Between July 1982 and July 1985, we treated thirty-one fractures of the tibial shaft by intramedullar ary Ender's nailing at the Department of orthopedic Surgery of Pusan Paik Hospital. Reductions of the fractures were achieved by closed method in 25 cases and open method in 6 cases. The results were as follows. 1. The average age was 34. 5 years and the most common cause of injury was traffic accident(67.7%) 2. Nineteen cases (61%) were closed fracture and 12 cases (39%) open. Seventeen cases (55%) were simple fracture and 14 cases (45%) comminuted. The most common level of the fracture was middle third of the tibial shaft. 3. Twenty cases (64.5%) had associated injuries and average interval from injury to operation was 11. 8 days. 4. The average healing time was 16.7 weeks and the time prolonged in comminuted fractures than in simple fractures. 5. Complications were one case of valgus deformity (11°), one case of delayed union with pseudoane urysm of anterior tibial artery on fracture site and one case of infected nonunion in Grade III open comminuted fracture. 6. Ender nails are relative ease of nailing, allow early weight bearing and decrease complication. Ender nailing is considered to be a good method in treating tibial shaft fracture especially for management of multiple injured patient and when other procedures have failed.
Busan ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Methods ; Orthopedics ; Tibia ; Tibial Arteries ; Weight-Bearing

It is generally accepted that posterior cruciate ligament is the prime stabilizer and perhaps the most importent ligament in the knee. We agreed that primary repair or reconstruction of ruptured posterior cruciate ligament is essential. Recently Clancy reported good results to correct knee instability due to rupture of the posterior cruciate ligament with a procedure that employes a free graft of one-third of the patella tendon with its tibial and patella attachments. The free patella tendon graft has been shown to revascularize readly, develop resonably high tensile strengh, allow bone to bone healing, have excellent static stability and not to deprive the knee of a significant stabilizer. So, we analized the 10 cases of the posterior cruciate ligament injuries who were admitted and treated reconstruction using free patella tendon graft in Busan Paik Hospital between May, 1984 to Dec, 1986 and obtained the following results. 1. In 8 cases, obtained satisfactory results. In 2 cases, obtained unsatisfactory results due to combined other compartment injuries, but improved posterior stability than preoperative status. 2. Reconstruction of posterior crucitae ligament using free patella tendon graft was excellent procedure for regaining of static stability of the knee.
Busan ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Posterior Cruciate Ligament ; Rupture ; Transplants

To know the effect of subconjunctival injection of liposome encapsulated cytarabine on proliferation of conjunctival fibroblasts, the conjunctiva was isolated at 180 degrees from the injection site 3 days after subconjunctival injection of the normal saline (control), cytarabine, liposome encapsulated cytarabine, and 1 day after injection of cytarabine, and then those were inoculated in the culture media of fibroblasts. In the case of 3 days after injection of cytarabine, there was 49% and 42% inhibition of proliferation of conjunctival fibroblasts compared with the control respectively. Therefore, the authors concluded that the liposome encapsulated cytarabine is effective on inhibition of proliferation of conjunctival fibroblasts and reduces the frequencies of subconjunctival injection compared with the cytarabine itself.
Conjunctiva ; Culture Media ; Cytarabine* ; Fibroblasts* ; Liposomes*

Although procedures to reproduce the lost thumb through osteoplastic reconstruction and adjacent finger transfer operations appeared reasonably successful in providing for better prehension, nonetheless the methods lacked predictabiiity and too often the results were unacceptable esthetically. In recent years the development of microsurgery and surgical experiences has made it possible to free one stage transplantation of toe to replace missing thumb. Based on our past experiences with limb replantation since 1975, we accomplished the first toe to thumb transplantation done in Korea on October 28, 1978. Therafter we succeeded in one stage toe-to-thumb transplanatation in five cases. The shortest follow up period was thirteen months, and the longest, twenty-three months. One cases was excluded in this report due to short follow up period. Excellent results were achieved in all cases. There were no limping or pain while walking after removal of great toes or second toe. Great toe transplantation is more favorable donor area than second toe in toe-to-thumb transplantation. Free toe-to-thumb transplantation on making a thumb in missing thumb is the most excellent method of thumb reconstruction, but skillful technique and specialized microsurgical training is mandatory.
Extremities ; Fingers ; Follow-Up Studies ; Humans ; Korea ; Methods ; Microsurgery ; Replantation ; Thumb ; Tissue Donors ; Toes ; Transplantation ; Walking

