Gorham's syndrome (Gorham's disease, Massive osteolysis, Disappearing bone disease, phantom bone) is a rare disorder characterized by histologically benign proliferation of thin-walled vascular channels originating in bone associated with extensive lysis of regional bone matrix. It starts in bone, but it may secondarily involve soft tissues and adjacent bones. Although the osteolysis usually arrests spontaneously, its biologic behavior is unpredictable. The etiolgy is still in dispute and the treatment presents many problems. The author's case was a 20-year old girl, who had pathologic fracture in neck and supracondylar area of left femur with osteolysis of left pelvis, femur, and proximal fibula and tibia. She also had lymphangioma involving bones and adjacent soft tissues. To our knowledge, there is no report on Gorham's syndrome in Korea. The authors report a case of Gorham's syndrome with review of literatures.
Bone Matrix ; Dissent and Disputes ; Female ; Femur ; Fibula ; Fractures, Spontaneous ; Humans ; Korea ; Lymphangioma ; Neck ; Osteolysis ; Osteolysis, Essential ; Pelvis ; Tibia

Since 1954 when the first biodegradable polymer, polyglycolic acid(PGA), was synthesized, many different biodegradable and tissue-tolerant materials have been invested and studied for internal fixation devices. The use of biodegradable materials for the internal fixation of fractures would avoid the need for later removal of the implant. However, problems of a physical and chemical nature have delayed the development of biodegradable implants applicable to fracture management. The authors reviewed 17 cases in which the absorbable pins made of poly-p-dioxanone were used for internal fixation at Seoul National University Hospital between December, 1987 and September, 1989, and report on 11 patients who had at least 6 months follow-up(average 9.1 months). The results were graded as excellent(5 cases), good(4 cases), poor(0 case), and questionable(2 cases). In the 9 cases where the absorbable pins were used for internal fixation of the intraarticular fractures or defects, satisfactory(excellent or good) results were obtained. In the 2 cases where the absorbable pins were used for intramedullary nailing, the role of the pins was questionable. There were no complications such as wound sinus formation, secondary displacement of the fragemts and delayed union or nonunion.
Absorbable Implants ; Fracture Fixation, Intramedullary ; Humans ; Internal Fixators ; Intra-Articular Fractures ; Polymers ; Seoul ; Wounds and Injuries

STUDY DESIGN: External linkage type of spine motion analyzer and special programs for calculation of the relative angular motion and graphical display were developed and used to measure relative thoracic and lumbar motion patterns in healthy subjects. OBJECTIVES: To examine the dynamic relationship of thoracic and lumbar spines during various trunk motions and to measure main and coupling motions in three-dimensional spinal kinematics. SUMMARY OF LITERATURE REVIEW: Many kinds of methods, such as inclinometer, stereoradiography, electrogoniometer, cadaveric study etc., were introduced for measuring lumbar spine motion. But, there is no reliable method for measuring accurate dynamic three-dimensional motion patterns of whole thoracic and lumbar spines. MATERIALS AND METHODS: Thirty healthy men, ranging in age from 21 to 29 years, participated in the study. The developed device was tested to measure spine motion patterns in flexion, extension, lateral bending and axial rotation. RESULTS: The average range of motion for flexion was 71.30degrees/16.54degrees(lumbar/thoracic), for exten-zion 25.11degrees/12.67degrees, for one side lateral bending 27.42degrees/31.71degrees, for one side axial rotation 30.86degrees/24.38degrees. There were more coupling motions in lateral bending and axial rotation than in flexion and extension. Coupling motion pattern were found to be relatively consistent among subjects in active axial rotation, and the direction of coupling motion was flexion plus ipsilateral side bending. CONCLUSIONS: It was rather simple and reliable method thor spine motion analysis. There were similarities between motion patterns of lumbar and thoracic spine. But, range of motion in sagittal plane was much greater in lumbar spine than in thoracic
Biomechanical Phenomena ; Cadaver ; Humans ; Male ; Range of Motion, Articular ; Spine*

The biomechanical responses, such as nucleus pulposus pressure, facet contact force, stress distribution among ligaments in the cervical spine under static loading like flexion and extension, were examined with 3-D nonlinear finite element model. Finite element model consisted of whole cervical spines with intact discs and ligaments was developed from 1mm thick CT-cross sections of a 25-year-old healthy young man. Geometrical nonlinearity was considered for the large deformation and ABAQUS package was used for calculation. Results were verified comparing with those of existing in vivo and in vitro experiments. Results indicated that, developed cervical spine FEM was well consistent with other experiments. Nucleus pulposus pressure increased in flexion and extension more in lower cervical region. Facet contact force increased more in lower cervical spine in extension. In addition, capsular ligament was the most important one among 7 cervical ligaments surrounding cervical spine both in flexion and extension. We could better understand the biomechanics of whole cervical spine with developed finite element model and it might be applied to dynamic or postoperative study.
Adult ; Humans ; Ligaments ; Spine*

