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

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

A clinical analysis was done on forty-five patients with fracture of the femoral neck, who have been admitted and treated at our orthopedic department during the period of 6 years, from January 1975 to December 1980. The following results were obtained: Age over 60 comprised 60% of the patients. Male to female ratio revealed no significant difference, being 21 to 24. However, with advancing age, female was affected more frequently than male. The major cause of injuries were “fall or slip down” occuring in 33 patients (73.3%) and “hit by car” in 12 patients (26.7%). Of the 39 patients in whom Garden's calssification of fracture could be applied. Stage II was the most common type occuring in 29 patients (75%), followed by Stage N in 6(15.4%), and Stage 5 in 4 (10%). Of the total 45 cases, forty patients were reduced and fixed with multiple Knowles pins and two patients with Jewett nail. Three patients with neglected treatment of the fracture for over 1 to 4 months were treated with primary replacement arthroplasty of the femur in two and total hip replacement in one. Fractures were united within 3 months in 10 patients (23%), 4 to 6 months in 19 patients (45.2%), and non-union in 2 patients. Relationship between accuracy of reduction using Gardens alignment index and develepment of avascular necrosis was evaluated. Of the 27 patients with reduction in the range of 155 180 in both frontal and lateral views, 3 patients were developed avascular necrosis, and of the 9 patients with reduction of less than 155 in frontal view or greater than 180 in lateral view, 4 patients were developed avascular necrosis.
Agriculture ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Humans ; Male ; Necrosis ; Orthopedics

Twenty-six cases of fracture of the femur and tibia on the same leg in twenty-five patients were treated at the Dept. of Orthopedic Surgery, Kyungpook National University Hospital during the period of 1973 to 1979. Twenty-two patients were sustained by the motor vehicle accident. Open fractures of the femur and tibia were ten cases, and closed femur fracture and open tibia fracture were twelve cases. Concomitant Injuries were brain Injury in eight patients and hemorrhagic shock In seven patients. Eight patients were treated by internal fixation (Kuntschernall or Compression plate) on femur and by conservative treatment on tibia. Conservative treatment was done in eleven patients on both femur and tibia fracture. Five patients were amputated. Average healing time of fracture was: twenty-two weeks in femur and twenty-seven weeks in tibia. Functional end results were assessed and rated with satisfactory results In six patients and fair and poor in elght patients respectively.
Brain Injuries ; Clinical Study ; Femur ; Fractures, Open ; Gyeongsangbuk-do ; Humans ; Leg ; Motor Vehicles ; Orthopedics ; Shock, Hemorrhagic ; Tibia

Authors have treated a case of glomus tumor which was occurred in the tip of the right thumb, 34 years old female. The patient has complained of pain, tenderness, and cold sensitivity on the lateral side of the tip of the right thumb for 10 years. Reddish purple discolorarion was noticed under the nail bed. On X-ray, erosion of the lateral cortex of the distal phalanx and increased soft tissue density around the erosion was noted. Grossly, the tumor was purple in color, more deeply colored than the surrounding tissue and tumor tissue will shell out of the surrounding bone and soft tissue. Glomus tumor was confirmed by the excisional biopsy.
Biopsy ; Female ; Glomus Tumor ; Humans ; Thumb

Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy

In the past 13 years period, authors experienced 14 cases of giant cell tumor, 3 of which were treated by bone cementing after curettage. The results of various methods of treatment applied were compared and literatures surveyed. The followings were noted: 1. The most efficient method of treatment for giant cell tumor is en bloc resection. 2. The method of bone graft after curettage has such disadvantages as high recurrence rate and sequelae due to long periods of immoblization, especially for the large lesion with severe bone destruction. 3. Bone cementing after curettage seemed to be a choice in the methods of primary treatment of long bone giant cell tumor, especially useful for the tumors near the knee joint; the main advantages over other methods of treatment were considered to be technical simplicity and lack of complications.
Curettage ; Giant Cell Tumors ; Giant Cells ; Knee Joint ; Methods ; Recurrence ; Transplants

