I had an opportunity to visit U.S. Naval Tissue Bank and observed tissue procurement and preservation by freeze-drying method and its clinical application while I stayed in the Naval Hospital, Bethesda in 1954. The freeze-dried tissues, especially bone graft, has shown excellent bone repair experimentally and clinically. Recently the mechanisms of osteoinduction have observed by many researchers and isolated the substance, bone morphogenetic protein, and clarified the interaction between BMP and the determined or inducible osteoprogenitor cells.
Bone Morphogenetic Proteins ; Methods ; Tissue and Organ Procurement ; Tissue Banks ; Transplants

Various devices have been introduced in the field of orthopaedic surgery for the treatment of fractures and dislocations. Widely used among these are metallic nails and pins. A rare complication is the migration of such intermal fixation devices from their original sites of insertion. Examples of migration have been shown in cases for which devices like Kirschner wire and Steinmann pin were used. Acromio-clavicular joint dislocation gives us another good example. Kuntscher nail has beenin worldwide use for the treatment of femoral shaft fractures since the original work of Kuntscher in 1940. Yet few cases were reported, for migration & Kuntscher nail. We, recently had an experience of proximal migration of a Kuntscher nail in a femoral shaft fractnre which was markedly comminuted. The case is presented here with references.
Dislocations ; Femur ; Joints

The spine can be divided into two structural columns; an anterior column consisting of vertebral bodies, discs and ligaments and a posterior column consisting of the neural arch, facet joints and interconnecting ligaments. Disruption of both anterior and posterior columns results in spinal instability. Laminectomy may produce greater spinal instability and will convert a stable injury into a unstable one. The compression that exists in these injury is anterior and therefore posterior laminectomy do little more than produce spinal instability. The technique of open reduction and Harrington rod fixation of unstable fractures improved nursing care, shortened rehabilitation and was effective in maintaining fracture reduction and promoting bony healing. Between 1978 and 1980, thirteen consecutive patient with unstable fractures and fracture-dislocations of thoracolumbar spine were treated by open reduction and spinal fusion with Harrington rod fixation at the Department of Orthopaedic Surgery of the Han Gang and Kang Nam Sacred Heart Hospitals. The following results were obtained from analysis of the cases. 1. The reduction and stability after reduction with Hsrrington instrumentation was excellent. 2. Laminectomy produced greater spinal instability. 3. Early ambulation was possible and the period of hospitalization was shortened. 4. Neurological recovery from incomplete neural deficit was good but from complete paraplegia was less effective.
Dislocations ; Early Ambulation ; Heart ; Hospitalization ; Humans ; Laminectomy ; Ligaments ; Nursing Care ; Paraplegia ; Rehabilitation ; Spinal Fusion ; Spine ; Zygapophyseal Joint

Malignant tumors arising from tendon and aponeurosis are very rare. Among those reported most have been interpreted as synovial sarcoma or fibrosarcoma until Enzinger in 1965 described a new type which he called “Clear Cell Sarcoma of Tendon and Aponeurosis”. The tumor has a uniform and distinctive clinical and morphological pattern which distinguishes it from other groups of tenosynovial tumors. The problem of its histogenesis remains, especially its relation to synovial sarcoma. In this paper, we reported one case which is believed to be “Clear Sarcoma in the thigh”.
Clothing ; Fibrosarcoma ; Sarcoma ; Sarcoma, Clear Cell ; Sarcoma, Synovial ; Tendons ; Thigh

Thirty one cases of acromioclavicular injuries were treated in both Kangnam Sacred Heart Hospital and Hangang Sacred Heart Hospital during the period from May 1974 to April 1981. Three cases were classified to type 2 injuries and twenty eight were type 3. Among 31 cases one of the type 2 injuries was treated with closed reduction followed by thoracobrachial cast and remaining thirty received surgical treatment. Twenty one cases were operated on by technique of Weaver and Dunn, 8 cases by modified Phemister method and one case by Stewart technique. Preperative and postoperative stress film were evaluated and cap the coracoclavicular distance were measured. In twelve complete dislocation the authors modified the original Weaver and Dunn procedure by taking a bone chip along with the acromial end of the coracoacromial ligament. This seemed to provide a strong bony fulcrum for the suture of the ligament to clavicle as well as promoting bone to bone union. The results of this modified procedure were excellent.
Clavicle ; Dislocations ; Heart ; Ligaments ; Methods ; Sutures

A fracture of the femoral neck in a young adult differs from the same fracture in an older patient in the following respects; 1. A relatively uncommon injury. 2. A significant difference in the severity of trauma. 3. A less satisfactory result. At the point of view, we studied the femoral neck fcartures in 15, 20- to 50-year-old patients. The aims were to analyze why these fractures occur in young adults, and what results can be expected after internal fixation. The results were as follows; 1. Common in men (3:1). 2. 80% (12/15 cases) of the fractures were caused by severe trauma. 3. The 3 cases (20%) were associated with the other fractures. 4. The factors infuencing the clinical results and complications in our study; a. Severity of trauma. b. Degree of displacement. c. Existence of posterior comminution. d. Time interval between accident and operation. 5. The multiple pinning got the more rigid fixation and diminished the rate of fixation failure. 6. All cases were achieved good to acceptable reduction. 7. Satisfactory functional results were achieved in 93.3%. 8. The rate of avascular necrosis was 15.4% (2/13 cases). It is concluded that the most of femoral neck fractures in younger patients occur because of the significant trauma. In our study, the incidence of avascular necrosis was not greater than in order patients. Therefore, to get as good a result as possible it seems important to perform the anatomical tion and rigid internal fixation with or without bone graft.
Femoral Neck Fractures ; Femur Neck ; Humans ; Incidence ; Male ; Middle Aged ; Necrosis ; Transplants ; Young Adult

