The application of arthroscopic surgery in wrist is not widely advocated because of technical difficulty. We analysed 11(10 patients) wrists of which were performed arthroscopic synovectomy in wrist from July 1991 to September 1992 in Kyung Hee University Hospital. The age of the patients ranged from 23 to 55 years old. Follow up period was from 12 months to 26 months. The application for the arthroscopic synovectomy in that group of patients were based on such disabling clinical symptoms as severe pain, swelling, limitation of range of motion and roentgenographic type from mild to severe stage. Postoperative diagnosis was histologically confirmed with rheumatoid arthritis in nine wrists (nine patients) and gout in two wrists (one patient). The results were assessed subjectively and objectively with pain, swelling and range of motion. Satisfactory overall results were obtained and there were no complications. Conclusively, arthroscopic synovectomy in the wrist is effective produce to relieve pain of the rheumatoid arthritis and gout but arthroscopic synovectomy of wrist is technically demanded.
Arthritis, Rheumatoid ; Arthroscopy ; Diagnosis ; Follow-Up Studies ; Gout ; Humans ; Range of Motion, Articular ; Wrist

We performed the partial or total meniscestomy in 143 cases with the meniscal injury by the arthroscopy or arthrotomy during the period from May, 1978. to November, 1987. There were 89 cases treated with arthroscopic partial, 11 csses treated with arthroscopic total, 16 cases with open partisl and 27 cases with open total meniscectomy. We did not include the cases of the discoid meniscus in the study. The statistic analyses were as follow ;1. The ratio of male to female was 106 to 37, and right to left was 79 to 64. 2. There were 82 cases in medial meniscus, and 61 cases in lateral meniscus. 3. The most common chief complaint and physical finding was pain, tenderness & McMurray(+). 4. The average period of hospitalization were 5 days in arthroscopic and 20 days in open meniscectomy. 5. The most cornmon associsted injury was the ACL injury in 36 cases. 6. The most common site and type of tear was the longitudinal tear at posterior horn. 7. In the preoperative arthrogram, the diagnostic accuracy was 78.3%. 8. The satisfactory results were 79.2% in arthroscopic and 64.7% in open meniscectomy.
Animals ; Arthroscopy ; Female ; Horns ; Hospitalization ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears

Arthroscopy of the knee joint is an essential diagnostic procedure of the knee joint lesions because of its high diagnostic accuracy and simple procedure and high safety. We analysed in 300 cases of knee joints arthroscopy which performed in Kyung Hee University Hospital from July 1978 to June 1982. The results were as follows: 1. The diagnostic accuracy of clinical diagnosis of knee joint lesions based on arthroscopic findings was 51.0%. 2. The diagnostic accuracy of clinical diagnosis in surgically confirmed cases of knee joint lesions was 56.1% and diagnostic accuracy of arthroscopy was 90.9%. 3. In meniscal lesions, the diagnostic accuracy of arthroscopic diagnosis was 94.5%, arthrographic diagnostic accuracy was 84.9%, clinical diagnostic accuracy was 48.9% and combined accuracy of three diagnostic methods was 97.3%. 4. In cases which diagnosed as I.D.K. (Internal Derangement of Knee) in initial stage of knee joint lesions, meniscal lesions (32.8%) and ligament injuries (22.4%) were predominant lessions based on arthroscopic findings. 5. The frequency of meniscal tear were no significant difference in lateral (33.3%) or medial (36.0%) meniscus except discoid meniscus rupture. 6. 68 Cases of 300 arthroscopies (22.7%) were avoided unncessary arthrotomy through preoperative arthroscopic examination of knee joint. 7. Arthroscopy is very useful and essential not only to confirm the diagnosis but also to treatment of knee joint lesions.
Arthroscopy ; Diagnosis ; Knee Joint ; Knee ; Ligaments ; Rupture ; Tears

