No abstract available.
Lacerations* ; Spine*

The anterior cruciate ligament injury is one of the most common ligament injury of the knee joint, and anterior cruciate ligament is as important structure for stabilization as a primary restraint. Noyes reported that the diagnosis of a tek of the anterior cruciate ligament was made by the original treating physician in only 6.8%. And there are many controversies in its treatment. It is certain thatearly diagnosis and treatment are th most important clue. Authors studied 48 patients of isolated anterior cruciate ligament injury who were diagnosed by same physician from Jan. 1983 to Dec. 1985 after follow ups ranging from six mnths to 4 years, average beimng one year and two months. The results were as followings: 1. The most common cause was sports injury. 2. The most common sign and symptom were hemarthrosis in acute injury and giving way in chronic injury. 3. Anterior drawer test without anesthesia had 25% of diagnostic accuracy but pivot shift test under anesthesia 95.8%. 4. 31 cases in 48 cases (64.8) had associated meniscal injury. 5. In acute torn ACL, the primajy repair was preparable but conservative treatment with arthroscopic partial menisectomy was eful in chronic case.
Anesthesia ; Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Hemarthrosis ; Humans ; Knee ; Knee Joint ; Ligaments

To observe the change in the status of stresses according to three different postural angulation of an intervertebral disc with or without nucleus pulposus, 6 specimens of a 3-dimensional photoelastic model of the spine were made of epoxy. The nucleus pulposus portion was replaced with silicon in three models, and the three were made without silicon. Through axial application of a vertical compressive load of 8 kg, the peculiar patterns of the isochromatic fringes were observed. Stresses on the intervertebral disc were analyzed according to three different postural angulations of the intervertebral disc with the nucleus pulposus and without the nucleus pulposus. The results of these study are as follow: 1. In an erect neutral posture with the nucleus pulposus, the stress concentration was much increased at the posterior portion rather than at the anterior portion. Also, the high stress was concentrated at the medial and central portion. In an erect neutral posture without the nucleus pulposus, the stress concentration was much increased at the anterior portion rather than at the posterior portion and the stress distribution seemed to be locally concentrated. 2. In a maximal flexed posture, the stress concentration was much increased at the posterior portion rather than at the anterior portion. Comparing the presence of the nucleus pulposus with the absence of the nucleus pulposus, the stress concentration was lower at the anterior portion in the presence of the nucleus pulposus than in the absence of the nucleus pulposus. However, the stress distribution at the posterior portion was nearly same in the two groups. According to the analysis of the stress distribution diagram, as a whole, the stress pattern around the disc was evenly distributed. 3. In a maximal extended posture, the higher concentration of the stress distribution at the anterior and medial portion rather than in the posterior and lateral portion was observed. The stress concentration was higher in the presence of the nucleus pulposus than in the absence of the nucleus pulposus. 4. Comparing the maximal flexed posture with the erect neutral posture, the stress concentration in the flexed posture was much decreased in the posterior portion rather than in the erect neutral posture, and an even distribution of the stress pattern in the flexed posture was observed. 5. In the presence of the nucleus pulposus, at the anterior and posterior portion, the stress concentration in the flexed posture was much decreased compared with the extended posture. In the absence of the nucleus pulposus, at the anterior and posterior portion, the stress concentration in the extended posture was much decreased compared with the flexed posture.
Intervertebral Disc* ; Posture ; Silicon ; Spine

Treatment of the olecranon fractures by prolonged immobilization often results in limited elbow motion. With the use of tension band wiring, anatomical reduction was obtainable, and only a short period of immobilization was needed. We reviewed the cases of 17 patients who underwent surgical treatment of the olecranon fracture. All patients were treated by tension band wiring. In the overall series, we were able to obtain 53 percent excellent, 30 percent good, and 18 percent fair results.
Elbow ; Humans ; Immobilization ; Olecranon Process*

Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture in itself were noted, but we have analyzed 18 femur neck fracture of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slipdown accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. Undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with preexisting disease in the same hip joint (total hip replacement).
Aged* ; Arthroplasty ; Cause of Death ; Classification ; Female ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Hemiarthroplasty ; Hip ; Hip Joint ; Humans ; Methods ; Mortality ; Necrosis ; Osteoporosis ; Preexisting Condition Coverage ; Prognosis

