In the fractures and dislocations of the carpus, prompt and accurate diagnosis is the prime prerequisite for restoring function to this most complicated joint in the body. And then, early precise reduction and continuous maintenance of the reduced position until ligamentous and bone healing is complete provide the best chance of achieving a satisfactory restoration of function. We analysed forty five cases of fractures and dislocations of the carpus which were treated for 5 years from Jan. 1984 to Dec. 1988 at the Department of Orthopedic Surgery, College of Medicine, Hallym University. The following results were obtained; l. Of the total 45 injuries, scaphoid fractures were seen in 32(71.1%), other carpal bone fractures except scaphoid in 13 patients(28.9%), and carpal bone dislocation and fracture- dislocations in 11 patients(24.4%). 2. Carpal scaphoid fracture 1) 19 of the 32 patients(59.4%) had an associated ipsilateral upper extremity injury. 2) This fracture was common in the young male. 3) A union rate(95.6%) was achieved using a usual conservative treatment for undisplaced racture(14), operative treatment for displaced(18). 4) The mean time to radiological union for all fractures was 11.1 weeks. Old fracture by SotoHall classification took the longest time to union(18.2 weeks), subacute fracture 13 weeks, and acute fracture 9 weeks. 5) 10 cases were treated for nonunion, 5 of 10 nonunions were classified as type (50%). 2 cases showed ultimately nonunion in spite of various sorts of treatment, which belonged to waist fracture. 3. Other carpal bone fractures except scaphoid were seen in 13(15 bones) of 45 injuries, and pisiform(4) and triquetrum(4) fractures were common. 4. Carpal dislocation and fracture-dislocations were seen in 11 of the 45 injuries and dorsal transscaphoid perilunate dislocations(4) were common. These were treated by C.R. and cast immobilization or O.R. and K-wire fixation relatively good results were obtained.
Carpal Bones ; Classification ; Clinical Study ; Diagnosis ; Dislocations ; Humans ; Immobilization ; Joints ; Ligaments ; Male ; Orthopedics ; Upper Extremity

The distal tibial physes begins its closure about 18 months prior to complete cessation of the tibial growth, closing first in its midportion, then medially, and finally, laterally. So the patterns of the ankle fracture during this period would be different from those of the adult or the children before this period. During the six year period from 1983 to 1988 at the department of orthopedic surgery, college of medi-cine, Hallym University, we found and analysed 54 adolescent patients with the ankle fracture which developed before the closure of the distal tibial growth plate, which were followed up more than 1 year. The results were as follows 1. During the 6 year period of this study, the adolescent ankle fracture comprise 4.4% (54 cases) of all the ankle fractures(1158 cases). Injury occurred more often in male than in female(44 versus 10). The mean age was 13.7 years. 2. The most common cause of injury was traffic accident being in 26 cases(48.1%), the next was slip down accident in 11 cases, and the third was sports activity in 10 cases. 3. The incidence of the adoescent ankle fractures using the Salter-Harris classification revealed 20 (37%) type II, 7 (13%) type III, 5 (9.3%) type IV, and 4 (7.4%) type I and that using the Dias and Tachdjian classification revealed 14 (25.9%) Supination-Inversion, 10 (18.5%) Supination-External rotation, 7 (12.7%) Pronation-Eversion-External rotation, and 1 (1.9%) no adjustable fracture. There were 9 (16.7%) Tillaux and 9 (16.7%) triplane fractures, which were belonged to both classifications 4. The treatments performed were closed reduction and cast immobilization for 28 cases (51.9 %), open reduction and internal fixation for 20 cases (37%), and closed reduction and percutaneous pinning for 6 cases. 5. There were complications experienced in 9 cases, which were 3 premature epiphyseal closure, 3 joint surface incongruity, 2 angular deformity, and 1 leg shortening. 6. For the prevention of the complication, the treatment of the adolecsent ankle fracture should be treated like as adult fracture.
Accidents, Traffic ; Adolescent ; Adult ; Ankle Fractures ; Ankle ; Child ; Classification ; Clinical Study ; Congenital Abnormalities ; Growth Plate ; Humans ; Immobilization ; Incidence ; Joints ; Leg ; Male ; Orthopedics ; Sports

