Approximately 15% of all fractures in children involve the physis. Although the majority heal without impairment of the growth mechanism, epiphyseal growth plate fracture-seperation can lead to shortening and angulation. The physiologic events in epiphyseal growth fracture seperation that lead to growth disorders relate to 1) destruction of the epiphyseal circulation and 2) communication between the epiphyseal circulation with its osteoprogenitor cells, thus forming a bony bridge. Although the classic procedure of osreotomy, epitphysiodesis, leg shortening and leg lengthening have not lost their importance in the treatment of the sequeales of partial closure of an epiphyseal plate, the possibility of regaining growth in the affected region should be considered before other measures are taken. Simple excision of the bone bridge is ineffective, since the large cancellous surface thus produced will allow for rapid reformation of the bridge. Thus, a material has to be interposed into the defect created by removal of such a bridge in order to prevent its reformation. Langenskiold first demonstrated that a bone bridge could be effectively resected and its reformation prevented by utilizing fat as an interposition material. Other investigators have used a variety of different interposition materials to prevent bone bridge recurrence following operative removal including cartilage, Silastic, Methymethacrylate, bone wax, muscle flap, Gelfoam as well as fat. Thus it is the purpose of this study to analysis and comparing shortening and angulation by resection of a bone bridge and its replacement with different interposition materials. For this study, a total of 32 rabbits with an initial weight of about 600 to 800 gm was used. Control group comprised 4 rabbits and after appmpriate preparation, the medial condyle of the pmximal tibia was exposed surgically. One plug of bone was removed at the level of the epiphyseal plate using a small curet to a depth of 5 mm. and in the other groups, we made a defect with the same curet and filled it with an interposition material directly. The following experimental groups were created. Group 1 (N-4) Control group: no interposition material Group 2 (N-4) Gelfoam interposition material Group 3 (N-4) Bone was interposition material Group 4 (N-4) Muscle flap interposition material Group 5 (N-4) Fat interposition material Group 6 (N-4) Bone cement interposition material Group 7 (N-4) Silastic interposition material Postoperatively the anirnals were sacrificed 15wks following operation. As sacrifice, tibia including fibular is removed, examined grossly and radiographed. Tibia length and angular deformity were determined by measurement of radiographs. Specimens stained with H-E stain were observed during 15 wks after operation. Through these examination, following results were obtained. l. In control group, coronal histological sections of each curetted proxirnal tibial growth plate revealed osseous bridging as early as 3 wks, and this bridging was found consistently in all control groups for the duration of the study. 2. The groups using gel foam, muscle flap and bone wax as interposition material were found effective for the prevention of the formation of epiphyseometaphyseal bone bridge to some extent. 3. The groups using Silastic or bone cement diminished both the angular deformity and growth retradation to a highly significant degree. Although the use of fat did reduce somewhat the amount of shortening and angular deformity when used as an interposition material, it was not effective as Silastic or bone cement. 4. Coronal histological section of the traumatized, margin of the growth plate, with an interposition material revealed thin fibrous layer and lose columnar orientation, foam rounded clone-like structures and randomness to growth. The injured portion of the cartilage may originate from the regeneration of the adjacent part of the growth plate. From these morphological and radiological results, it is suggested that Silastic or bone cement is better interposition material in the elimination of trahsphyseal closure after physeal damage.
Cartilage ; Child ; Congenital Abnormalities ; Gelatin Sponge, Absorbable ; Growth Disorders ; Growth Plate ; Humans ; Leg ; Rabbits ; Recurrence ; Regeneration ; Research Personnel ; Tibia

The cases of 128 humeral fractures were evaluated at the Department of Orthopedic Surgery, Chosun University Hospital, during the six year period from January 1974 to December 1979 and the following results were obtained. 1. The high incidence of the humeral fracture was found under the age of 30 years and the sex ratio between the male and female was 3.6:1. 2. The most common causes of injuries were fallen down on the ground (36.7%) and the nexts were traffic accidents (34.4%). 3. Among the 128 cases of fractures, humeral shaft fractures were 33 cases (32%) under the age of 40 years and 47 cases (67.1%) of supracondylar fractures under the age of 20 years and 6 cases (54.5%) of neck fractures over the age of 60 years were noted. 4. The shapes of humeral fractures found out transverse fracture in 31 cases (65.9%) and the short oblique or spiral fracture in 35 cases (71.4%). 13 cases were combined with the open would to the fracture site (10.2%). 5. In the Correlation between the age and the union rate, sound union was more rapid under the age of 20 years than the aged person. Delayed unions were revealed 5 cases in transverse fractures, 2 cases in spiral fractures and 2 cases of nonunions were experienced on both segmental and transverse fracture of the shaft (1.6%). 6. The radial nerve paralysis revealed 5 cases (10%) at the shaft fracture and 2 cases (4.3%) Volkmanns ischemic contracture, 2 cases (4.3%) of cubitus varus, 2 cases (4.3%) of cubitus valgus were experienced on the complicution in there 47 cases of supracondylar fractures.
Accidents, Traffic ; Female ; Humans ; Humeral Fractures ; Humerus ; Incidence ; Ischemic Contracture ; Male ; Neck ; Orthopedics ; Paralysis ; Radial Nerve ; Sex Ratio

