STUDY DESIGN: This study analyzed the efficacy of the reduction and its maintenance using the posterior pedicular screw system in adult patients undergoing surgical treatment for symptomatic, isthmic spondylolisthesis. OBJECTIVE: To evaluate the effect of the reduction for lumbar isthmic spondylolisthesis in adult. SUMMARY OF LITERATURE REVIEW: If the increase of the shear force is approved as a main biomechanical feature of spondylolisthesis, reduction of the shear forces to the physiologic level must be regarded as the goal of surgical treatment. MATERIALS AND METHODS: 11 cases were treated with posterior monosegmental two point f;cation and posterolateral fusion (Group 1), 8 cases with a combined surgery of posterior monosegmental two point fixation, posterolateral fusion and anterior interbody fusion (Group 2), and 20 cases with posterior two segmental three point fixation and posterolateral fusion (Group 3). We assessed the clinical results and the radiologic objective parameters. RESULTS: The patients were followed up for more than 2 years (mean : 64 months). The satisfactory clinical results were 9 cases (81.8%) in Group 1 ,7 cases (87.5%) in Group 2 and 17 cases (85%) in Group 3. Radiologically, the efficacy of reduction and its maintenance were satisfactory results in Group 2, and the changes of the slip angle and the disc height showed that the loss of correction was greater than postoperative correction, although there were no statistical significant differences in the three groups. CONCLUSION: According to the our results, there was no significant relationship between the clinical result and the rdiological one. However, we think that the correcton of the deformity using the posterior pedicular screw system have some biomechanical advantages and seem to be recommendable for the treatment of isthmic spondylolisthesis in adults.
Adult* ; Congenital Abnormalities ; Humans ; Spondylolisthesis*

Synthetic hydroxyapatite is a safe, nontoxic, biocompatible, and osteoconductive material. Hydroxyapatite-coated implants have the property of achieving a very strong bond with living bone in a relatively short period. From March 1992 to June 1994, 140 hydroxyapatite-coated primary total hip prostheses were implanted. This study included 60 cases that could follow up minimum 3 years. At the time of mean follow up, 45 months after operation, the mean Harris hip score was 92 points. Only two patients complained of thigh pain at last follow up. On radiographic evaluation, radiolucent lines were seen around the uncoated distal part of the stem in 46 percents of the implants. No radiolucent line was observed around the coated area of the prosthesis. Cancellous condensation was seen in 95 per cents of the implants at the Gruen zone 2 and 6 area. Cortical hypertrophy was present in 32 percents. Fourteen cases had the gaps at the bone to acetabular cup interface in the immediate postoperative period. The gaps disappeared in 12 months after operation. Five implants were revised because of polyethylene wear, cup migration and periprosthetic fracture. The clinical outcome was excellent. But this result was obtained in the relatively short-term follow up. Longer-term data will be the only true test of the value of hydroxyapatite coated implant.
Acetabulum ; Arthroplasty, Replacement, Hip ; Durapatite* ; Follow-Up Studies ; Hip Prosthesis* ; Hip* ; Humans ; Hypertrophy ; Periprosthetic Fractures ; Polyethylene ; Postoperative Period ; Prostheses and Implants ; Thigh

Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.
Acetabulum ; Child ; Diagnosis ; Dislocations* ; Dronabinol ; Follow-Up Studies ; Hip Joint ; Hip* ; Humans ; Retrospective Studies

