No abstract available.
Anterior Cruciate Ligament* ; Autografts* ; Tendons* ; Transplants*

No abstract available.
Diskectomy*

No abstract available.
Mass Screening* ; Prospective Studies*

Double contrast arthrography has been widely accepted as a method to diagnose the internal derangement of the knee. It is a safe and technically simple procedure permitting accurate diagnosis of lesions of the menisci. In 20 cases operated upon, with the diagnosis of internal derangement of the knee, we performed double contrast arthrography before surgery. We analysed the cases concerning the diagnostic accuracy of arthrography, its clinical significance and discrepancies between arthrographic findings and postoperative lesions. The results were as follows: 1. The cases consisted of 16 cases of meniscal lesion, 4 cases of ligamentous lesion and 3 cases of loose body. 2. In the meniscal lesions, 14 of the 16 cases (87.5%) were diagnosed accurately by arthrography, Therefore arthrography was more useful in diagnosing meniscal lesions as compared with clincal symptoms (69%). 3. In cases of ligamentous lesions arthrography was not significant-ly helfpful, in contrast clinical signs afforded important clues. 4. We encountered 1 case of false positive and 1 case of false negative.
Arthrography ; Diagnosis ; Knee ; Ligaments ; Methods

After discovery of Penicillin by Fleming in 1939, a great improvement in the treatment of osteomyelitis has been made and the mortality rate in acute stage was markedly decreased. But due to misplacement of antibiotics, and the improper treatment of the osteomyelitis, the tendency to chronicity and various sequellae of the osteomyelitis are still persist. So, it will be of importance to reconsider the management of various sequellae of pyogenic osteomyelilis. We reviewed 3 cases of sepsis, 10 cases of pathologic fracture, 6 cases of sepsis, 6 cases of malignant turnor developed in an old draining sinus, 2 cases of bone defect, 3 cases of joint contracture and 4 cases of deformity and growth disturbance 604 cases of osteomyelitis treated at National Medical Center between 1972 to 1983. The results were as follows: 1. Established sepsis was noted in 3 cases, and one of these patient dead. We treat these patients with high dose of the antibiotics accompanied by decompression of the lesion. 2. Pathologic fracture developed in 10 cases, which was treated with either conservative or operative treatment. All cases obtained good union except one. 3. Spuamous cell carcinoma developed in 6 cases around the old draining sinus. All cases were treated with amputation. Theres no recurrence except one. 4. Bone defect developed in 2 cases. A case of bone defect in humeral shaft was treated with vascularized fibular graft and obtained firm union and good function. 5. Joint contracture was treated with soft tissue release and even joint fusion in severe case. The results were not gratifying. 6. Deformity and growth disturbance of limbs were treated with soft tissue release, osteotomy and stapling. Most of the cases obtained good results, but limb length discrepancy was not recovered satisfactorily.
Amputation ; Anti-Bacterial Agents ; Congenital Abnormalities ; Contracture ; Decompression ; Extremities ; Fractures, Spontaneous ; Humans ; Joints ; Mortality ; Osteomyelitis ; Osteotomy ; Penicillins ; Recurrence ; Sepsis ; Transplants

