Early diagnosis and treatment of congenital dislocation of the hip is the only means of obtaining good results with consistent regularity. But a large number of congenital dislocation of the hip remain undiagnosed before the child begins to walk. One hundred and nine cases of congenital dislocation of the hip had been clinically diagnosed and 48 cases of them were treated conservatively or operatively at Department of Orthopedic Surgery, College of Medicine, Seoul National University from January, 1965 through September, 1975 with following results. 1. Among 109 cases of congenital dislocation of the hip, 48 cases were admitted and treated. In recent 10 years the number of the out-patient was increasing. 2. The preponderance of female to male (4:1) was found. 3. The age ranged between 3 months and 24 years, and 46 cases (42%) between 12 and 24 months. 4. In most cases the chief complaint was limping. 5. The associated congenital anomalies were observed in 3 cases of the series, comprising two cases of arthrogryposis multiplex congenita and one case of hydrocephalus. 6. The scetabular index was increased in affected hip. 7. The ratio of unilateral cases to bilateral ones was 100: 9, and right to left was 47: 53. 8. Closed reduction was satisfactory in 25 cases under 2 years of age. 9. Open reduction was necessary in 18 cases of failed closed reduction and 5 cases of redislocation. 10. Eleven cases of Salter's operation, 4 cases of Pembertons operation, 2 cases of Colonnas operation, and 8 cases of derotational osteotomy were performed to increase the stability of the hip joint.
Arthrogryposis ; Child ; Dislocations ; Early Diagnosis ; Female ; Hip Joint ; Hip ; Humans ; Hydrocephalus ; Male ; Orthopedics ; Osteotomy ; Outpatients ; Seoul

It is obvious that the examination of nerve conduction as a diagnostic tool is a relatively new field of interest with a state of still undergoing evaluation and improvement. Problems of technique and interpretation notwithstanding, determination of nerve conduction has progressed to a level where it is now used routinely as a part of the electrodiagnostic examination. The present study has been undertaken to determine the normal range of the motor nerve conduction velocity, distal motor latency, amplitude of the muscle action potentials, sensory nerve conduction velocity, distal sensory latency, amplitude and duration of the sensory nerve action potentials of median and ulnar nerves in healthy Korean. One hundred twenty healthy subjects (sixty male and sixty female) were examined. Their ages ranged from 5 to 69 in years and the subjects were arranged in three age groups of 5–9 years, 10–49 years and 50–69 years. The results obtained were as follows: l. In median nerve, mean values for motor nerve conduction velocity, distal motor latency, and amplitude of the muscle action potantials were 56.57± 4.55 (45.2–69.4) m/sec, 3.02±0.48 (1.6–4.5) msec, and 14.2±5.0 (4–28) mV, respectively. 2. In ulnar nerve, mean values for motor nerve conduction velocity, distal motor latency, and amplitude of the muscle action potentials were 58.60±5.06 (43.5–71.4) m/sec, 2.35±0.50 (1.3–4.1) msec, and 11.7±3.7(4–22) mV, respectively. 3. In median nerve, mean values for sensory nerve conduction velocity, distal sensory latency, amplitude and duration of the sensory nerve action potentials were 63.50±5.63 (53.1–75.9) m/sec, 2.37±0.38 (1.0–3.4) msec, 45.5±16.9 (13–120)u V, and 1.68±0.29 (0.9–2.5) msec, respectively. 4. In ulner nerve, mean values for sensory nerve conduction velocity, distal sensory latency, amplitude and duration of the sensory nerve action potentials were 65.34±5.16 (50.6–78.1) m/sec, 2.09±0.38 (1.3–3.2) msec, 45.6±17.5 (12–118) uV, and 1.54±0.32 (0.8–2.5) msec, respectively. In comparison of the obtained values of two nerves. 5. A significant difference was observed between motor nerve conduction studies of the median and ulnar nerves. 6. A significant difference was observed between sensory nerve conduction studies of the median and ulnar nerves except amplitude of the sensory nerve action potentials. 7. Nerve conduction velocity was significantly faster in sensory nerve than in motor nerve. In comparison of conduction velocities among 3 age groups. 8. Motor nerve conduction velocity of the median and ulnar nerves was slow in age groups of 5–9 years and 50–69 years as compared with that of age group of 10–49 years. 9. Sensory nerve conduction velocity of median nerve was slow in age groups of 5–9 years and 50–69 years as compared with that of age group of 10–49 years, and sensory nerve conduction velocity of ulnar nerve was slow in age group of 50–69 years as compared with that of age groups of 5–9 years and 10–49 years.
Action Potentials ; Healthy Volunteers ; Humans ; Male ; Median Nerve ; Neural Conduction ; Reference Values ; Ulnar Nerve

