No abstract available in English.
Humans ; Infant ; Sarcoma, Ewing ; Scapula

Suppurative arthritis of the hip joint in infants and children is always a serious disease. In management of suppurative arthritis of the hip joint, early diagnosis and treatment is far most important. Authors had treated 22 cases with acute suppurative arthritis of the hip joint in infants and children at the Department of Orthopedic Surgery, St. Benedict Hospital during period from January 1976 to December 1982, and clinically analyzed these 22 cases. The following results were obtained: 1. The incidence of suppurative arthritis of the hip joint was higher in infants and children less than 4 years old, and male predominated by a 2.7:1 ratio. 2. Lag period to diagnosis and treatment in 3 cases was within 4 days, 6 cases within 8 days: usually lag period was long. 3. In general, leukocytosis and elevated ESR were noted, but in infants, these were not always noted. 4. Sometimes, the classic signs of fever, chills, sweats, and prostration were not seen in affected infants. 5. Causative oraganisms were isolated in diseased hip joint: positive cultures were 55%, and most ommon organism was Staphylococ'cus aureus. 6. After diagnosis, immediate arthrotomy, continuous irrigation with normal saline solution, through the irrigation tube, parenteral administration of specific antibiotics, and immobilization with Bucks extension traction were performed in all cases without serious complications. The results were acceptable. 7. Authors concluded as follows: a. Infants and young children are more likely to have poor result than older children. b. When treatment was performed beyond 4 days, more likely to have poor result. c. Associated osteomyelitis of the femoral neck increases the possibility that the patient will have a poor result.
Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Child ; Chills ; Diagnosis ; Early Diagnosis ; Femur Neck ; Fever ; Hip Joint ; Hip ; Humans ; Immobilization ; Incidence ; Infant ; Leukocytosis ; Male ; Orthopedics ; Osteomyelitis ; Sodium Chloride ; Sweat ; Traction

The veins of the lower limb are subdivided into deep veins, superficial veins, and comminucating veins. The deep veins accompany the arteries, while the superficial veins course under the superficial fascia just beneath the skin and they have great, small saphenous veins, and their tributaries. The superficial and deep veins are connected by the commincating veins, which are usually located along the intermuscular septum. There are many reports about the venous system of the lower limb in foreign countries but a few in Korea. It is considerably valuable in the vascular surgery of the lower limb and the surgical management of the varicose veins. This study deals with the Korean cadavers, the authors observed the location of the saphenofemoral junction, medial and lateral femoral circumflex veins, and deep femoral veins, and the termination modes between the superficial veins and great saphenous veins and the femoral circumflex veins to the deep femoral veins or femoral veins. The following results were: 1. Any noticeable anomalies of the femoral vein proper were not present. 2. The saphenofemoral junctions were located at 3.78±0.91cm below the inguinal ligaments, 2.22±1.18cm below the pubic tubercles, 3.99±0.99cm lateral to the pubic tubercles. 3. The termination modes of superficial veins to the great saphenous veins around the fossa ovalis were classified into 3 types, Type I: Superficial epigastric vein, superficial iliac circumflex vein, external pudendal vein emptied into the upper end of the great saphenous vein(45.1%). Type II: One or more veins among above mentioned 3 veins emptied into the lateral accessory saphenous vein (48.8%). Type III: One or more veins among above mentioned 3 veins emptied into the medial accessory saphenous vein(4.9%). One cadaver(1.2%) was not belonged to the above classification, in which above mentioned 3 veins were emptied directly into the femoral vein. 4. The termination level of deep femoral veins into the femoral veins was 8.68±1.92cm below the inguinal ligaments, 6.60±1.98cm below the pubic tubercles, 5.28±51.46cm lateral to the pubic tubercles. 5. The termination level of medial femoral circumflex veins into the femoral veins or deep femoral veins was 5.10±1.73cm below the inguinal ligaments, 3.65±1.92cm below the pubic tubercles, 4.62±1.41cm lateral to the pubic tubercles, and the termination level of the lateral femoral circumflex veins into the femoral veins or deep femoral veins was 7.00±1.48cm below the inguinal ligaments, 5. 05±1. 67 cm below the pubic tubercles, 5. 41±1.21 cm, lateral to the pubic tubercles. 6. The termination modes of femoral circumflex veins were classified into 4 types in male cadavers, Type A: Medial and lateral femoral circumflex veins emptied into the femoral vein. Type B: Medial femoral circumflex vein emptied into the femoral vein and lateral femoralcircumflex vein emptied into the deep femoral vein. Type C: Medial femoral circumflex vein emptied into the deep femoral vein and lateral femoral circumflex vein emptied into the femoral vein. Type D: Medial and lateral femoral circumflex veins emptied into the deep femoral vein. In the right sides, type A was 94.1% and type C was 5.9% while in the left sides, type A was 79.4%, type B was 5.9% and type C was 14.7%. 7. The collateral circulations were identified in 67 observations (81.7%) and venous circles were identified in 46 observations (56.1%).
Adult ; Arteries ; Cadaver ; Classification ; Collateral Circulation ; Femoral Vein ; Femur ; Humans ; Korea ; Ligaments ; Lower Extremity ; Male ; Saphenous Vein ; Skin ; Subcutaneous Tissue ; Varicose Veins ; Veins

