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 purpose of this study was to evaluate the results and complications in difficult periarticular fractures of the knee treated with a circular(Ilizarov) external fixator. The mean follow-up period was 34 months(range: 12-55 months). Of the 27 cases, 12 cases involved fractures of distal femur (two M ller type A3, four type C2, six type C3) and 15 cases involved fractures of the proximal tibia (one Schatzker type V, eight type VI, two segmental, four metaphyseal comminuted fractures). Twenty-two cases(81%) were open fractures and most of the cases were open intra-articular comminuted fractures. The average duration of external fixation was 7.7 months (9.8 months for the distal femur cases, 6.5 months for the proximal tibia cases and 11.5 months for the cases which required lengthening, and 6 months in the non-lengthening group). In 8 cases, in which bone lenthening was done, no leg length discrepancy occurred after lengthening. The mean length gained was 5.9 cm and the mean healing index was 1.8 months/cm (1.8months/cm in distal femur cases and 1.9 months/cm in proximal tibia cases). According to Neers criteria, the treatment results for cases involving distal femur fracture were as follows: six satisfactory, three unsatisfactory, three failures; cases with proximal tibia fractures had these results: nine excellent, three satisfactory, three unsatisfactory. Average range of motion was 67 degrees in distal femur fracture cases and 114 degrees in proximal tibia fracture cases. According to Paleys complication grading system, six problems, six obstacles, and eight com- plications occurred. In conclusion, the Ilizarov external fixator can be a useful treatment method in periarticular fractures of the knee with severe intra-articular or metaphyseal comminution, bone loss, severe soft tissue injury, or multiple associated injury. Its use can reduce the associated complications such as leg length discrepancy, infection, and nonunion.
External Fixators* ; Femur ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Knee* ; Leg ; Range of Motion, Articular ; Soft Tissue Injuries ; Tibia