In clinical practice fractures of the forearm bones are encoutered as frequently as fractures of other bones. As has been pointed out in many articles, however, the surgical anatomy of the forearm evokes problems in dealing with the diaphyseal fractures of the forearm bones not found in the treatment of diaphyseal fractures of other long bones, The authors have experienced 107 cases of diaphyseal fractures of the forearm bones during the fiveyear period from January, 1972 through December, 1976. A comparison has been made between the two groups one treated by conservative method and the other by open reduction and internal fixation. The results are as follows: 1. The time required for the healing of the fractures was shorter in the conservatively treated group. 2. Restoration of function was more satisfactory in the surgically treated group. 3. Rotational and angulatory deformities were less in the surgically treated group. 4. Forty-one fractures were internally fixed with compression plates, the union rate of which was 100%.
Congenital Abnormalities ; Forearm ; Methods

Delayed diagnosis of the compartmental syndrome and subsequent delay in performing the fasciotomy can result in needless loss of function and possible amputation of the involved extremity. Unfortunately early evidence of this syndrome is difficult to assess. A direct measurement of the tissue pressure within a closed compartment has been developed which provides physicians with reliable information for determining the need for fasciotomy. In the 27 cases of the tibia fracture, tissue pressure was measured directly by method of the needle manometer in the Department of Orthopedic Surgery, Han Kang Sung Sim Hospital from March, 1979 to August, 1979. The results were as follows: 1. The highest mean tissue pressure per hour was 28 mmHg in anterior compartment at 24 hours after trauma, and 28.4 mmHg in deep post compartment at the same hours. 2. The highest pressure measured in all cases was 38 mmHg in anterior compartment at 24 hours and 39 mmHg in deep posterior compartment at 48 hours after trauma. 3. The return of increased tissue pressure to less than 10 mmHg took 122.6 hours in anterior and 124.4 hours in deep posterior compartment. 4. Tissue pressre was higher when there was associated fibula fracture. 5. Tissue pressure was higher in displaced fractures than in undisplaced fractures. 6. Tissue pressure was higher when fracture was in its upper one-third. 7. Tissue pressure was higher in comminuted fracture than simple fracture.
Amputation ; Delayed Diagnosis ; Extremities ; Fibula ; Fractures, Comminuted ; Methods ; Needles ; Orthopedics ; Tibia

Spinal stenosis is defined as any type of narrowing of the main spinal canal, nerve canal or foramina caused by bony or sourrounding soft tissues. Its pressure symptoms are characterized by ill localized back pain, and usually bilateral chronic sciatica. During the past 80 years, the knowledge subjected to the spinal stenosis has been inproved but still many problems are remaining to be solved. Recently, the diagnosis and treatment of spinal stenosis have been facilitated due to introduction of computerized tomographic scanning apparatus. During the period of 3 years, from May 1979 to March 1982, we experienced 40 cases of spinal stenosis at Han Gang Sacred Heart Hospital and Gang Nam Sacred Heart Hospital. In study of this 40 cases clinical and radiological evaluation were made and obtained following result (25 cases of which were operated on). 1. The most common type was degenerative one (50%) 2. There were 16 males and 24 females (4:5) 3. The age distribution showed a peak incidence is the third decade (25%) 4. The most common chief complaint on admission was ill localized chronic sciatica (50%) 5. Decompressive surgery was carried on 25 cases such as; Laminectomy only (8%), Posterolateral fusion (20%), Both Laniinectomy and posterolateral fusion (72%) 6. The longest follow-up was 3 years and the shortest one was 4 months and the average was one year and four months. The outcome of follow-up were; excellent (52%), good (40%), fair (8%), poor (0%).
Age Distribution ; Back Pain ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Incidence ; Laminectomy ; Male ; Sciatica ; Spinal Canal ; Spinal Stenosis

Papineau's technique represents an excellent method of dealing with serious bone infections with significant bone and soft tissue loss. The procedure is carried out in three stages: the 1st stage is the excision of infected bone and soft tissue, stabilization of the fracture site, the 2nd stage is the cancellous bone grafting, and the 3rd stage is the skin coverage. During the period from June 1980 to September 1982, our limited experience with 14 cases has been extremely satisfactory; 1. This method is applicable to traumatic osteomyelitis and some cases in which the infection has been blood borne. 2. Successful bone grafting in the presence of infection depends upon; a. complete sequestrectomy and removal of all infected tissue b. an adequate vascular bed for the graft c. no dead space d. sufficient immobilization.
Bone Transplantation ; Immobilization ; Methods ; Osteomyelitis ; Skin ; Transplants