Primary repair of anterior cruciate ligament is superior to late reconstruction procedures for two reasons; objective stability is more easily restored due to intact secondary restraints not subjected to chronic stress, and the quality of the joint is superior with greater chance of intact menisci and normal articular cartilage not yet damaged through recurrent subluxation. We present the result of thirty-eight kness in thirty-seven patients who had been treated with primary repair of augmented repair for acute ACL rupture from March, 1984 to August, 1990. Twenty-one knees were treated with primary repair and seventeen knees augmented repair. At an average 33 months follow up, the results obtained were as follows: 1. The patients were 23 males and 14 females with an average age of 27.1 years. 2. Twenty four knees were injuried during athletic endeavors, 9 knees by automobile accident, and 5 knees by landing from height. In 18 knees anterior cruciate ligament was ruptured at the proximal attachment, in 17 knees at the midsubstance tear and in 3 at the near distal attachment. 3. The average interval from injury to operation was 7.5 days (ranged from 1 to 14 days). 4. The results were evaluated by Hospital for Special Surgery knee rating scale (modified by Marshall) at an average 33 months (range from 13 months to 7 years and 6 months) follow-up study. 16 (76%) out of 21 knees treated with primary repair were rated as good or excellent. 12 (86%) out of 14 knees treated with augmented repair were rated as good or excellent. As the result of this study, acutely torn anterior cruciate ligaments appear to be successfully treated with primary repair or augmented repair according to torn site and shape of ligaments.
Anterior Cruciate Ligament ; Automobiles ; Cartilage, Articular ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Ligaments ; Male ; Rupture ; Sports ; Tears

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

No abstract available.
Skin Diseases, Vesiculobullous*

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

The degenerative arthritis following total menisectomy has led to consideration of the need for meniscal transplantation, this study evaluates the morphologic and histologic changes fol lowing fresh meniscal autograft and allograft in therabbits. Transplantation of the medial meniscus was carried out in two groups of 32 rabbits(autograft group=16 rabbits, allograft group=16 rabbits). The morphological and histological changes of the transplanted auto-and allografted menisci and the articular cartilage of the medial femoral and tibial condyle were observed at 2,4,6,8,10,12,22,28 weeks postoperatively. There were no significant differences between auto and allograft groups in gross appearance. Histologically, the fibrous adhesion was noted between grafted meniscus and joint capsule 2 weeks after operation, but complete healing was seen at the suture sites without rejection phenomenon at 6 weeks in both groups. There were prominent inflammatory reactions such as lymphocytes and inflammatory cells infiltration during early postoperative stages(2,4 weeks) only in the allograft group, and more prominent fibrotic reactions in the allograft group than auto-graft group. The results of this study suggest that meniscal allografts are able to adapt to the host tissues, survive within the joint environment, and provide a functional replacement for the removed meniscus, but further studies for graft-host immune response and a method to take the maintenance and deposits of graft must be needed to perform the meniscal allograft in human.
Allografts ; Autografts ; Cartilage, Articular ; Humans ; Joint Capsule ; Joints ; Knee Joint ; Knee ; Lymphocytes ; Menisci, Tibial ; Methods ; Osteoarthritis ; Rabbits ; Sutures ; Transplants

The intramedullary nailing is a good method of treatment in femur shaft fracture but it is not available in some fracture pattern or fracture level. And it is very difficult with conventional Kiintscher nailing to prevent torsional stress and fix rigidly in unstable fracture of the femur shaft. The unstable fracture by comminuted fracture or segmental fracture, nonunion and pathologic fracture needed the rigid fixation. Interlocking Kuntscher IM nailing can provide antitorsional stability, good axial alignment and prevent shortening of the fracture site, also allow early ambulation and joint exercise. We analysed 51 patients 52 cases of interlocking Kiintscher IM nailing from May 1981 to March 1988. The interlocking Kuntscher IM nailing prevents the rotational and axial roading. The interocking Kuntscher IM nailing has expanded its application in fracture pattern and fracture site. The interlocking IM nailing provides rigid fixation in severe comminuted fracture. segmental fracture, long spiral fracture, and other several unstable fractures and eliminates splinting or external supports, so it is possible doing early joint exercise. The interlocking Kuntscher IM nailing was also considered best internal fixation method in pathologic fracture or sever osteoporosis. The static interlocking for rigid fixation and the dynamic interlocking method for axial compression to fracture site during weight bearing can be adapted appropriately to fracture pattern. Radiation hazard during the interlocking nailing is not considerable.
Early Ambulation ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Fractures, Spontaneous ; Humans ; Joints ; Methods ; Osteoporosis ; Splints ; Weight-Bearing

No abstract available.
Drainage*

The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fraction site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analyzed these cases and out own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4.3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.
Clinical Study ; Early Ambulation ; Hospitalization ; Joints ; Muscular Atrophy ; Orthopedics ; Walking

No abstract available.

PURPOSE: To evaluate the surgical results and clinical effectiveness of silicone tube intubation through Hasner's valve under intranasal endoscopic guidance in children with congenital nasolacrimal duct obstruction (CNDO). METHODS: The present study enrolled a total of 58 eyes of 46 children over 12 months of age diagnosed with CNDO in the Department of Ophthalmology, Inje University College of Medicine from 2003 to 2010. Patients who had previously undergone ineffective probing or had a combination of an anatomical abnormality such as secondary nasolacrimal duct obstruction were also included. The silicone tube was intubated through the Hasner's valve and observed with intranasal endoscopy; tube retention time was planned for at least 12 weeks. RESULTS: A total of 20 eyes were previously probed preoperatively (mean 1.7 times). After the average follow-up period of 13.5 months, the overall success of silicone intubation was 57 of 58 eyes (98%). In one failed eye, nasolacrimal obstruction was already combined preoperatively, and unintentional tube removal by the patient occurred within one week. Silicone tube reintubation was performed after four months, and CNDO symptoms improved. CONCLUSIONS: Intranasal endoscopic observation to ensure the passage of a silicone tube through Hasner's valve decreases anatomical injury. When considering patient age and former treatment, silicone tube intubation with intranasal endoscopic observation could produce desirable results with a higher success rate.
Child ; Dietary Sucrose ; Eye ; Follow-Up Studies ; Humans ; Intubation ; Nasolacrimal Duct ; Ophthalmology ; Retention (Psychology) ; Silicones