With the recent development of tumor prosthesis, limb salvage technique has attributed to the preservation of the limb function in patients with malignant bone tumors around the knee without substantial difference of local recurrence and the survival rate. From Feb., 1991 to Sep., 1992, 9 patients were treated with limb salvage operation with total knee arthroplasty due to the malignant bone tumor around the knee at Dept. of Orthopedic Surgery, Kyungpook National University Hospital. We applied the above procedure mainly to young adult whose tumor was expected to be excised wide marginally without damaging major neurovascular structures. We evaluated the functional status of all 9 patients(4 osteosarcoma, 2 chodrosarcoma, 2 malignant fibrohistiocytoma, 1 malignant giant cell tumor) to estimate the efficacy of limb salvage operation with tumor prosthesis total knee arthroplasty. Mean follow up period was 10 months. Primary tumor site was 4 in distal femur, 5 in proximal tibia and stage was 4 IIa, 5 IIb. Range of the motion of knee is maximum 0°
Arthroplasty ; Arthroplasty, Replacement, Knee ; Artificial Limbs ; Extremities ; Femur ; Follow-Up Studies ; Giant Cells ; Gyeongsangbuk-do ; Humans ; Knee ; Limb Salvage ; Methods ; Orthopedics ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Survival Rate ; Tibia ; Young Adult

No abstract available.
Ligaments* ; Posterior Cruciate Ligament* ; Prostheses and Implants*

No abstract available.
Intra-Articular Fractures* ; Tibia*

No abstract available.
Cicatrix* ; Contracture* ; Forearm* ; Hand*

No abstract available.

No abstract available.

We reviewed 90 cases of popliteal cyst in 88 patients, managed at Department of Orthopedic Surgery, Severance Hospital from January 1976 to June 1985 and the following results were obtained. 1. The average age of the 88 patients was 42 years. There were 23 males and 65 females. Of the all patients, 47 were occured in right side and 39 the left. Two patients were both sides. 2. Of the all cysts, 62 were found to be bursa between the semimembranosus and the medial head of the gastrocnemius muscles(68.8%). 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 4. Communication of the cyst with the joint was apparent in 44 cases(49%). 5. Twelve patients were recurred and associated abnormality of the knee joint was osteoarthritis. Three patients were children and they had no abnormality of the knee joint. 6. Recurrence after primary operation was rare when the stalk of the cyst had been opened.
Child ; Clinical Study ; Female ; Head ; Humans ; Joints ; Knee Joint ; Male ; Orthopedics ; Osteoarthritis ; Popliteal Cyst ; Recurrence

BACKGROUND: Propofol has a high incidence of pain with intravenous injection, and different methods have been used to minimize the incidence and severity of this pain. In this study, we have compared the effect of lidocaine pretreatment with that of ketamine pretreatment on propofol injection pain. METHODS: Ninety healthy female patients scheduled for general anesthesia were randomly divided into three groups; saline group (n=30), lidocaine group (n=30) and ketamine group (n=30). Each patient received 2 ml of pretreatment solution (normal saline, 1% lidocaine, 0.5% ketamine) via 18G angiocatheter inserted in the antecubital fossa after applying an arm tourniquet inflated to 50 mmHg. The tourniquet was released 1 minute later, followed by intravenous injection of 2.5 mg/kg of propofol. The assessment of pain was made at the induction of anesthesia and in the recovery room, and the severity of pain was classified as none, mild, moderate, severe by one observer. RESULTS: The severity and incidence of pain diminished significantly in the lidocaine group and the ketamine group compared with the saline group at the induction of anesthesia (p<0.05) and there was no significant difference between the lidocaine group and the ketamine group. We had similar results in the recovery room and one patient from the saline group and the ketamine group had no recall regarding injection pain. CONCLUSION: Intravenous ketamine pretreatment is as effective as intravenous lidocaine pretreatment in alleviating the propofol injection pain.
Anesthesia ; Anesthesia, General ; Arm ; Female ; Humans ; Incidence ; Injections, Intravenous ; Ketamine* ; Lidocaine* ; Propofol* ; Recovery Room ; Tourniquets