The management of subtrochanteric fracture of the femur is one of the most difficult problems. Subtrochanteric area is predominantly composed of cortical bone and highly concentrating portion of stress. So, there is high incidence of Complication after treatment of subtrochanteric fractures. The results were as follows :l. Of 56 cases, 45 occurred in male, 11 in female. 2. The fractures occured mainly between 20 to 40 years of age(55.4%) and mean age was 41.4 years. 3. The most common cause of fracture was traffic accident.(67.9%) 4. According to the Seinsheimer classification, 16 cases were type IIb(most common), 13 type IIIa and 9 type IIIb. 5. 49 cases with treated wutg open reduction and internal fixation and 7 cases conservatively. 6. The average weight bearing time was 14.0 weeks; 13 weeks in operatively treated group and 18.3 week in conservative group. 7. Radiological union was obtained in average 25.1 weeks ; shortest group was type IIc(16 weeks) and longest group was type IV(30 weeks). 8. Complication were as follows; 8 cases of delayed union, 3 nonunion, 4 metallic failures, 7 varus deformities and 1 nail migration. 9. In the cases treated by Judet plate or compression hip screw, there was no complications and relatively short duration of bony union than other implants. So, they are one of the good implant for the treatment of subtrochanteric fracture of the femur.
Classification ; Congenital Abnormalities ; Female ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Male ; Weight-Bearing

The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

Usually, fractures of the humerus can be expected to unite. Circumstances often predisposing to nonunion are open reduction and internal fixation, infection, soft tissue interposition between fracture fragments and inadequate external immobilization. The effectiveness of various methods of treatment and the complication was discussed. The best results are achieved in cases treated by compression plates and iliac bone graft. Total 21 cases of nonunion of shaft of humeral fractures from Jan., 1980 to Dec., 1986 were treated at the Department of Orthopedic Surgery of Soon Chun Hyang University Hospital. The results were as follows ; 1. Incidence of nonunion of humerus shaft among the 270 cases has 7.8%; rates of non-union was 5.4% with nonoperative treatment of fractures of humeral shaft and 10.5% with operative methods. 2. Of 21 cases, male between 20–40th age group was predominant and mean age was 36 years. The cases of fracture was mainly due to the car and machinary accident. 3. Prevalent type and site was lower 2/3 transverse fractures. 4. There were associated injuries in ipsilateral upper extremity in 12(52%) patients. 5. The probable causes of nonunion were complex; 9 of inadequate internal fixation and fixation metal failure, 7 cases of poor external fixation, 3 cases of soft tissue interpostion between fracture fragments and 2 cases of infection. 6. The treatment performed were somewhat variable to include open reduction and plate (DCP) fixation for 18 cases, open reduction and circlage wiring for 2 cases and open reduction and screw fixation for 1 cases. All were supplemented with autogenous iliac bone graft. 7. Postoperative immobilization was done with shoulder spica cast, abduction splint and long arm cast for average 6.5 weeks. 8. All were united at average 4.7 months. Transient radial nerve palsy in 2 cases, and limitation of motion of shoulder and elbow iri 2 cases, which required considerable time of physical therapy, but postoperative infection was none.
Adult ; Arm ; Clinical Study ; Elbow ; Humans ; Humeral Fractures ; Humerus ; Immobilization ; Incidence ; Male ; Orthopedics ; Paralysis ; Radial Nerve ; Shoulder ; Soft Tissue Infections ; Splints ; Transplants ; Upper Extremity

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

A clinical application of the arthroscopy to the three hundred symptomatic knees were performed, and seven knees with a symptomatic seprated suprapatellar bursa were successfully managed and followed by arthroscopic surgery at the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from May 1983 to May 1985. The results obtained are as follows; 1. Separated suprapatellar bursa may cause some internal derangement of the knee. 2. The incidence of the separated suprapatella bursa in our view was 5% that is, of 300 symptomatic knees. 3. Separated suprapatellar bursa may have to be excised under arthroscopy.
Arthroscopy ; Incidence ; Knee

The primary aims of fracture treatment include the restoration of normal anatomy and a return of function to the injuried as early as possible. In pilon fracture, various methods of treatment were developed to accomplish this purpose. Fibular fixstion is a rarely accepted mehtod in the treatment of pilon fractures because it can't provide rigid internal fixation, But it might be indicated when an open wound was : present medially over the distal tibia, the ligamentous attachments of distal fibula and medial malleolus to talus and calcaneus and of the distal tibiofibular syndesmosis are largely intict. Utilizing these attachment, Fibular fixation can stabilize comminuted fractures of distal tibia affecting ankle joint. This procedure is so effective and simple The author has used this technique in three instances for two years with excellent results. This is not an original method, but worthy of being remindful of the literature.
Ankle Joint ; Ankle ; Calcaneus ; Fibula ; Fractures, Comminuted ; Ligaments ; Methods ; Talus ; Tibia ; Tibial Fractures ; Wounds and Injuries

