacrylate* ; Rats

We developed Extor pins for Extor external fixator, it made of stainless steel and applied it clinically to manage open fractures and chronic osteomyelitis from December, 1993 to January, 1995. The main aim of present study is to compare the mechanical strength and biocompatibillity between Extor pins and AO Schanz pins, and to determine the safety and possibility of clinical use. We performed the biomechanical test for bending, tension, and shearing of pin itself using universal testing machine (LR5OK) and pullout test in cadeveric cortical femur to determine the bone holding power. There was no significant difference between Extor and AO Schanz pin (p>0.05). Clinically, the incidence of pin site infection, pin lossening, radiological rarefaction, and pathological change were not different significantly (p>0.05). Although Extor pins are somewhat different from AO Shanz pins in material and design characteristics, we can find the safety and possibility of clinical use of Extor pins made in Korea.
External Fixators* ; Femur ; Fractures, Open ; Incidence ; Korea ; Osteomyelitis ; Stainless Steel

Injuries are serious problem common to all societies. Yet even within a single community, groups of injured persons differ as to the nature and severity of their injuries. The difficulty of adjusting for such variations has hampered scientific study of injured persons. Neverthless it is essential to take differences in severity of injury into account when comparing the morhidity & mortality of various groups for the purpose of evaluating their emergency & subsequent care. In order to provide the guidelines of mass emergency care & transportation, the authors analysed the 206 injured patients of train accident at Kyungsan, May 14th, 1981 and compared mortality with severity and body system of the injuries. The results were obtained as follows: l. Of 206 injured patients, most were young people & the ratio of male & female was about equal. 2. Extremities were the most frequently injured parts of body system & single injury was more common. 3. According to most severe injury of AIS, 78% of injured persons belonged to below AIS grade 3 and none was dead. 4. Average ISS of survival groups was 6 and that of death groups was 34. None was dead below average ISS of 15. 5. Death rate was higher for patients above 50 years of age, than that for young patients and there was no age difference in mortality for ISS of 50 and higher. 6. Majority of death group were invclved in multiple injuries and major cause of death were chest and head injuries. 7. Average ISS and age of hospital death group were less than those of DOA group. 8. The authors thought that it was necessary to estahlish Emergency Service System including training and education of both professionals and the pulic, hospital categorization, communication and transportation system for the mass emergency care.
Cause of Death ; Craniocerebral Trauma ; Education ; Emergencies ; Emergency Medical Services ; Extremities ; Female ; Gyeongsangbuk-do ; Humans ; Injury Severity Score ; Male ; Mass Casualty Incidents ; Mortality ; Multiple Trauma ; Thorax ; Transportation

Experimental osteoarthritis has been studied by various methods such as local compression of the joint, immobilization of the joint, relief of the contact and incision of the meniscus. The instability caused by the ligament injuries of the knee joints of the rabbits induced degenerative changes of the articular cartilages. After excision of the medial collateral ligament, medial meniscus and both cruciate ligament, the articular cartilages were observed serially after 1, 2, 3, 4, 6, 8, 10 and 12 weeks, grossly and microscopically. The results obtained are as follows; 1. Loss of transluscency and luster was observed even in the early group of the first week, and was followed by erosion and fissure on the articular cartilage in the groups of the third and later weeks grossly. 2. Microscopically, cluster formation of the chondrocytes on the articular cartilage was observed in the group of the first week and there was tendency of increase in its numbers and extents in the subsquent groups. Fibrillation and cleft formation was also observed in these groups. 3. Loss of metachromasia was observed in the groups of the second and subsquent weeks, but it was most prominant in the groups of the sixth and eighth weeks. 4. The tendancy of cluster formation was more prominent, compared with those of fibrillation or erosion.
Cartilage, Articular ; Chondrocytes ; Collateral Ligaments ; Immobilization ; Joints ; Knee Joint ; Knee ; Ligaments ; Menisci, Tibial ; Osteoarthritis ; Rabbits

The use of a central one-third patellar tendon as an autograft for surgical reconstruction of a c4maged cruciate ligament is common. However, recent clinical studies indicate that decreased quadriceps strength, decreased range of motion, decreased thigh circumference and patello-femoral problems can be associated with this procedure. Some of these complications may result from alterations in the structural properties of the remaining patellar tendon. The objective of this study was to examine tructural change of the remaining patellar tendon using MRI after removal of its central one-third. We evi.luated 10 patients received ACL reconstruction using autogenous central third bone-patellar tendon-bone. The mean age of the. Patient was 24 years old. The mean follow-up period was 30 months. The surgicd techn:ique was arthroscopically assisted ACL reconstruction using single incision. Only paratenon was repaired, reniaining patellar tendon defect. We checked the thickness, width, length and cross-sectional area of patellar te.ndon defect from axial MR scan. We also checked preoperative MR image of the same patient and compare, Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts ; Follow-Up Studies ; Humans* ; Ligaments ; Magnetic Resonance Imaging ; Patellar Ligament* ; Range of Motion, Articular ; Tendons ; Thigh ; Young Adult

Intrahepatic stones are frequently associated with recurrent pyogenic cholangiohepatitis and complete surgical removal of the stones is almost always difficult because of the large number of stones and associated bile duct strictures. One hundred and seventy-nine patients with retained intrahepatic stones underwent percuttaneous stone removal utilizing a preshaped angulated catheter and a Dormia basket under fluoroscopy with a combination of techniques including irrigation-suction. crushing of large stones. balloon dilatation of strictures and extracorporenal shock wave lithotripsy. The procedure was performed through a mature T-tube tract (177 patients) and a mature transhepatic tube tract (two patients). Stones were exclusively intrahepatic in 130 patients. whereas 49 patients also had stones in the common bile duct. In 91 (50.8%) of 179 patients. the stones were completely removed and in 36 (20.1%) patients most of the stones were removed. The overall success rate was 70.9% ngulation deformity. stricture of bile ducts and impacted stones were the factor most often responsible for failure, No significant complications were observed. Fluoroscopicalyy-guided percutaneous interventional procedures with a preshaped angulated catheter is an useful complementary procedure to surgery for patients with intrahepatic stones. the major benefits of an individually fitted angulated catheter are its safety and easy access to small peripheral bile ducts.
Bile Ducts ; Catheters* ; Common Bile Duct ; Congenital Abnormalities ; Constriction, Pathologic ; Dilatation ; Fluoroscopy ; Humans ; Lithotripsy ; Shock