The incidental observation of periosteal new bone formation on long bones is common in pediatric radiology without any symptoms in extremities : for example, the humeri on chest examination and the femora on abdominal roentgenograms. The purposes of the author is to report the results of a roentgenologic study of the long bones in 100 normal infants and 100 chilren between 1 and 2 years old who had no symptoms refereble to the skeleton to determine the incidence, roentgen characteristics, pathogenesis and significance of this type of periosteal new bone. The results obtained were as follows : 1. Periosteal new bone occured in 28% in normal infants group but did not occured in children group between 1 and 2 years. 2. The site in order of decreasing frequency were femur, tibia, and humerus. 3. Periosteal new bone is always on the diaphysis and usually extended onto the metaphysis to a variable extent, but it has not been observed to reach the end of metaphysis. 4. It seems most logical that the periosteal new bone found in these infants is simply a roentgen manifestation of normal periosteal bone growth in the period of greatest activity. 5. It is not an indication for treatment unless a definite relationship with a specific disease is proven.
Bone Development ; Child ; Diaphyses ; Extremities ; Femur ; Humans ; Humerus ; Incidence ; Infant ; Logic ; Osteogenesis ; Skeleton ; Thorax ; Tibia

No abstract available.
Cartilage* ; Fetus* ; Humans* ; Osteogenesis* ; Talus*

No abstract available.
Humans* ; Membranes*

Supracondylar fracture of the humerus is the most common fracture of the elbow in children and it can also be one of the most difficult fractures to be treated. A number of methods to manage supracondylar fracture of the humerus in children, have been being practiced and the ideal one is generally agreed with prompt, accurate and anatomical. reduction performed with the least possible trauma, and, it will prevent most complications. It is essential to minimize additional trauma to the already traumatized joint and pericapsular tissues including blood vessles and nerves. 105 patients with supracondylar fracture of the humerus managed at the Department of Orthopedic Surgery, Busan National University from January, 1971 to June, 1976 were reviewed and the following results were obtained. 1. The age of the patients ranged from 2 years to 14 years; the average age was 7. 0 year. 70 patients were boys. 2. The left side was involved in 62 patients; The distal fragment was displaced posterioly in 102 patients and anteriorly in 3 patients The medial displacement in the posteriorly displaced distal fragment was 60 patients. 3. 20 fractures were treated by open reduction and internal fixation. The indications for open reduction were failure to obtain accurate reduction after a few attempts of closed reduction in 15, an open fracture in 2, acute vascular embarrassment in 2, and redisplacement after open reduction in 1. 4. 15 of the 20 fractures treated by open reduction were re-examine 1 to 5 years; The results were normal elbow motion in 10, loss of extension (average 24 degree) in 5, loss of flexion in 2 and neuro-vascular complication in 2.
Busan ; Child ; Elbow ; Fractures, Open ; Humans ; Humerus ; Joints ; Orthopedics

No abstract available.
Foot*

Venous island flap has many advantages over other flaps, such as random pattern flap, island flap or free flap. It can cover the defect with wide arc of rotation and does not require vessel anastomosis and arterial pedicle, hence more sites are available for donor. The procedure is a time saving and simple procedure and can be performed even by two operating members. But it is not frequently used because of the poor survival of the flap. In this study, we attempted to allow whether pharmacological or delay procedure can enhance the survival of the venous island flap and the mechanism of the delay flap survival. We devised a model of venous island flap whose pedicle was a branch of central vein on the auricle of Newzeland white rabbit. SOD, allopurinol and SOD and allopurinol were given as pharmacological treatment and delay procedure was carried out to enhance the survival of the flap. For the study of survival mechanism of the delay flap, SOD levels of the delay and non-delay flap were observed by SOD 525 method. The results were as follows: 1. Allopurinol, SOD and, SOD and allopurinol improved the survival of the flap significantly. 2. Delay procedure improved the survival of the flap significantly. 3. The level of SOD in delay flap was higher than that of non-delay flap regardless of the site within the flap or time passage. In conclusion, it is inferred that the administration of allopurinol and SOD and surgical delay can enhance the survival of the venous island flap. In delay venous island flap, increased level of SOD within the flap seem to contribute to the increased survival of the flap.
Allopurinol ; Free Radicals* ; Free Tissue Flaps ; Humans ; Oxygen* ; Tissue Donors ; Veins

No abstract available.
Humans ; Mucocele*

No abstract available.
Congenital Abnormalities*