Ganglion cysts of the cruciate ligament are quite rare. Ganglion cysts on the anterior cruciate ligament(ACL) should be suspected in any patient having pain and clicking sensation during terminal knee extension. A few cases have been reported concerning ganglion cysts present on the surface of the anterior cruciate ligament. We report three cases of a ganglion cysts on the ACL that was treated with arthroscopic excision.
Anterior Cruciate Ligament ; Ganglion Cysts ; Humans ; Knee ; Ligaments ; Sensation

The medial collateral ligament is the most commonly injured ligamentous structure of the knee and it has been demonstrated that this ligament is the prime static stabilizer of the medial side of the knee joint. The management of the medial collateral ligament injuries were divided into surgical and conservative treatment. Many investigators reported consistently good to excellent results following surgical treatment. More recently, other investigators reported that isolated medial collateral ligament injuries did equally well under non-operative as operative treatment. For accurate diagnosis, arthroscopic examination of the knee to rule out other intraarticular pathologic conditions such as cruciate ligament injuries, maniscal tears and bony injuries is essential. From October 1988 to January 1991, we treated 76 cases of isolated medial collateral ligament injuries which was confirmed by diagnostic arthroscopy. Among them, we analyzed 31 cases that minimum follow-up was over 1 year and could be re-examed, 20 cases were treated with surgery and 11 cases were not. With comparision between initial and final follow-up stress X-ray, 5.45 ± 3.17mm in non-operative group had improved in medial laxity(P < 0.05). The Marshall scores which checked at final follow-up, averaged 40.3 ± 7.299 in operative and 37.364 ± 6.485 in non-operative group (P>0.05). In conclusion, medial stability was improved in operative than in non-operative group, however functional score was equally well under non-operative as operative treatment.
Arthroscopy ; Collateral Ligaments ; Diagnosis ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Ligaments ; Research Personnel ; Tears

Surgical reconstruction of the anterior cruciate ligament is undergoing constant evolution. The variable success of these procedures can be attributed to many factors including graft selection, graft placement, graft tensioning, graft remodelling and rehabilitation program. Rigid fixation is probably the most important factor in the success of these procedures during the initial stages of healing. Arthroscopically assisted reconstruction of the ACL-deficient knee using a bone-patellar tendon-bone graft(two-incision technique) is a reliable and evolving technique. Rosenberg et al, described a one-incision technique that allows endosteal fixation of bone plugs within their femoral tunnels intraarticularly via the intercondylar notch. These two techniques are different from their femoral tunnel direction and bone plug placement. The present study was designed to develop a swine model for in vitro biomechanical testing of the bone-patellar tendon-bone ACL autograft to compare the pull-out strength of Outside-In technique and Inside-Out technique. The result were as follows: 1. Normal ACL(N=10 knees) pull-out tensile strength tests showed a maximum tensile strength of 1295.34(N), a stiffness of 120.95(N/mm), and a linear load of 1104.26(N). The failure sites were all tibial attachments. 2. Femoral and Tibial interference fit pull-out tensile strength tests(N=10 knees) showed a maximum tensile strength of 463.23±42.27(N), a stiffness of 33.62±3.18(N/mm), and a linear load of 392.51±95.42(N). The failure sites were all in the tibial tunnel area(N=9 knees), except for one which femoral tunnel area. 3. Inside-Out technique(N=15 knees) showed a maximum tensile strength of 1250.64±75.67(N), a stiffness of 94.31±26.44(N/mm), and a linear load of 1046.92±367.55(N), but the Outside-In tech-nique(N=15 knees) showed a maximum tensile strength of 805.35±54.61(N), a stiffness of 83.33±10.98(N/mm), and a linear load of 685.99±86.32(N)(p < 0.0001). The failure sites were all in the femoral tunnel area. 4. Tensile testing demonstrated that the Inside-Out technique was significantlly stronger than Outside-In technique for maximum tensile strength, stiffness and a linear load.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; In Vitro Techniques ; Knee ; Rehabilitation ; Swine ; Tensile Strength ; Transplants

Ommaya reservoir implantation has been used for sterile assessment into ventricular CSF or direct chemotherapy of chronic meningitis and meningeal involvement of malignancy since 1963. We experienced two cases with chronic meningitis, one was tuberculous meningitis with obstructive hydrocephalus which was not improved by repetitive shunt and the other was cryptococcal meningitis which was not improved by traditional chemotherapy of intravenous amphotericin B and oral flucytosine. Ommaya reservoir was implanted for daily CSF drainage of intractable hydrocephalus in the first patient and for direct injection of amphotericin B into ventricle in the second patient. Both of two cases were successfully managed by the reservoir. Therefore, Ommaya reservoir could be useful in patients with chronic meningitis which are not improved by traditional management.
Amphotericin B ; Drainage ; Drug Therapy ; Flucytosine ; Humans ; Hydrocephalus ; Meningitis ; Meningitis, Cryptococcal ; Tuberculosis, Meningeal