Patella position in the normal knee jolnt has been discussed by many authors such as Boon-Itt 1930, Blumensaat 1938, and Insall 1971. But measure with Boon-Itt's method was so complicated and with Blumensaat's was denied by others due to inefficacy. Insall suggested more simple and clinically applicable method that was based on the fact that patellar tendon is inelastic. Now, we measured 100 healthy Korean knee accordlng to Insall's method. The following results were obtained in the study, 1. The length of the patellar tendon is 4.45 In males, 4.08 In females, and 4.26±0.40 cm. in average. (p<0.001) 2. The length of the patella is 4.51 in males, 4.09 In females, 4.36±0.40 cm. in average. (p<0.001) 3. The length of the patellar tendon (LT) and the dlagonal length of the pattella (LP) are almost same (LT: LP is 0.99 in both males and females, 98% of normal knees are contained within the difference of +20%). Difference above this limit may mean high-riding patella. 4. Blumensaats line on the distal femur doesnt pass the lower pole of the patella but the Iine passes 1 cm. below it in average. 5. The length of the patella (LP) and of the width of the femoral condyles at Blumensaat's line (WCBL) are almost same. When LP is markedly decreased in comparison with WCBL, this case may suggest hypoplasia of the patella. 6. Height of insertion of the patellar tendon (Hl) dlffers among various indlviduals. Its length is cllnically not so significant.
Female ; Femur ; Humans ; Knee Joint ; Knee ; Male ; Methods ; Patella ; Patellar Ligament

The object of this study was to determine the physiological range of talar tilt angle of the Korean and to establish the basis for diagnosis and treatment of the lateral instability of the ankle. The anteroposterior inversion stress view of both ankles was taken in the 108 healthy Korean who had no history of ankle injury or disease. The sagittal stress films were also performed on 96 ankles (48 cases) of these to further define the physiological limits of the sagittal mobility of the normal talus. We compared these two values of normai mobility of talus to deterrnine the significance and relationship of the rwo. The results obtained were as follows: 1) Talar tilt over 10 degrees was seen in only 6 ankles (1.9%) and most of the ankles (279 ankles, 88.4%) showed a tilt less than 5 degrees. 2) Normal talar tilt angle was increased in 30 degrees plantarflexed position than in 90 degrees neutral position of ankle. In 12 cases the value was different between the right and the left; but there was no significant difference between the sexes. 3) The anterior displacement index over 200 was seen in only 5 ankles (5.2%). 4) There was gross positive inter-relationship between physiological. range of talar tilt angle and talar sagittal mobility.
Ankle ; Ankle Injuries ; Diagnosis ; Talus

There has been much dispute about the pathomechanics and the significance of the test even among the most competent surgeons in this field. Some have claimed that the posterolateral capsule must be torn to initiate the pivot shift. Some have even gone as far as to deny the importance of the anterior cruciate ligament as a main stabilizing structure of the knee. We evaluated the concept of MacIntosh in anatomical studies which were carried out at the both Pathology and Orthopedic department of Kyungpook National University, School of Medicine, Taegu Korea. Experiments have been carried out to study the etiology of anterolateral instability and the production of a pivot shift sign. In the cadaver knees and A/K amputation knees, which did not have any sign of instability or osteoarthritis, the anterior cruciate was severed by a short medial incision. We could immediately detect a pivot shift. No pivot shift resulted however when the posterolateral capsule was completely divided first and the anterior cruciate left intact, or when the medial collateral ligament and medial capsule were cut. If both the anterior cruciate and posterolateral capsule were divided the pivot shift became more prominent than after cutting the anterior cruciate alone. When the medial collateral ligament including the capsular structures was completely severed, however, the pivot shift disappeared. In summary the experiments show the following: 1. An isolated rupture of the anterior cruciate ligament or its combination with a partial tear of the medial collateral ligament may be detected with the pivot shift sign. 2. If the rupture of the medial collateral ligament is complete the pivot shift test can be negative in spite of a tear of the anterior cruciate ligament.
Amputation ; Anterior Cruciate Ligament ; Cadaver ; Collateral Ligaments ; Daegu ; Dissent and Disputes ; Gyeongsangbuk-do ; Humans ; Knee ; Korea ; Orthopedics ; Osteoarthritis ; Pathology ; Rupture ; Surgeons ; Tears