Glomus tumor is a kind of vascular tumor that arises from the glomus body, which regulates skin temperature and is placed in the skin and the subcutaneous area. It is a benign tumor that usually presents in the subungal area. It is relatively common in areas other than the fingers, but its occurrence in peripheral nerves is known to be comparatively rare. We report our experience with a case of glomus tumor arising from the brachial plexus, a rare site of occurrence for glomus tumors.
Brachial Plexus ; Fingers ; Glomus Tumor ; Peripheral Nerves ; Skin ; Skin Temperature

Gastric bezoars are large masses or concretions, composed with plant fiber, hair and miscellaneous foreign bodies, found in the stomach and occur usually as sequele of gastric surgery. We experienced 2 cases of fat bezoars which developed after drinking of melted beef fst. They had postprandial epigastric fullness and pain, those were relieved on supine and left recumbent position. Upper gastrointestinal series showed a large movable mass in the stomach in hoth cases. On gastrofibercopic examination, a large egg sized white bezoar was cordirmed in both cases and a gastrie ulcer at antrum associated in one case. In attempt to removal of the bezoars, we tried to break them, but failed because of its character. The patients were treated with pancreatic lipase containg digestives, Pancreon-F and Azintal. From one day after this treatment, symptoms were completely relieved. Five days later, we confirmed disappearance of bezoars by gastrofiberscopy. and upper gastrointestinal barium
Barium ; Bezoars* ; Drinking ; Foreign Bodies ; Hair ; Humans ; Lipase* ; Ovum ; Plants ; Stomach ; Ulcer

Tuberculosis of the bone and joints is either one of the generalized manifestation or solitary localized lesion. The involvement of bone after Bacille Calmette Guerin (BCG) vaccination is very rare. We experienced a case of which developed tuberculous osteomyelitis after BCG vaccination. The case is a 14-month-old male. The patient had the history of BCG vaccination 1 year ago. The presenting symptoms were swelling, redness and discharge of the left shoulder. The lesion in the left proximal humerus was mainly erosive lesion with minimal periosteal reaction. We are going to report a case of 14-month-old child with tuberculous osteomyelitis after BCG vac-cination with brief review of literature.
Child ; Humans ; Humerus* ; Infant ; Joints ; Male ; Mycobacterium bovis* ; Osteomyelitis* ; Shoulder ; Tuberculosis ; Vaccination*

Discoid lateral meniscus is wider and thicker than normal lateral meniscus. The tear pattern and vulnerability to injury of discoid lateral meniscus may be different from that of normal shaped meniscus. Seven hundred and seventy one meniscal tears which were treated arthroscopically between the period of 1982 and 1995 were reviewed retrospectively. Of those cases, tear of normal shaped lateral menisci occupied 327 knees (42.4 %) and discoid lateral menisci 132 knees (17.1 %) representing the higher incidence of tear in normal shaped lateral meniscus. In normal shaped menisci there were no tear in the age of below 10 and there were 37 knees of teens. In discoid lateral menisci, there were 3 knees (2.3 %) of below 10 and 42 knees of teens (31.8 %) that represent higher incidence of younger age group (P<0.05). Tears without trauma history in 31 knees (9.5 %) of normal shaped lateral meniscus and in 70 knees (53.0 %) of discoid menisci represent vulnerability of the discoid lateral meniscus to tear without injury (P<0.05). Symptomatic menisci without tear were noted only in 16 knees (12.1 %) of the discoid lateral menisci. In normal shaped menisci, longitudinal tear within the substance was most common (119 knees, 36.4 %) whereas peripheral tear was most common (57 knees, 43.2 %) in the discoid lateral meniscus, Concealed horizontal tear (11 knees, 8.3 %) and Wrisberg type discoid lateral menisci (2 knees, 1.5 %) was noted only in the discoid lateral meniscus. In summary, discoid lateral meniscus revealed different tear pattern and vulnerability to injury and different age incidence from that of normal shaped lateral meniscus.
Adolescent ; Humans ; Incidence ; Knee ; Menisci, Tibial* ; Retrospective Studies