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

No abstract available.
Head* ; Neck* ; Plasmacytoma*

A new bioelectrical impedance method has been developed and evaluated. The electrodes; were made of stainless steel and electrical interfaces were created by an upright subject gripping hand electrodes and stepping onto foot electrodes. Eight tactile electrodes were in contact with surfaces of both hands and feet; thumb, palm and fingers, front sole, and rear sole. Automatic on-off switches were used to change current pathways and to measure voltage differences for target segments. Segmental body resistances and whole body resistance(RWHOLE)were measured in 60 healthy subjects. Segmental resistances of right arm(RRA), left arm(RLA), trunk(RT), right leg(RRL) and left leg(RLL)were310.0+/-61.6 omega, 316.9+/-64.6 omega, 25.1+/-3.4 omega, 236.8+/-31.2 omega and 237.6+/-30.4 omega, respectively. Individual segmental impedance indexes(Ht2/RRA, Ht2/RT, and Ht2 /RLA) were closely related to lean body mass(LBM)as measured by densitometry ranged from r=0.925 to 0.960. Ht2/(RRA+RT+RLA) predicted LBM slightly better(r=0.969) than the traditional index, Ht2/RWHOLE(r=0.964), supporting the accuracy of the segmental measurement. A multiple regression equation utilizing Ht2/RRA, Ht2/RT and Ht2/RRL predicted LBM with r=0.971. Ht2/RRA term of the regression contributed to more than 40% of the LBM prediction, indicating that lean mass of arm represented whole body LBM more closely than other body segments. The new bioimpedance method was characterized by upright posture, eight tactile electrodes, segmental measurements and utilization of electronic switches in comparison with the traditional method. The measurement with this new method was extremely reproducible, quick and easy to use.
Adipose Tissue ; Arm ; Body Composition* ; Densitometry ; Electric Impedance* ; Electrodes ; Fingers ; Foot ; Hand ; Hand Strength ; Posture ; Stainless Steel ; Thumb

A long arm deletion of chromosome 2 is very rarely reported. Particular deletion uniformly resulted in developmental delays, craniofacial changes, and occasionally resulted in microcephaly, low set ears, and hand and foot abnormalities. We experienced a case of partial monosomy 2 in a 5-months-old girl, who showed low set ears, hypertelorism, low nasal bridges, small mouth, cleft palate, inguinal hernia. Chromosome analysis on a G banding with high resolution showed a deletion of the long arm of chromosome 2. Her karyotype was designated as 46, XX, del (2) (q33q35). A brief review of the literature is also presented.
Arm ; Chromosome Aberrations ; Chromosome Deletion ; Chromosomes, Human, Pair 2 ; Cleft Palate ; Ear ; Female ; Foot ; Hand ; Hernia, Inguinal ; Humans ; Hypertelorism ; Karyotype ; Microcephaly ; Mouth

A case report of a perforated choledochal cyst with bile peritonitis occurring in a 13-month old girl is presented. The perfortion was identified on the right lateral aspect of the common bile duct. And T-tube drainage was instituted. Episodes of ascending cholangitis followed pooling of the stagnant bile in the biliary system. Reoperation was recommended but in vain.
Bile* ; Biliary Tract ; Cholangitis ; Choledochal Cyst* ; Common Bile Duct ; Drainage ; Female ; Humans ; Infant* ; Peritonitis* ; Reoperation

No abstract available.

PURPOSE: We reviewed the clinical and radiological outcomes of total hip arthroplasty and bipolar hemiarthroplasty for avascular necrosis of the femoral head. MATERIALS AND METHODS: From January 1986 to December 1989, 24 cases were treated with total hip arthroplasty and 27 cases with bipolar hemiarthroplasty for avascular necrosis of the femoral head. Clinical outcomes were assessed using Harris Hip Score. Serial radiographs of the hip were used to assess stability of the femoral component, change of the acetabular cup angle, osteolysis of acetabulum or femur, wear of polyliner and erosion of the acetabular cartilage. RESULTS: The average Harris Hip Score was 93.1 in bipolar hemiarthroplasty group and 86.8 in total hip arthroplasty group at last follow up. Femoral osteolysis was observed in 17 patients of 24 total hip arthroplasties and in 14 patients of 27 bipolar hemiarthroplasties. Acetabular osteolysis was observed in 8 cases of 24 total hip arthroplasties. Revision was undertaken 8 cases (33.3%) in the total hip arthroplasty group and 6 cases (22.2%) in the bipolar hemiarthroplasty group. The main causes of revision were wear of polyliner and severe osteolysis in the total hip arthroplasty group and erosion of the acetabular cartilage in the bipolar arthroplasty group. CONCLUSION: The main cause of failure after total hip arthroplasty for avascular necrosis of the femoral head was using a 32 mm femoral head and a polyliner less than 8mm thickness.
Acetabulum ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Cartilage ; Femur ; Follow-Up Studies ; Head* ; Hemiarthroplasty ; Hip* ; Humans ; Necrosis* ; Osteolysis