Sixteen microvasular free flap transfers have performed during recent two years in this department, which was first attempt in Korea. Neurovascular free flap was nine and vascular free flap was seven. The donor flaps were thirteen dorsalis pedls falps, two groin flaps and one latissimus dorsi flap respectively. The recipient sites were heel pad loss, vital organ exposure and scar contracture lesions in extremity. Their main cause of soft tissue defect was traumatic in all. All patients have experienced more than two times of split thickness skin graft before free flap transfer. The success rate of vascular free flap transfer was 94%. The only one failure case was due to venous thrombosis, but secondary split thickness skin graft performed with satisfactory result. The follow up period was from 5 months to 20 months. Sweating in transferred free flap was found at all neurovascular free flap within postoperative 4 months. Adequate 2-point discrimination was obtained at six patients of nine neurovascular free flaps and protective sensation seems to progressively improve in remained three patients. Two point discrimination was shortened at hand after neurovascular dorsalis pedis flap transfer in two cases. The weight bearing function at heel pad region and tactile sensation at hand have satisfactorily recovered after free flap transfer. Free flap transfer have many advantages compare to conventional skin graft, such as shorter therapeutic time, lesser physical and economic burdens, primary covering to vital organs and protective sensation of neurovascular free flap transfer. The most important factors are meticulous microvascular operation technique and anatomic knowledge.
Cicatrix ; Contracture ; Discrimination (Psychology) ; Extremities ; Follow-Up Studies ; Free Tissue Flaps ; Groin ; Hand ; Heel ; Humans ; Korea ; Microsurgery ; Sensation ; Skin ; Superficial Back Muscles ; Sweat ; Sweating ; Tissue Donors ; Transplants ; Venous Thrombosis ; Weight-Bearing

It is notoriously difficult to obtain a sound bony union of congenital paeudarthrosis of tbe tibia with conventional methods. This paper is the results of using the free vascularized fibular graft for congenital pseudarthorsis of the tibia in 7 patients since 1978 in this hospital, which is the first attempt in Korea. During the follow-up periods from 9 months to 32 months, 5/7 patients(71%) had good or excellent bony union, 2 patients had bone resorption at tbe distal site of grafted bone and required a second supplementary cancellous bone graft with electrode insertion. So it is thought that the free vascularized fibular graft is one of good methods of treatment for congenital pseudarthrosis of the tibia.
Bone Resorption ; Electrodes ; Follow-Up Studies ; Humans ; Korea ; Pseudarthrosis ; Tibia ; Transplants

Chordomas are maligaant tumors which arise in the remnants of the embryonic notochord, and exhibit a definite predilection for the extremes of the spinal axis, the great majority arising either in the basioccipital or in the sacrococcy geal regions. Particularly, complete surgical removal is almost impossible, therefore, local recurrence after the surgical removal of this tumor is common or rule. This report describes a csse of chordoma arising sacrococcygeal region treated with block resection.
Chordoma ; Notochord ; Recurrence ; Sacrococcygeal Region

The preoperative measurement of adequate nail length is very important for femoral shaft fracture naiTing Operation. To reduce the disadvantages of scanography which are the fracture site pain, motion and radiation hazard, the simple external measurement method of intramedullary nail length was designated through this study. The fifty normal Korean whose bone growth v:as ceased were chosen for this study. And the lengths with the simple external measurement of thigh and scanogram of femur were compared at both side. The lateral roentgenographic view of femur was checked to analysis of anterior angulation at the proximal one third of femur was checked to analysis of anterior angulation at the proximal one third of femur. The following results were: 1. Femoral length was about 24% body height on an average. 2. The distance between the lower margin of the anterior superior iliac spine and the patellar upper pole (SPD) was equal to the distance between the tip of the greater trochanter and the cented of distal subchondral line. 3. Straight intramedullary nail length was 40 to 45 mm shorter than SPD. 4. The roentgenogram revealed that the femur took its anterior bowing by 9 degrees.
Adult ; Body Height ; Bone Development ; Femur ; Humans ; Methods ; Spine ; Thigh

Histiocytosis-X has several mode of presentation, from the mildest solitary eosinophilic granuloma of bone to the most severe, with multiple granulomata in bones and soft tissues. This disease previously described as eosinophilic granuloma, Hand-Schuller-Christian disease and Letterer-Siwe disease. Lichtenstein (1953) used the term histiocytosis-x to encompass the above three names. We experienced a case of histiocytosis-x which had occured at multiple site of bones. The patient has good general condition with complete subsidance of specific symtoms and signs in our thirty-eight months follow up treatment.
Eosinophilic Granuloma ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans

Older children with neglected ongenital dislocation of the hip is not easily reduced. Even if reduction is achieved, the overstretched muscle tends to resume its original length, provoking either a redilocation or a pressure necrosis with resultant stiffness of the hip joint and deformity. The authors treated 15 cases of the C.D.H. in older children by combined procedure of open reduction, Salter's innominate osteotomy, and femoral shortening with redirection of the femoral head. The results were obtained in 15 operated hips with follow-up from 1 to 5 and 3/12 years. l. We had good results in 11 among 15 cases(73%). 2. Femoral shortening was spontaneously correctd 1.3cm in 1 year, 2.1cm in 2 years follow-up. 3. The improvement of acetabular index following Salter's innominate osteotomy was about 12.4 degrees. 4. We had no serious complication such as avascular necrosis, stiffness, and redislocation, but 3 cases of mild limitation of hip joint motion were noted. 5. Two skin incision were more convenient in operative procedure and handling of instruments than one incision(Klisić).
Acetabulum ; Child ; Congenital Abnormalities ; Dislocations ; Femur ; Follow-Up Studies ; Head ; Hip ; Hip Joint ; Humans ; Necrosis ; Osteotomy ; Skin ; Surgical Procedures, Operative