Pseudo-Bartter syndrome is a rare medical disease of the kidney characterized by normal blood pressure, hypokalemic metabolic alkalosis, hyperreninemia and hyperaldosteronism with drug history of diuretics. We report US, CT and MRI findings of a patient with clinically proved pseudo-Bartter syndrome. The patient was a 37-year-old woman with a history of long term ingestion of the diuretics(furosemide) for 20 years. Renal US revealed hyperechoic renal medulla at both kidneys. The resistive index(RI), calculated from the duplex doppler waveform is 0.61. Unenhanced CT revealed faint high attenuation along the medulla. Tl-weighted MRI revealed indistinct corticomedullary differentiation.
Adult ; Alkalosis ; Blood Pressure ; Diuretics ; Eating ; Female ; Humans ; Hyperaldosteronism ; Kidney ; Magnetic Resonance Imaging

PURPOSE: Objective measurements of knee of flexor and extensor strength using isokinetic equipment and function after total knee arthroplasty (TKA) were evaluated until postoperative 12 months. MATERIALS AND METHODS: The control group constituted of 15 persons who were of same age and weight without knee problems. Most of the patients (70%) were operated on both knees simultaneously. The patient group consisted of constituted with 20 patients (34 cases). Isokinetic testing (Cybex) of knee flexor and extensor strength of knee and functional evaluation by HSS score was performed preoperatively and at 3, 6, 12 months postoperatively. RESULTS: The peak torque of the knee extensor and flexor muscle in the patient group was decreased by 17-41% compared to the control group. Especially, the peak torque of extensor was more decreased than flexor muscles. At postoperative 12 months, the peak-torque values of hamstring and quadriceps were able to attain the same strength levels of the preoperative knee. According to the grade of the Hospital for Special Surgery knee rating scales by Insall, 28 cases (82 %) in the patient group could obtain good result at postoperative one year. CONCLUSIONS: Exercises to increase the strength of extensor should be emphasized in the rehabilitation programs after TKA
Arthroplasty* ; Exercise ; Humans ; Knee* ; Muscle Strength* ; Muscles ; Rehabilitation ; Torque ; Weights and Measures

No abstract available.
Child* ; Humans ; Humerus*

Various kinds of spinal instrumentation have been developed for treatment of spinal disorders which are associated with instability. Recently, newly designed devices using pedicle screw were developed with advantages of short segment fixation and firm internal fixation. This is a retrospective clinical and roentgenographic study to evaluate the effectiveness of Cotrel 1. Of the 27 cases, spinal stenosis were 11, spondylolisthesis were 8, spondylolysis were 4, burst fracture were 2, metastatic bone tumor was 1, and failed back syndrome was 1 case. 2. Result of clinical evaluation by Hanley's criteria at last follow up were excellent in 7(27%), Good in 15(58% ), fair in 4(15%). (1 case of metastatic bone tumor was excluded). 3. In the cases of spondylolisthesis, we tried to reduce the displacement in 2 cases of Meyerding Grade II, and 1 case was reduced and 1 case was not reduced. In the cases of of Meyerding Grade I, no further displacement was developed. 4. The complications were observed in 10(37%)cases. A) Generalized complications were 2 cases of hematoma, 3 cases of superficial infection of wound, and 1 case of nerve root irritation. B) Failure in instrmentation were 1 case of screw breakage, 1 case of complete loss of fixation between screw and rod, and 2 cases of partial loss of fixation. 5. To prevent above mentioned complications in fixation of the instrument, the following factors are recommended: 1) Selection of the adequate length of rod. 2) Fixation of the additional implant such as security bolt when instability between screw and rod is predictable. 3) Selection of the closed head screw in the fixation of proximally sided screw if possible. 6. Cotrel-Dubousset instrument has many advantages such as rigid internal fixation, anatomical reduction, and good maintenance and also effective in reduction and maintenance of spondylolisthesis and in wide posterior decompression of spinal stenosis, but for prevention of some complications, precise use of instrument and good application of surgical technique will be needed.
Decompression ; Follow-Up Studies ; Head ; Hematoma ; Internal Fixators ; Pedicle Screws ; Retrospective Studies ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis ; Wounds and Injuries

Squamous cell carcinoma from the draining sinus of chronic osteomylitis has been recognized as a rare complication. The incidence of this complication is between 0.23% and 1.6% in cases of osteomyelitis. The cause of development of carcinoma at the site of chronic osteomyelitis is not well understood. This is a disease of middle aged men, and tibia is the most common site. Biopsy of squamous cell carcinoma which arises in the proliferating edge of the cutaneous ulcer and invades the bone, should include tissues from all sites of ulcer and bone marrow spaces. Histological diagnosis may be difficult because of preexisting metaplasia and pseudoepitheliomatous hyperplasia. Amputation at the adequate level is the treatment of choice. Four cases of squamous cell carcinoma involving tibia, metatarsal bone or calcaneus are reported with review of literatures.
Amputation ; Biopsy ; Bone Marrow ; Calcaneus ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelial Cells ; Humans ; Hyperplasia ; Incidence ; Male ; Metaplasia ; Metatarsal Bones ; Middle Aged ; Osteomyelitis ; Tibia ; Ulcer

After the discovery of penicillin by Fleming, a great improvement in the treatment of osteomyelitis was obtained and the mortality rate in the acute stage was markedly decreased. But, because of abuse of the antibiotics and resulting resistant organisms to antibiotics, the incidence of acute hematogenous osteomyelitis tends to increase recently. During the period of 6 years extending from 1979 to 1984, we have treated 45 cases of acute hematogenous osteomyelitis in children and clinical analysis was made about the causes of the development of chronic osteomyelitis with particular emphasis on the time interval from onset to treatment, and on the operative methods in the surgical treatments. The following results were obtained; 1. The incidence in males was 1.5 times greater than females. 2. Age incidence showed that it was most prevalent in the age group of 6 to 15 with 66.2% of the total cases. 3. The most common sites of the involvement was femur and tibia in orders. 4. Most of cases showed pain, local tenderness, pyrexia, loss of motion, swelling, and heat of the involved limbs. 5. Among the causative organisms, staphylococcus aureus was most prevalent one. 6. Cephalosporin, methicillin, gentamicin showed the highest sensitivity while penicillin showed marked resistancy (80%). 7. Time interval from onset to treatment was persistently an important factor in the development of chronicity. 8. Bone fenestration was the best method in the surgical treatments of acute hematogenous osteomyelitis in children. 9. Early diagnosis, adequate antibiotics, and early surgical decompression and drainage (esp. bone fenestration) were considered to be the essential part of management of acute hematogenous osteomyelitis in preventing its chronicity.
Anti-Bacterial Agents ; Child ; Decompression, Surgical ; Drainage ; Early Diagnosis ; Extremities ; Female ; Femur ; Fever ; Gentamicins ; Hot Temperature ; Humans ; Incidence ; Male ; Methicillin ; Methods ; Mortality ; Osteomyelitis ; Penicillins ; Staphylococcus aureus ; Tibia

Twenty-six cases of Colles fracture were treated with closed reduction and percutaneous K-wire fixation under C-arm field and then wrist was immobilized by sugar tong splint and then short arm splint from Jan. 1982 to Dec. 1985 at the department of orthopaedic surgery of St. Benedict hospital. A prospective study was made and evaluated under the subjective and objective criteria of Gartland and Werley, and the objective criteria of Scheck. The result of this study were as follow: 1. The incidence of Colles fracture was highest in 3rd decade(26.9%) and 7th decade(23.1%) respectively. In the 3rd decade the reason for the highest incidence was the job-related accident during the productive age and they were male patients. 2. The main cause of the injury was falling accident comprising of 53.8% and the male to female ratio was about equal. 3. Among the 26 cases treated with the percutaneous K-wire fixation, the result was satisfactory in 92.2% but was unsatisfactory in one case with severe comminuted fracture. 4. The percutaneous K-wire fixation for Colles fracture had less complication and more advantages such as the early disappearance of edema by early exercies, the early returning of range of motion of joint to normal, and the comfortable cast immobilization in neutral position of wrist. 5. The percutaneous K-wire fixation for Colles fracture was applicable to the concept that the anatomical reduction and maintenance would lead to the improvement of the joint function. 6. The percutaneous K-wire fixation for Colles fracture was indicated when neurologic sign developed after reduction of fracture by classic methord and when the exercise of joint was required in the old age. 7. When the articular surface of the radius was severely comminuted and the distal radius became severely osteoporotic, the result from the use of percutaneous K-wire fixation was also poor. In this case we considered the use of an external fixator.
Accidental Falls ; Arm ; Clinical Study ; Colles' Fracture ; Edema ; External Fixators ; Female ; Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Joints ; Male ; Neurologic Manifestations ; Prospective Studies ; Radius ; Range of Motion, Articular ; Splints ; Wrist