The ischial weight-bearing functional long leg brace is one of the new immobilization devices, which allows patients to walk using less energy than was required by other devices-e.g. cast, cast-brace, conventional long leg brace. It has advantages as minimal pain and irritation, more natural gait, convenience of free joint motion, and good skin hygiene. The brace consists of quadrilateral total contact thigh shell, bilateral up-rights, knee joint, tibial cuff band and ankle-foot section. The brace was applied to 10 patients with variable diseases treated at the Department of Orthopedic Surgery, Seoul National University Hospital, from Mar-74 to May-76. It was applied postoperatively to 4 cases of femoral shaft fractures and 1 case of fibrous dysplasia of the tibia and applied to 4 cases of Legg-Perthes' disease as one of conservative managements. The brace was modified into “abduction-internal rotation functional long leg brace” in cases of Legg-Perthes disease. In 1 cases of post-infectious subluxation of the hip, the stability was maintained by use of the brace. With this experience, it is expected that the ischial weight-bearing functional long leg brace may be applied to other pathologic conditions of the lower extremity in which weight-bearing is to be avoided or guarded.
Braces ; Gait ; Hip ; Humans ; Hygiene ; Immobilization ; Joints ; Knee Joint ; Leg ; Legg-Calve-Perthes Disease ; Lower Extremity ; Orthopedics ; Seoul ; Skin ; Thigh ; Tibia ; Weight-Bearing

Osteochondritis dissecans is a joint affection characterized by partial or complete detachment and necrosis of cartilage fragment and underlying bone from the articular surface. It is seen frequently in knee, elbow and ankle joints. Young males are most commonly affected. Also it develops not infrequently in children, but never in a child under 4 years of age. A case of osteochondritis dissecans which occurred in a 6-year-old boy is reported here. The patient had been sufferred from pain, swelling and progressive limitation of motion of the left knee. X-ray showed shadows like loose bodies on posteromedial aspect of the left knee. Clinically, possibility of tuberculous arthritis could not be rulled out. Loose bodies were removed, and almost detached ostechondral fragment was excised. At post-operative second week, crutch walking and physiotherapy were recommended.
Ankle Joint ; Arthritis ; Cartilage ; Child ; Elbow ; Humans ; Joints ; Knee ; Male ; Necrosis ; Osteochondritis Dissecans ; Osteochondritis ; Walking

No abstract available in English.
Scoliosis

Maroteaux and Lamy coined the term Pycnodysostosis derived from the Greek, Pycnos (thick or dense), Dys (defective), and Ostosis (bone). The principal characters of this syndrome are short stature, dysplasis of the skull, obtuse manibular angle, dysplastic clavicles,partial or total aplasia of the terminal phalanges, and generalized increased roentgenographic density of the skeleton. Patient so affected are predisposed to fracture. Pycnodysostosis seems to be a genetic disorder, inherited as an autosomal recessive trait. Here, it is reported a case of incidental finding of pycondysostosis with chronic renal failure in 12 years old girl.
Female ; Humans ; Incidental Findings ; Kidney Failure, Chronic ; Numismatics ; Pycnodysostosis ; Skeleton ; Skull

