No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Nose* ; Transplants*

No abstract available.
Retrospective Studies* ; Ribs* ; Transplants*

In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

No abstract available.
Transplants*

No abstract available.

Open reduction and internal fixation of the displaced fractures of the acetabulum represents one of the greatest challenge in fracture surgery. The purpose of our study is to report the results of operative treatment and establish the guideline for the operative treatment of the displaced acetabular fractures with the analysis of the clinical and radiological results. This retrospective study reports the results of 21 fractures in 21 patients(19 male and 3 female) treated by open reduction and internal fixation from January 1990 to July 1994. The patients were followed up more than 1 year and mean length of follow-up was 2.3 years. According to Letournel's classification, we had 9 elementary fractures(42.8%) and 12 associated fractures(57.2%). Among the elementary fractures, the posterior wall fracture was the most common type(7 cases, 33.3%) and the transverse-posterior wall fracture was the most common type among associated fractures(4 cases, 19.0%). Surgical approaches were 14 Kocher-Langenbeck, 6 Ilioinguinal and 1 extended iliofemoral. Indirect reduction and specially designed reduction method using C-arm and radiolucent operating table were also helpful to achieve satisfactory reduction. Overall quality of clinical results was graded according to the D'Aubigne and Postel rating score. Satisfactory reduction was gained in 16 cases(76.1%). Unsatisfactory reduction was gained in 5 cases(23.8%). Among the cases within category of satisfactory reduction, there were 7 excellent and 8 good clinical results. But among unsatisfactorily reduced 5 cases, there were 2 good clinical results. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result. There were complications such as 3 secondary osteoarthritis(14.2%), 3 wound infection(14.2%, 2 superficial and 1 deep), 2 iatrogenic nerve palsy(9.5%, 1 sciatic and 1 obturator nerve) and 1 intrapelvic protrusion acetabuli(4.7%) and no postoperative ectopic ossification.
Acetabulum ; Classification ; Follow-Up Studies ; Humans ; Male ; Methods ; Operating Tables ; Ossification, Heterotopic ; Retrospective Studies ; Wounds and Injuries

The significance of the posterior cruciate ligament (PCL) in the stability of the knee and the necessity for surgical repair of its tears are still controversial. The purpose of this study is to present the short term results of surgical repair and Kennedy LAD augmentation for 15 cases with PCL injury. In 14 patients (15 knees), the torn PCL was repaired with pullout suture technique and Kennedy LAD augmentation was done from june 1993 to june 1994. The follow-up period ranged from 12 months to 25 months (average, 18months). The main causes of injuries were traffic accidents in 12. Thirteen of the patients were men and one was a woman, ranging in age from 17 to 52 years(average, 35 years). 10 knees were acute injury and repaired at average 9 days after injury. There were 11 cases that had combined injuries(4 ACL injuries, 4 meniscus injuries, 3 MCL injuries etc). In eight knees, the tear was in mid substance area and in five it was near femoral attach site and in two it was near tibial attach site. Postoperative results were evaluated by roentgenographic evaluation of posterior sagging and Lysholm knee score. 11 knee were stable but 4 knees were unstable posteriorly during postoperative follow-up period. 3 chronic injuried knees were included in 4 posteriorly unstable knees. There are 7 combined knee injuries in 11 stable knees and no combined injuries in unstable knees and average Lysholm knee score was 89.7 in stable knees and 90 in unstable knees and there was no significant difference between two groups. On the based of this study, surgical repair with pollout suture technique and augmentation with Kennedy LAD in acute PCL injury is a one of the good method for preventing posterior sagging but more longer follow-up period and more cases must be needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Knee Injuries ; Lysholm Knee Score ; Male ; Methods ; Posterior Cruciate Ligament ; Suture Techniques ; Tears

Pigmented villonodular synovitis and synovial chondromatosis are known as a poup of interrelated tumorous disorders that involve the lining of the joints, hursa and tendon sheath. Pigmented villonodular synovitis consists of proliferatin synovia1 tissue containing histiocytes, librohlasts, multinucleated giant cells, and capillaries that can destroy dense fihrous tissue, form soft tissue masses, and invade bone. Synovial chondromatosis consists of hyaline cartilage nodules within the synovium and synovial joint cavities, develop multiple loose fragments of cartilage within the joint. They may represent a reactive inflammatory process or henign neoplasm and usually occur in latge synovial joints, including the knee, hip and ankle. There are some reports stating that pigmented villonodular synovitis has coexisted with synovial chondromatosis. but none have reported that they occurred simultaneously in a large single joint. This is a report on a diagnosed and arthroscopicully treated pigmented villonodular synovitis and synovial chondromatosis that occurred simultaneously in the same ankle joint.
Ankle Joint* ; Ankle* ; Capillaries ; Cartilage ; Chondromatosis, Synovial* ; Giant Cells ; Hip ; Histiocytes ; Hyaline Cartilage ; Joints ; Knee ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Tendons

Specific bone signal abnormalities of MRI of patient with knee injury, although plain radiographs are normal, suggest that ACL injury may be present. Twenty eight MRI examinations in which ACL injury were present, were retrospectively reviewed and were correlated with bone signal changes. The results obtained were as follows; 1. Of twenty eight ACL injuries seen with MR imaging, bone signal abnormality was present at the lateral femoral condyle (LFC) in 8 patients (29%), at the posterolateral tibial plateau in 10patients (36%) and at both sites in 5 patients (18%). 2. In acute knee injury, all seven patients with complete ACL tear had bone signal abnormalities at MRI and of all seven patients, six patients showed bone signal abnormalities at lateral femoral condylar or posterolateral tibial plateau. 3. In conclusion, bone signal abnormalities at posterolateral tibia or lateral femoral condyle are present in almost cases of acute complete ACL tear. Therefore the bone signal abnormalities suggest that there may be ACL injury.
Humans ; Knee Injuries ; Magnetic Resonance Imaging* ; Retrospective Studies ; Tibia

Nevus lipomatosus superficialis presented as soft, yellowish papules or cerebriform plaques occurring usually on the buttock or thigh, less often on the ear or scalp. We herein report a case of nevus lipomatosus superficialis on the leg.
Buttocks ; Ear ; Leg* ; Nevus* ; Scalp ; Thigh