In 1974, bipolar endoprosthesis was first introduced by Bateman & Giliberty. It has theoretical advantages including minimizing acetabular wear, possible reduction of incidence of stem loosening, lessening of dislocation and easy revision procedure. Various methods for the treatment of fracture of the femur neck have been developed & performed, but it is still called “the unsolved fracture” in certain situation. But the role of it as primary treatment of fracture of the femur neck continues to be controversial. Current clinical results encourage its continued use and expansion of indication. Authors reviewed and analysed 21 cases of bicentric endoprosthesis and 1 case of Giliberty endoprosthesis those have been operated at the Department of Orthopaedic Surgery, National Medical Center from 1981 to 1983. Following results were obtained, l. According to disorder distribution, 14 cases were neglected fracture of femur neck, 2 old fracture, 1 idiopathic femoral head necrosis and 2 avascular necrosis & 1 non-union complicated by femoral neck fracture. 2. Among 20 cases, 8 cases were operated within 1/2 1 month after injury and 6 cases within 1 3months 3. Harris lateral appmach was used in 16 cases (80%) and Modified Gibson approach in 4 cases (20%). There were no significant differences in morbidity during operation and postoperative complication. 4. We used femoral stems those head diameter was 22 and 32mm(Charnley & Miiller type) and head pieces those diameter was 48-51 mm in male and 44–48 mm in Ifemale. 5. 3 cases were stiff in inner bearing without acetabular erosion. 6. In 6 cases more than 2 years followup 1 degree CE angle of Wiberg was increased in 2 cases of youngage respectively without associated hip joint pain. 7. Although inclination of head piece was vertical in 8 cases, fracture and dislocation were not found. 8. The circumference of head piece and opposite femoral head was measured and compared. There were 12 cases (mean 12.6 mm) that of head piece larger than opposite femoral head and 3 cases smaller than opposite femoral head. 9. There was 4 cases of complication (3 patients) and still no reoperation and revision converted to T.H.R. 10. With regard to average 18 months of follow-up, 7 cases of 81–90 Harris hip-rating score, 6 of 91–100, 4 of 71–80 and 3 of 61–70.
Acetabulum ; Dislocations ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Incidence ; Male ; Neck ; Necrosis ; Postoperative Complications ; Reoperation

The peripheral vascular occlusion in the diabetes was studied in fifty-nine male and forty-six female diabetic patients by means of doppler flow meter performed on the dorsalis pedis arteries & post. tibial arteries of the both lower limbs. Patients were divided into two groups, one with occlusion and the other without occlusion. Various predisposing factors causing peripheral vascular occlusions were examined. The results are summerized as follows: 1. Peripheral vascular occlusions were more prevalent in male than in female (male: 25.4%, female: 17.4%). 2. In male patients age, plasma cholesterol level & smoking were statically significant among the various predisposing factors between occlusion & nonocclusion groups. 3. In female patients, duration of diabetes mellitus and the sugar levels of fasting blood and post prandial 2 hours were statiscally significant.
Arteries ; Causality ; Cholesterol ; Diabetes Mellitus ; Fasting ; Female ; Foot ; Humans ; Lower Extremity ; Male ; Open Bite ; Plasma ; Smoke ; Smoking ; Tibial Arteries

After amputation of the extremities, many patients developed problematic sequelae such as loss of function, cosmetic point of view, and psychiatric problems. For period of eleven yesrs from 1976 to 1986, we performed amputation of the fingers in 461 persons, and problematic sequelae were noted in 181 cases of 105 persons. The results were as follows : 1. Causes of the amputation were trauma, infection, burn, frost bite, tumors, and vascular diseases in that order of frequency. 2. Problematic sequelae of the fingers were scar contracutre, scanty soft tissue, neuroma, bony spur formation, deformities, hypersensitivity, ulceration, phantom pain, and depression in that order of frequency. 3. Problematic sequelae in amputation of the fingers could be classified as functional, cosmetic and psychiatric problems. In most instances, the primary concern of a particular patient was amputation itself, and this kind of psychiatric problems should be taken into consideration in the treatment of the amputated fingers.
Amputation ; Burns ; Cicatrix ; Congenital Abnormalities ; Depression ; Extremities ; Fingers ; Humans ; Hypersensitivity ; Neuroma ; Phantom Limb ; Ulcer ; Vascular Diseases

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

The delayed rupture of the flexor tendons is a rare complication of malunited distal radius fractures after nonoperative management. The known cause of a flexor tendon rupture is attrition between the palmarly displaced ulnar head and the involved tendons. Sharp bony spurs on the volar side of the malunited distal radius can also cause flexor tendon rupture. About 30 cases have been reported in literature. There were only four case reports about the delayed rupture of the 2nd, 3rd, 4th, and 5th flexor tendons. In this case, we experienced flexor digitorum superficialis and flexor digitorum profundus tendon ruptures of the index, middle, ring, and little fingers, after 8 months following the malunion of a distal radius fracture. At two years follow-up after tendon graft and corrective osteotomy, the range of motion and motor weakness of the 2nd, 3rd, 4th, and 5th fingers improved.