The incidence of trochanteric fracture of the femur is increasing, which is likely to continue for many years because of an increase in traffic accidents and the population of elderly people. The primary goal in the treatment of an elderly patient with an intertrochanteric hip fracture is to return the patient to his prefracture activity without any complication, as soon as possible. Rapid mobilization with stable internal fixation helps to prevent skin ulceration, pneumonia, urinary stasis, thromboembolic disease and other complications of confinement to bed in the elderly. Stable internal fixation depends mainly upon the fracture type and operative techniques. A clinical study of operative techniques was done in twenty three patients with trochanteric fracture of the femur who had been admitted and treated surgically at the Orthopaedic Department of W.M.B.H. during of two years from Mar. 1982 to Feb. 1984. The following are brief descriptions of the operative techniques. l. An L-shape incision and refiection of the vastus lateralis muscle provided wide exposure and facilitated anatomical reduction under direct vision. 2. The nail insertion site was selected at a slightly eccentric position anterior to rather than exactly midway from the opposite lateral cortex of the lesser trochanter. Therefore the nail could be laid rigidly between the thick anteromedial cortex and the posteromedial calcar portion. 3. The best stable position among the fracture line, the neck shaft angle and the nail plate could be obtained by the yoking procedure. It also allowed for later proximal migration of the shaft fragment and fracture impaction without impingement on the base of the barrel.
Accidents, Traffic ; Aged ; Clinical Study ; Femur ; Hip ; Humans ; Incidence ; Neck ; Pneumonia ; Quadriceps Muscle ; Skin Ulcer

BCG osteomyelitis occurs in the infants and children as complication of BCG vaccination and its occurrence is very rare. It involves the metaphysis of the long bone and its development is chiefly hematogenous spread and direct inoculation. Radiologic feature shows well demarcated, eccentrically located destruction in the metaphysis of the long bone and soft tissue swelling about the lesion but periosteal reaction was absent initially. We experienced a case of BCG osteomyelitis which occurs in the left proximal humerus in 3 month after BCG vaccination.
Child ; Humans ; Humerus ; Infant ; Mycobacterium bovis ; Osteomyelitis ; Vaccination

Supracondylar fracture of the humerus is the most common fracture of the elbow in children For period of 4 years from Jan. 1980 to Dec. 1983, 54 children with dispaced supracondylar fracture of the humerus were classified by direction of displacement of distal fragment and treated by immediate closed reduction after lateral skeletal traction. 32 cases of these were followed up for more than 6 months. The results were obtained as follows.: 1) The most common incidence (79.6%) was 5 to 12 years of age and male and female ratio was 2.4 : l. The left humerus was involved in 35 cases (64.8%). 2) Of all fracture, extension type was 96.3% and flexion type 3.7%. 3) Under the exact anteroposteier and lateral views, fractures were classified by displaced direction of distal fragment. Immediate closed reduction was done by using thick and strong periosteal hinge after lateral skeletal traction. The more accurate anatomical reduction was obtained by maintenance of reduction state and further correction during lateral skeletal traction, and complications such as VIC, loss of reduction were lessened probably. 4) For follow up study of 32 cases, final result were analized according to Mitchells classification. Excellent results were obtained 23 cases (71.9%) Good results were 8 cases (25.0%) Unsatisfactory result was 1 case (3.1 %) 5) In 2 cases of treatment failure, the brachialis muscle was buttonholed by metaphyseal spike of the proximal fragment. 6) During lateral skeletal traction, superficial infection was developed through pin tract in 4 cases. These were treated by the administration of antibiotics and there were no complication such as osteomyelitis.
Anti-Bacterial Agents ; Child ; Classification ; Elbow ; Female ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Male ; Osteomyelitis ; Traction ; Treatment Failure

Avascular necrosis of the carpal lunate (Kienbock's Disease) was first described by Peste in 1843. It's etiology is still unknown. Since Lippman, in 1949, there have been many operative treatments for this disease but they had many complications and technical difficulties. The treatment of Kienbock's disease by resection of the lunate and replacement with fascia lata through the dorsal approach is very simple in operation method and its results were satisfactory in follow up study for postop 12, 18 months. We report two cases of Kienbock's disease with brief review of literature.
Fascia Lata ; Fascia ; Follow-Up Studies ; Methods ; Necrosis ; Osteonecrosis

A major problem in the repair of the torn Achilles tendon has been providing the restoration of the anatomic continuity such that virtually normal plantar flexion power and ankle mobility result. Continuity should be restored without subsequent pain, disconfiguration, occupational limitations. If possible, postoperative complications, or tendon-rerupture should be avoided. Surgeons have long advocated the use of strips of facia and other tissues, including the plantaris tendon, to reinforce the repair of the torn Achilles tendon, The repair effected by these methods not infrequently is bulky and not too secure. Non-absorbable suture materials utilizing in the end to end anastomosis of the torn Achilles tendon cause sinus formation and discharge of suture materials. A secure method of repair for the tom Achilles tendon, which decreases sinus formation and is not bulky, should be required. The plantaris tendon, which has been used as a reinforcing material, can be utilized in the end-to-end anastomosis of the torn Achilles tendon by detaching from the muculotendinous junction. The 11 patients with the torn Achilles tendon were treated by end-to-end anastomosis using the plantaris tendon as suture material. The postoperative results were staisfactory without significant functional deficit and complication.
Achilles Tendon ; Ankle ; Humans ; Methods ; Postoperative Complications ; Surgeons ; Sutures ; Tendons

STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, of the anterolateral thigh caused by entrapment or metabolic neuropathy of the lateral femoral cutaneous nerve. Many cases of meralgia paresthetica have been presented for a century. We have experienced a case of meralgia paresthetica which was misdiagnosed as lumbar radicu- lopathy at other hospital, of a 53-year-old man who had developed painful paresthesia and dysesthe- sia of the anterolateral thigh caused by soft tissue tuberculosis of oblique abdominal muscles just proximal to the lateral inguinal ligament where the lateral femoral cutaneous nerve passes. We report a case of unilateral meralgia paresthetica secondary to soft tissue tuberculosis with review of literatures because it has not previously been reported.
Abdominal Muscles ; Humans ; Ligaments ; Middle Aged ; Paresthesia ; Thigh ; Tuberculosis*

Bone injuries of the extremities can be found in 0.2-2% of all living newborns. The most common location of the fracture was clavicle, and followed by humerus, femur in orders. Fractures of the femur are relatively rare. Authors have analyzed 9 cases of the femoral shaft fractures in the newborns, treated at Severence Hospital from January 1985 to March 1992. Seven cases were born by Cesarean section, two cases were by normal spontaneous vaginal delivery. Vertex presentation were three cases, breech presentation were five cases, and transverse presentation was one case. The mean birth weight was 2.93kg and four cases were born in prematurity. The location of fracture were seven cases in proximal shaft, one case in mid shaft, and one case in distal shaft. The type of fracture were all spiral fracture except two fractures. Five cases were treated by splint and 4 cases were treated by traction method. No further immobilization was needed for 8 cases but two weeks long leg cast after splint was applied for one case. Two cases of complication were noted. Skin necrosis developed due to the traction to the popliteal fossa and minimal anterior angulation of femora, and no functional deficit were found, but bony protrusion of proximal femora were palpated.
Birth Weight ; Breech Presentation ; Cesarean Section ; Clavicle ; Extremities ; Female ; Femur ; Humans ; Humerus ; Immobilization ; Infant, Newborn ; Leg ; Methods ; Necrosis ; Parturition ; Pregnancy ; Skin ; Splints ; Traction

Total cholesterol and triglyceride were measured in sera of 40 cases of hypertension, 22 cases of myocardial infarction, 14 cases of cerebral thrombosis, 18 cases of subarachnoidal hemorrhage and 30 cases of normal control in Chungnam national University Hospital from October 1980 to September 1981, and the results are as follows; 1) The mean serum total cholesterol and triglyceride levels in normal control group are 153.57+/-40.60mg% and 150.82+/-51.76mg%. 2) The age incidence of these diseases were highest in 6th decade. 3) Serum cholesterol levels of myocardial infarction, hypertension, cerebral thrombosis and subarachinoidal hemorrhage group were higher than that of normal control group. 4) Serum triglyceride levels of acute myocardial infarction and hypertension were significantly higher than that of normal control group, but there is only slightly increases in cerebral thrombosis and subarachinoidal hemorrhage. 5) In general, serum lipid levels are higher in cardiovascular diseases(hypertension and myocardial infarction) than cerebrovascular diseases(cerebral thrombosis and subarachnoidal hemorrhage). 6) Serum Cholesterol and triglyceride levels decreased by administration of pancreatic mucopolysacharide for 1 or 2 months. In conclusion, it seems that high serum cholesterol and triglyceride level may play and important risk factor in development of hypertension and myocardial infarction.
Cholesterol ; Chungcheongnam-do ; Hemorrhage ; Hypertension ; Incidence ; Intracranial Thrombosis ; Myocardial Infarction ; Risk Factors ; Thrombosis ; Triglycerides

Gastric stump cancer is defined as cancers that develop in the gastric remnant after the gastric resection of nonmalignant lesions or malignant lesions. The interval between gastrectomy and the detection of gastric stump cancer must be over 5 years in nonmaligant lesions and 10 years in malignant lesions. Symptoms of gastric stump cancer are not specific, so, diagnosis is often delayed. Early detection and curative operation is very important in gasric stump cancer and follow-up endoscopic examination is the most importaint diagnostic tool to detect gastric stump cancer. Recently we experienced a case of early gastric stump cancer. We report review of the literature to remind the important of gastric stump cancer and the important of follow-up endoscopic examination.
Diagnosis ; Esophagus* ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Intestines* ; Stomach*