Neuroblastoma is a malignant tumor of sympathetic nerve origin. They are derived from sympathetic formative cells, the primitive neuroblasts that have failed to mature. They may be located wherever sympathetic nerve tissue is found, The majority of cases occured in the suprarenal medulla, posterior mediastinum, and orbit. The tumor metastasized early by the hematogenous or lympathic route, or both to skeletal system, liver, and skin, etc. Since the vast majority of children with neuroblastoma have local or distant metastases at the time of original diagnosis, the clinical manifestation and the prognosis are variable. The age distribution is from birth to 19 years old. Many methods of treatment of neuroblastoma have been advocated such as surgical excision,roentgen thrapy, and its combipation therapy but the effect is questionable. Here, it is reported a case of neuroblastoma with systemic skeletal metastasis originated from posterior mediastinum in 8 years old girl.
Age Distribution ; Child ; Diagnosis ; Female ; Humans ; Liver ; Mediastinum ; Neoplasm Metastasis ; Nerve Tissue ; Neuroblastoma ; Orbit ; Parturition ; Prognosis ; Skin

It is assumed that the frequency of the meniscus tear on the right and the left knee and the mechnism of injuries in westerners are different from those in easterners. The writer had experienced 32 cases of the meniscus tear in National Police Hospital, during the period from 1973 to 1977, and inquired into its frequency and cause based on appropriate references. This is the report on the result of our study. 1. Out of 32 cases, 21 cases were found in the group of 20 to 29 years of age. 2. Eleven years of age with a discoid type was noticed as the youngest. 3. Out of 32 cases, 20 cases were found on the lateral meniscus and 12 on the medial, showing every five lateral cases to every three medial cases. 4. Out of 32 cases, 17 cases were found on the right knee joint with 14 lateral and 15 on the left knee joint with 9 medial. 5. Out of 32 cases, 27 cases were found on the male and 5 on the female, showing 5. 4 male cases to every one female case. 6. Out of 32 cases, 29 cases had the apparent history of trauma. 7. Transverse tear was found more frequent on the lateral meniscus and longitudinal or bucket handle tear was found more frequent on the medial meniscus.
Clinical Study ; Female ; Humans ; Knee ; Knee Joint ; Male ; Menisci, Tibial ; Police ; Tears

Certain motion in the sports of volleyball can cause injury. For examples, excessive spiking, jumping, receiving and rolling may produce strain, sprain and stress fracture, etc. of all extremities and spine. The authors analized injuries of 160 Korean young women volleyball players treated and managed at Department of Orthopedic Surgery, National Police Hospital from September, 1973 to October, 1977. The results were as followings: 1. Of 160 cases, age distribution was ranged from 15 to 26 years and average was 20. 7 years. 2. Out of 495 injuries, 113 (23%) were upper extremities, 93 (19%) were lumbar and lumbosacral regions and 289(58%) were lower extremities. The most common site of injury was knee joint. 3. As to the ratio of the side, in the upper extremities 77% were in the right side and 23% in the left, but in the lower extremities both sides were nearly equal. 4. The injuries were composed of strain, sprain and the others, including stress fracture in 14, linear fracture of patella in 2, chip fracture of ulnar styloid process in 4, H.I.V.D. in 4 and meniscus tear in 6, etc.. 5. The injuries were supposed to be prevalent for the first one month after change from one to another team (14%). 6. The injury was usually more frequent in incidence among the exercise in winter and the heating in Gymnasium also one of the important factors to induce the injury, the injuries were less frequent at the good heating (40%). 7. It was concluded that the career of play did not affect significantly to incidence of the injury.
Age Distribution ; Athletic Injuries ; Extremities ; Female ; Fractures, Stress ; Heating ; Hot Temperature ; Humans ; Incidence ; Knee Joint ; Lower Extremity ; Lumbosacral Region ; Orthopedics ; Patella ; Police ; Spine ; Sports ; Sprains and Strains ; Tears ; Upper Extremity ; Volleyball

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
Adenoidectomy ; Adenoids ; Child ; Continuous Positive Airway Pressure ; Enuresis ; Failure to Thrive ; Follow-Up Studies ; Humans ; Hypertension ; Hypertrophy ; Palatine Tonsil ; Pulmonary Heart Disease ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy