No abstract available.

Osteonecrosis (Avascular necrosis) of the bone is a known complication of systemic corticosteroid therapy and may he dose related. It also has been associated less commonly with nonsteroida1 chemotherapy. Nonetheless, avascular necrosis of bone has heen reported infrequently in children who have received antileukemia regimens including prednisone. We report our experience with one adolescent girl with acute lymphocytic leukernia (ALL) who developed hoth femoral condylar osteonecrosis presenting bone pain after aggressive chemotherapy that including high cumulative dosage of corticosteroid as well as other antileukemia agents. We performed arthroscopic surgery with debridement, multiple drilling and screw fixation to the lesion sites. Eight months after operation, she was free of pain with full range of both knee movements. We got good resuit according to Hughston criteria.
Adolescent ; Arthroscopy ; Child ; Debridement ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Knee* ; Osteonecrosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisone

No abstract available.
Hip Joint* ; Hip*

No abstract available.
Hyperostosis, Sternocostoclavicular*

Soft tissue reconstruction of the hand remains a challenge for the hand surgeon, who must choose whether to use a local flap, a distant flap or a free flap. Local flaps, derived from tissue immediately adjacent to the primary defect, are the first choice. But there is a shortage of skin in the hand and there are regions of the hand that should not be used as donor sites since cover of the resultant secondary defect with a skin graft would be inappropriate. We used island flaps for the small soft tissue defects in the hand which were difficult to cover with a conventional skin graft or local flap. The results were as follows; 1. The causes of the soft tissue defects were traumatic amputation in 4 cases, camptodactyly in 4 cases, replantation in 3 cases, infection in 3 cases and tumor in 1 case. 2. The sites of the soft tissue defects were thumb tip in 6 cases, fifth finger PIP joint volar aspect in 3 cases, index tip in 2 cases, thumb volar and dorsal surface in 2 cases, third and fourth MP joint dorsal surface in 1 case, fourth finger PIP joint volar aspect in 1 case and first interdigital web space in 1 case. 3. The donor flaps were fourth finger neurovascular island flap in 8 cases, reverse dorsal matacarpal flap in 5 cases and first dorsal metacarpal artery flap in 4 cases. 4. The sizes of the flap were from 1. 0×1. 5cm to 2.0×4.0cm and and average of 1.5×2.0cm. 5. The flaps were survive completely with a touch sensat,ion except 2 cases which were covered by reverse 5th dorsal metacarpal flap.
Amputation, Traumatic ; Arteries ; Fingers ; Free Tissue Flaps ; Hand ; Humans ; Joints ; Replantation ; Skin ; Surgical Flaps ; Thumb ; Tissue Donors ; Transplants

Fractures of the patella are intra-articular fractures of a sesamoid bone. The goal of treatment is to restore the function of the extensor mechanism and congtvity of the articular surface of the knee. So postoperative traumatic arthritis is minimized by an accurate reduction of the articular surfaces. We analyzed nine cases of the patella fractures which were treated by the use of arthroscopy to allow visualization of and working inside of joints, and the use of the image-intensifier fluoroscope to allow real-time vi.sualization of the skeleton. The results were as follows The fixation of patelia fractures using an arthroscopy could be applied to transverse or vertical fractures without comminution and severe osteoporosis. 2. In the treatment of two types of patella fractures (simple transverse e rnarginal vertical fractures without comminution), clinically satisfactory results were obtained through the accurate reduction of articular surface using an arthroscopy and image intensifier.
Arthritis ; Arthroscopy* ; Intra-Articular Fractures ; Joints ; Knee ; Osteoporosis ; Patella* ; Sesamoid Bones ; Skeleton

No abstract available.
Ligaments* ; Posterior Cruciate Ligament* ; Prostheses and Implants*

No abstract available.
Humans ; Knee*

No abstract available.
Arthrodesis* ; External Fixators* ; Knee*

The tibial plateau fracture involving the articular surface clinically is a very important injury which often can cause disabilities of the knee joint. Open reduction and internal fixation have been proposed as the optimal treatment of patient with Schatzker's type VI tibial plateau fracture because of the decrease in the functional impairment of the knee joint by allowing early motion. But the injury to the soft tissue is usually severe, which may lead to wound complications after internal fixation. Also delayed union, nonunion, and infection after such operation is not a few. Recently some authors have studied about the external fixation or minimal internal fixation as the treatment for tibial plateau fracture. The purpose of the current study was to compare the results of two different operative methods. The authors analyzed 9 cases of Schatzker's type VI tibial plateau fracture surgically treated at the Pusan National University Hospital from March 1991 to August 1994. The follow-up period ranged from 1 year to 4 year 7 months. The results were obtained as follows. 1. Of the 9 cases, 7 were male and 2 were female, the major population were the 6th and 7th decades. 2. The most common cause of this injury was traffic accident in 7 cases(78%). 3. About the fracture pattern, the most commom type was intercondylar fracture type in 5 cases(56%), the next one lateral condyle fracture type in 4 cases (44%). 4. Common associated injuries were ipsilateral fibula fracture in 8 cases(89%) and ipsilateral femur fracture in 4 cases(44%). 5. Six cases were treated by open reduction and internal fixation, and 3 cases were treated by external fixator. 6. According to Poster's criteria, the results were “Acceptable” in 7 cases(89%), “Unacceptable” in 2 cases(11%).
Accidents, Traffic ; Busan ; Diaphyses ; External Fixators ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Knee Joint ; Male ; Methods ; Tibia ; Wounds and Injuries