Supracondylar fracture of the humerus is the most common fracture about the elbow in children, and frequently accompanies neurovascular complications. It is one of the most difficult to manage and is frequently associated with significant residual complications. In the treatment of supracondylar fracture of the humerus, prompt and accurate reduction without additional trauma is mandatory. 114 patients with supracondylar fracture of the humerus who were admitted and treated at the Department of Orthopedic Surgery of Hanyang University Hospital from May, 1972 to May, 1981 have been reviewed. The results obtained are as follows: 1. Supracondylar fractures of the humerus frequently occurred between the ages of 5 and 12 years (77.2%), and the sex ratio was 2.5:1 in male to female. 2. Of all fractures, 96.5% were the extension type and 3.5% were the flexion type. According to the Holmberg classification, type IV fractures were most common. 3. In the injuries associated with fracture, there were 6 ipsilateral forearm fractures, 6 neural injuries, 4 vascular injuries, and 2 neurovascular injuries. In 8 traumatic neuropathies, median nerve was involved most commonly, and they were recovered spontaneously within 6 week except 1 case, which was repaired surgically. 4. Most cases were treated successfully by early manipulative reduction, but in the presence of neurovascuiar signs and symptoms, continuous traction or open reduction was indicated. 5. The result of treatment of the conservative treatment group was better than that of the operative treatment group.
Child ; Classification ; Clinical Study ; Elbow ; Female ; Forearm ; Humans ; Humerus ; Male ; Median Neuropathy ; Orthopedics ; Sex Ratio ; Traction ; Vascular System Injuries

A clinical study including physical examination, electromyographic and roentgenological studies of the 2. Taekwondoists hands who mainly practiced the object-breaking maneuver with a hand who were cared at the department of orthopedic surgery, Hanyang University Hospital from November 1, 1981 to January 31, 1982, The results of the survey were as follows. 1. The average age of the athletes was 26.7 years, the average Taekwondo-practicing career was 9.7 years, the average object breaking career was 6.4 years, and the startmg age of breaking was 20.1 years in average. 2. The main parts of the hand for the breaking were Joomeok(fist) and Sonnal (ulnar edge of the palm; hand knife). 3. Bricks and tiles were commonly used as materials for breaking. Seventeen(74%) athletes could break 1 to 2 layers brick blocks, and twenty(87%) could break the 10 to 15 layers roof-tile blocks. 4. Twelve (52.1%) athletes got injuries during breaking practice. The most common injury was metacarpal fracture (7/14, 58.5%), dislocation (2/14, 16.7'lo), subluxation, sprain, and contusion (1 each/14, 8.3%) were less frequent. 5. The thickness of the knuckle pad varied from 2 to 3.9mm in 16/23 (69.5%). The average grasping power of the athletes was 97.6 1bs, and it was stronger than normal person by 9.3 lbs. 6. The electromyographic study showed no isgnificant difference in nerve conduction velocity between the af- fected and unaffected hands, which was within the normal range. It was found that the muscle primarily used was flexor digitorum profundus. 7. In the roentgenological study, the length of the second metacarpal on the affected side was the same or 0 tc 2mm shorter than the unaffected side, and when the athlete was in the growth period, the metacarpal short ness was more marked. 8. Roentgenologically no hypertrophy of the metacarpal and phalangeal bones noted.
Athletes ; Clinical Study ; Contusions ; Dislocations ; Hand Strength ; Hand ; Humans ; Hypertrophy ; Neural Conduction ; Orthopedics ; Physical Examination ; Reference Values ; Sprains and Strains

No abstract available in English.
Clinical Study ; Shoulder Fractures

Thumb reconstruction with a free neurovasculsr wrap around flap from the great toe by microsurgery had been first reported by O'Brien, Macleod and Morrison in 1980. We have performed one case of thumb reconstruction with psrtial first metstarsus for loss of thumb except pulp and one digital vessel by microsurgery. The results were summerized as followings ; 1. This one stage procedure has the unique advantage to reconstruct a thumb almost identical to the origin. 2. This technique allows preservstion of the toe and the secondary defect results in no significant morbidity.
Free Tissue Flaps ; Microsurgery ; Thumb ; Toes