Many kinds of lumbar diseases cause lumbar segmental instability and/or limitation of motion. But, there is no reliable method for measuring accurate trunk motion. In order to measure relative trunk motion respect to the pelvis in vitro, external linkage type of spine motion analyzer was developed. Special programs for calculation of the relative angular motion and graphical display were also developed. The developed device was tested to compare spine motion pattern between 15 normal volunteers and 18 lumbar fusion patients in flexion, extension, lateral bending and axial rotation. It was rather simple and reliable method for spine motion analysis. And it was possible to measure not only angular displacement but also angular velocity and angular acceleration. There were more coupling motions in lateral bending and axial rotation than in flexion and extension. Compared to the normal subjects, patients showed different angular motion, especially in the angular acceleration. Optimal trajectory of the trunk motion derived from mathematical model in flexion and extension matched well with measurement for normal subjects.
Acceleration ; Healthy Volunteers ; Humans ; Models, Theoretical ; Pelvis ; Spine*

No abstract available.
External Fixators* ; Foot Deformities* ; Foot*

No abstract available.
Adolescent* ; Dislocations* ; Hip* ; Humans

Cubitus varus deformity following elbow fracture in children rarely limits the function of the upper extremity, but the patients and/or their parents often request an operation for the aesthetic purpose. Various surgicsl techniques have been proposed to correct the deformity, however, the complications following operation are still common. We critically reviewed 55 patients with cubitus varus deformity treated by supracondylar closing osteotomy at Seoul National University Hospital between January, 1980 and April, 1989, and report on 25 patients who had at least one year follow-up (average 4.0 years). The results were graded as excellent (13 cases), good (8 cases), and poor (4 cases). The average amount of correction was 29.1 degrees by humero-elbow-wrist angle. There were two cases with ulnar nerve palsy and one case with radial nerve palsy, however, all of which were spontaneously recovered with time. The factors related to poor results were age at operation, degree of deformity, improper wedge size, and nerve palsy. In this article, we also illustrate our new, simple and safe technique of supracondylar closing spring (incomplete) osteotomy based on careful preoperative planning and special attention to surgical details.
Child ; Congenital Abnormalities ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Osteotomy ; Paralysis ; Parents ; Radial Nerve ; Seoul ; Ulnar Neuropathies ; Upper Extremity

For young children with scoliosis before growth spurt, suhcutaneous lengthening without fusion was designed by Harrington and modified by Moe and Luque. However, many problems including spontaneous fusion, rod breakage, and hook disloclgement have been ohserved. CotrelDubousset(CD) instrumentation was sometimes used, but it usually resulted in failure due to soft tissue adhesion around the rough surface of ordinary CD rod. We tried to use the smooth CD rod, transvcrse-pedicle clawing on the upper part, and pedicle screw inscrtion on upper and lower part of the curve to reduce the hardware failures. Among 8 patients in whom suhcutaneous lengthening with smooth CD rod was carried out hetween October l992 and Suly 1996. 4 cases perfomed with final spinal fusion were analysed. There were I central core disease, 1 multicore disease and 2 idiopathic scoliosis(infantile and juvenile type). Mean age at the first operation was l0.0(8.8-11.8) years, and the Risser sign was all grade 0 except one with grade 1. Suhcutaneous lengthening was performed every 5 or 6 months Mean lengthening duration was 22(9-39) months and mean age at spinal fusion was 11.7(9.6-13.8) years. Mean Cobb angle decreased from 7ldegrees (55degrees-88degrees) at preoperative stage to 32 (10degrees-59degrees) at the last follow-up. There were 5 complications during 21 operations, and three hardware failures comprised 2 hook dislodgcment and 1 screw pull-out. Crankshaft phenomenon happened in I case who had had a posterior fusion in young age(9.6 years) due to laminar fracture. The suhcutaneous lengthening with smooth CD rod can he another option of treatment for young children with severe scoliosis. prescrving the powth potential of involved vertebrae with few complications.
Animals ; Child* ; Follow-Up Studies ; Hoof and Claw ; Humans ; Myopathy, Central Core ; Scoliosis* ; Spinal Fusion ; Spine ; Tissue Adhesions

PURPOSE: To estimate the prognosis of surgical treatment through the comparative analysis of patients who had reoperation for failed lumbar disc surgery space (FLDS). MATERIALS AND METHODS: 31 patients who had a surgical operation for sciatica due to recurrent disc herniation or fibrous tissue adhesion were analyzed. Clinical features and surgical results of both groups were evaluated. RESULTS: In clinical analysis, a positive SLR test of less than 40, pain upon coughing, and a reduced walking capacity were common in recurrent herniation. Satisfactory postoperative results were achieved in 12 cases (80%) of the recurrent disc herniation group, 2 cases (50%) of the diffuse type and in 8 cases (67%) of the focal type of fibrous tissue adhesion group. CONCLUSION: In term of clinical signs, the SLR test is one of the most important factors in differentiating the preoperative cause of FLDS. Although them was no difference in the statistics, the surgical outcome in patients with focal root compression is more satisfactory than in the diffuse type in the fibrous tissue adhesion group.
Cough ; Humans ; Prognosis ; Reoperation ; Sciatica ; Tissue Adhesions ; Walking