Insall-Burstein Posterior stabilized knee prosthesis is a variant of total condylar prosthesis. It is designed to get more wide range of flexion and stability with the transverse cam. We analyze with modified HSS knee rating score clinically and scoring system of AKS(American Knee Society) radiologically. We report the operative results in 34 cases of 25 patients whom we operated with Insall-Burstein PSP from August, 1982 to May, 1985 and the long term follow-up result of 24 cases of 16 patients, excluding three death and 7 cases of 6 patients who were lost to follow up. Follow-up period is average 11 years and 5 months. The average preoperative flexion contracture improved markedly. The average preoperative flexion arc was 95° and preoperative flexion contracture was 14°. The postoperative ROM and flexion contracture improved markedly. The average preoperative modified HSS knee rating scoring was 52 points and improved to 91 points at last follow-up. Patients with rheumatoid arthritis had progression of other joints involvement which limited the activity of daily living. At the last follow up, loosening signs were not observed radiologically but three cases of radiolucent zone were observed in the zone I, II, III, IV, VII of tibial components and zone III, VI of femoral components. There were two deep infections.
Arthritis, Rheumatoid ; Arthroplasty ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Knee Prosthesis ; Knee ; Lost to Follow-Up ; Prostheses and Implants

237 patients with Legg-Calve-Perthes disease were treated during past 12 years. Among them, a comparative study was done for 87 patients who were followed up over 2 years. They were analyzed according to Catteralls classification and divided into a group of conservative treatment and of surgical treatment. 74 patients were boys and 13 patients were girls and the ratio of boys to girls was 5.7 to 1. The mean age was about 6.9-year-old. Bilateral involvement was observed in 6 patients. According to Catterall classification. 1(1.1%) was classified as group I, 27(29.0%) as group II, and 36(38.7%) as group III, and 29(31.2%) as group IV. According to assessment by Harrison et al., satisfactory result was achieved in 63.2% of cases of conservative treatment and 34.3% of cases of operative treatment. The measurement of epiphyseal quotient and femoral head sphericity(by Mose) were considered meaningful methods for assessing the result of the treatment. The most frequent one of “Head-at-Risk” factors was lateral subluxation of femoral head. The result of treatment was not always coincided with the classification by Catterall. In bilateral involvement, the first affected hip had better prognosis than contralateral one.
Classification ; Female ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Prognosis

Since the term “facet syndrome” was introduced by Ghormley in 1933, arthropathy of the lumbar facet joint has long been recognized as an important source of low back pain, even sciatic pain. And facet joint injection has been helpful in the diagnosis and therapy for this facet syndrome. However, considering the possible complications such as infection, neurologic deficit and difficulty in locating the symptpmatic joint, and placebo effect, we have frequently doubted about clinical application of these procedures. This study is a retrospective review of 18 patients who got lumber facet joint injection for low back and leg pain with various previous indication that are not response to convential therapy for 2 months or more for therapeutic purpose. The response to facet joint injection was analyzed according to the entire spectrum of symptoms, physical findings, and X-ray findings. 13 or 15 patients with back pain with thigh or groin pain aggrevated by extension/rotation of trunk had successful response but patients with leg pain below the knee joint or pathology in the other structures in the spine got poor response. Strict diagnostic criteria through scoring system, provocation test, relief test and analysis of patient's signs and symptoms is needed to get higher degree of predictability and effectiveness of facet joint injection.
Back Pain ; Diagnosis ; Groin ; Humans ; Joints ; Knee Joint ; Leg ; Low Back Pain ; Neurologic Manifestations ; Pathology ; Placebo Effect ; Retrospective Studies ; Spine ; Thigh ; Zygapophyseal Joint

The biocompatibility of the titanium has been estabilished through various experimental studies such as cell culture toxicity test, pyrogen test, mutagen test and others. In order to confirm biocompatibility after fabrication of titanium and to clarify the difference between the bone reaction after insertion of the lathed titanium rods and the bone reaction after insertion of the finished and polished rods, both rods were implanted into the proximal femur of a rabbit. Histologic reactions in the bone were observed according to the ASTM standards at the intervals of 6 weeks, 12 weeks and 26 weeks after implantation. The result were as follows In 6 weeks after implantation of lathed titanium rods, inflammatory reactions, such as minimal degree infiltration of polymorphonuclear leukocytes and lymphocytes were observed in all cases. This was thought to be caused by surgical trauma. However, inflammatory cell infiltration was not seen after implantation of polished and finished rods in all cases. The cellular infiltration and the histologic reaction of the bone after implantation of lathed group were significantly more pronounced than those after implantation of the finished group. In 12 weekt after implantation of lathed rods, two of four cases revealed a minimal degree of cellular infiliration and histologic reaction seemed to be more pronounced in the lathed group, but they were not significant statistically.
Cell Culture Techniques ; Femur ; Lymphocytes ; Neutrophils ; Titanium* ; Toxicity Tests

No abstract available.
Intervertebral Disc*