This report describes the pathologic features of 17 cases of Castleman's disease, examined at the Department of Pathology, Seoul National University Hospital during a period from 1973 to 1989. The lesions in 12 cases were hyaline-vascular type and the remainders plasma cell type. The pathologic features favoring the plasma cell type over the hyaline vascular type included a sufficient number to large-sized follicles. However, a histologic overlapping between two types was present. In the hyaline vascular type the age of the patients ranged from 7 to 76 years and they appeared to be no particular sex predominence. The majority of the lesions occurred in the neck and within the chest. Almost all cases presented with a solitary mass except three cases. Neither conventional symptoms nor systemic manifestations were associated. The plasma cell type was characterized by presentation of constitutional symptoms, involvement of intra abdominal and inguinal lymphnodes, in association with unusual clinicopathologic features including IgA nephropathy, diabetes mellitus, systemic progressive sclerosis, peripheral neuropathy, and anemia. Immunohistochemical study was performed in three cases of the plasma cell type. Two cases revealed poly-clonal plasma cell infiltration. In a patient with IgA nephropathy, however, serum IgA was increase and a strong immunoreactivity to IgA heavy chain was found. Another case, associated with systemic progressive sclerosis and neuropathy, revealed monoclonal plasma cell infiltration (IgG and lambda light chain). The above results support a possibility that in some of the plasma cell type an altered immune mechanism is involved in its pathogenesis.

Although the reported number of malignant lymphoma of the thyroid has been increased, primary malignant lymphoma of the thyroid associated with chronic lymphocytic thyroiditis has been sporadically reported since its first description by Graham in 1931. The apparent coexistence of these two conditions has undoubtedly been noted by other observers. And they suggested that malignant lymphoma of the thyroid might arise from the lymphoid tissue ina wide variety of preexisting thyroidal disease. This report was made to record a case of primary thyroid lymphoma recently seen in this department with special emphasis on the associated thyroiditic changes in the uninvolved portion of the gland, which suggest the antecedent presence of chronic lymphocytic thyroiditis.

A total of 66 cases of thymoma(57 surgically resected cases and 9 incisional biopsy cases) were reviewed with an attempt to correlate pathomorphologic features and clinical presentations. Criteria of benign or invasive thymoma were primarily determined by operative clinical and pathologic findings. Of them, 21 cases were invasive thymomas. The mean age of patients at the time of surgery was 47 years and it occurred largely in the sixth decade. Myasthenia gravis was accompanied in 29 cases(43%). One patient died during folow-up period, and five of the remainder suffered from recurrence. Microscopically, mixed type was the most common one(33 cases), being followed by predominantly epithelial type(17 cases) and predominantly lymphocytic type(16 cases). Thirty four cases of thymomas were cortical type, 29 mixed type, and the remaining 3 medullary type. None of the histologic type were significantly correlated with tumor invasiveness, Myasthenia gravis was more frequently associated with mixed and cortical type, respectively.
Biopsy

The congenital dislocation of the hip is one of the most common congenital disease of the infants. The diagnosis and treatment of comgemital dislocation of the hip has been developcd since Lorenz published the methods of the closed reduction and immobilization in 1895. By replacing the displaced femoral head in the acetabular socket in early time, the normal development of acetabulum and femoral head were expected. So the early diagnosis and treatment were very important for good results. The authors studied 19 cases of 18 patients of congenital dislocation of the hip at the Department of Orthopedic Surgery of Hanyang University Hospital from June, 1972 to June, 1977. As results of this study, the following concolusion were result reached: 1. The proponderance of girl to boy was 13: 5. 2. The ratio of left side to right was 12:7. 3. The chief complaints were shortening of lower extremity, limitation of hip motion(esp. abduction) below 1 year old age and limping in over 1 year old age. 4. The associated congenital anomaly was abserved in a case of internal tibial torsion and metatarsus varus deformity. 5. In birth history, there was 1 case of breech presentation. 6. The acetabular index was much decreased in involved hip than the sound hip in treatment. 7. The arthrogram was valuable to detect any obstacles of closed reduction. 8. In 16 cases of 15 patients, 13 cases were treated by closed reduction, 1 case was open reduction, 1 case was derotation osteotomy, 1 case was varus and derotation osteotomy. 9. The results of treatment was Excellent:8 Good:8.
Acetabulum ; Breech Presentation ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Early Diagnosis ; Female ; Head ; Hip ; Humans ; Immobilization ; Infant ; Lower Extremity ; Male ; Metatarsus ; Orthopedics ; Osteotomy ; Pregnancy ; Reproductive History

It has been well known that the knee joint is burdened on motion and weight bearing and structurally, it is more frequently injuried than other joints. Injuries to the ligaments of the knee joint are of frequent occurrence because of the increasing traffics and popularity of sports. It seems to be impotant to study on the mechanism of Injury, method of physical examination and treatment of the Iigamentous injuries of the knee. The purpose of this paper is to get accurate diagnosis and proper treatment. 68 cases of ligamentous injuries in 65 patients who were admitted and treated at the Department of Orthopaedic Surgery of Hanyang University Hospital from May, 1975 to April, 1979 have been reviewed. The results of this study were as follows: 1. The ligamentous injuries of the knee were more prevalent in male 4.9 times than female; and frequently occured in 20 to 30 decades (60%). 2. Traffic accident was the most common cause, and the most frequent injury associated with the ligament injuries of the knee was fracture. 3. Medial collateral ligament was ruptured most frequently and its tibial attachement was the most common site of the rupture. 4. Frequently, lateral collateral ligament was detached from the fibular attachment, anterior and posterior cruciate ligaments were ruptured through their substances. 5. There were 3 cases of isolated cruciated ligament injury, one was anterior and others were posterior. 6. Excellent or good result was obtained in 77.3% by operative treatment and in 93.3% by nonoperative treatment. 7. Early repair (under two weeks) gave much better results than late repair.
Accidents, Traffic ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Male ; Methods ; Physical Examination ; Posterior Cruciate Ligament ; Rupture ; Sports ; Weight-Bearing

The increased incidence of the trochanteric fracture of the femur was accompanied by the development of the vehicle and the prolongation of the average life-span. Recently it has been also increased in an active person from thirties to forties. 87 cases of the trochanteric fracture of the femur in 86 patients who have been admitted and treated at the Department of Orthopedic Surgery of Hanyang University Hospital during 8 years and 10 months, from May, 1972 to February, 1981, were reviewed. The results of this study were as follows: 1. The trochanteric fracture of the femur was more common in male and was frequent in a person who was from thirties to forties and who had vigorous social activity. 2. An injury from traffic accident was the most common cause of the fracture from thirties to forties and an injury from slip down was most common in seventies. 3. The unstable fracture which was classified by Evans' classification, Boyd and Griffin Type II Fx. and Tronzo Type III Fx. were most common in the intertrochanteric fracture and the Fielding Type II Fx. was most common in the subtrochanteric fracture of the femur. 4. Other injuries were accompanied by the trochanteric fracture of the femur in 38 patients (44.2%) and the pelvic bone fracture was the most common associated injury in these patients. 5. The weight bearing was allowed earlier in the patient who had been given the surgical Tx. than in the patient who had been given the conservative Tx. 6. In adults, there was no significant differences in the duration to achieve the bony union between the conservative treatment and surgical treatment performed. 7. We considered that the diminution of the probable complications by early weight bearing after accurate open reduction in accordance with the Type of the Fx. followed by secure internal fixation with devices is an ideal method of the Tx.
Accidents, Traffic ; Adult ; Classification ; Clinical Study ; Femur ; Hip Fractures ; Humans ; Incidence ; Male ; Methods ; Orthopedics ; Pelvic Bones ; Weight-Bearing