The principle in the treatment of an elderly patient with an intertrochanteric fracture has swung from traction to internal fixation due to complication such as pneumonia, skin ulcer, and throm-boembolic disease, etc. Since the introduction of the Smith-Peterson nail, numerous internal fixation devices such as I-beam nail, Thornton plate, Jewett nail and Holt nail have been developed by gadgeteers and instrument companies. Recently Compression Hip Screw is popular because of rigid internal fixation. The operative management of intertrochanteric fractures of the hip using Compression Hip Screwplate was performed in thirty-three patients who were followed more than 5 months after operation at Department of Orthopedic Surgery, Kyung Hee University Hospital, from Feb. 1974 to 1978. The results were as follows. 1. Of 33 cases of intertrochanteric fractures, 3 cases were stable fracture and 30 cases were unstable fracture. The commonest type was Tronzo type III with 42 percentage. 2. Dimon-Hughston reduction in 13 cases with unstable fracture and anatomical reduction in 20 cases with stable and unstable fracture were achieved. 3. The average time to fracture union was 12 weeks, minimum in 8 weeks (maximum 20 weeks). The average union time in age group over 50 years was 14 weeks and 11 weeks in age group under 50 years. 4. The average union time was 13 weeks in medial displased group and 10 weeks in anatomical reduction group. 5. Complication after internal fixation were 4 cases e.g., two cases of varus deformity, one case of genitourinary tract infection and one transient peroneal nerve palsy. 6. Compression Hip Screw is a good internal fixation device to treat intertrochanteric fracture.
Aged ; Congenital Abnormalities ; Hip Fractures ; Hip ; Humans ; Internal Fixators ; Orthopedics ; Paralysis ; Peroneal Nerve ; Pneumonia ; Skin Ulcer ; Traction

70 cases free fiap were performed from March 1978 to July 1985. The donor fiap were dorsalis pedis flap in 34 cases, groin flap in 8 cases, osteocutaeous flap in 3 cases, gracilis flap in 17 cases, and latissimus dorsi flap in 8 cases respectively. The success rate was 90% in total including partial success. The causes of failure were 2 cases infection necrosis, and 1 case kinking of drain vessel. The gracilis and latissimus dorsi myocutaneous flap were very satisfactory method for the reconstruction of the upper extremity flexion power, especially in the case of Volkmann's ischemic contracture. The neurovascular dorsalis pedis flap was regarded as excellent method for the heel pad reconstruction, and tactile sensation reconstruction of the hand.
Free Tissue Flaps ; Groin ; Hand ; Heel ; Humans ; Ischemic Contracture ; Methods ; Microsurgery ; Myocutaneous Flap ; Necrosis ; Sensation ; Superficial Back Muscles ; Tissue Donors ; Upper Extremity

The skin defect with sensory impairment of volar aspect of fingers should be reconstructed for the better function of hand. The Neurovascular island graft has been used to provide sensation to volar surface the thumb and to replace pulp tissues avulsed from thumb or index finger. Authors performed neurovascular island graft for defective sensibility of finger tip loss in 14 cases since Jun. 1979 to Mar. 1985. The donor flaps were obtained from the ring finger in 9 cases and middle finger in 5 cases. Among 14 cases, the donor flaps were taken from the ulnar side of 3rd and 4th finger in 11 cases. We followed up the the patients from 7 months to 4 years and 6months and in last follow-up, recovery of protective sensation such as sharp/blunt discrimination, temperature discrimination, and touch/stroke discrimination, was good but two point discrimination and reorientation of sensa-tion were poor. Cold intolerance was developed in 11 cases, and longitudial linear scar band of donor digit was demonstrated in 12 cases.
Cicatrix ; Discrimination (Psychology) ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Sensation ; Skin ; Thumb ; Tissue Donors ; Transplants