Traumatic dislocation of peroneal tendons is caused by sudden dorsiflexion of the foot accompanied by a powerful contraction of peroneal muscles. This tears the peroneal retinaculum and allows the tendons to dislocate anteriorly. This injury is not uncommon, but clinically it has been given little attention. Authors experienced a case of traumatic dislocation of peroneal tendons which was treated surgically with good result.
Dislocations ; Foot ; Muscles ; Tears ; Tendons

No abstract available.
Patella*

Spinal stenosis was defined as any type of narrowing of the vertebral canal, nerve canals or intervertebral foramina. It is difficult to diagnose spinal stenosis due to obscure symptoms and signs, and there is not established theory on its surgical treatment. Two hundred and three patients who had been treated surgically for lumbar spinal stenosis between 1979 and 1985 at Department of Orthopedic Surgery, Seoul National University Hospital, were studied in an attempt to define the etiology and the diagnosis, and to assess the results of surgical treatment. They were followed up from 1 year to 8 years with average duration of 3.5 years. 1. Degenerative change in the lumbar spine was the principal etiologic factor in 142 patients (70.0%) Spondylolisthesis was found in 47 patients (23 1%). 2. Back pain(81.3%) and intermittent claudication(71.4%) were the predominant symptoms, and sensory (61.1%) and motor(59.6%) deficit were the leading signs. Limitation of straight leg raising was observed only in 12.3%. 3. The most common myelographic finding was hourglass defect(38.4%) and that of CT was facet joint hypertrophy(97.6%). Preoperative CT with myelographic findings were confirmed intraoperatively in 97.4%, revealing their diagnostic significance. 4. Total laminectomy combined with foraminotomy and posterolateral fusion was the most frequently employed procedure and performed in 153 patients(75.4%). 5. The results were classified as excellent or good in 88.2%. Whether or not Knodt rod was used for internal fixation, there was no statistically significant difference between the two groups in reation to the results(P>0.05). Factors for satisfactory results were adequate decompression and posterolateral fusion with sufficient bone graft.
Decompression ; Diagnosis ; Foraminotomy ; Humans ; Laminectomy ; Leg ; Orthopedics ; Seoul ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants ; Zygapophyseal Joint

Electrical burn is thought to be similar to crushing injury in that it usually involves skin, muscle and neurovascular structure simultaneously. Especially in extremity, there are many occasions that amputations are inevitable. Since the demarcation between viable and non-viable tissue tends to be obscure, electrical burn greatly differs from other types of injury in detailed methods of treatment, such as the level, the timing and the technique of amputation. During the past 10 years from January, 1978 to December, 1987, authors experienced 285 amputations in 181 cases of electrical burn at Orthopedic Department of Hanil Hospital. The clinical data of our experience were reviewed and analysed. The results were as follows ;l. Amputation rate in electrical burn was 22.4%. 2. Out of total 285 amputations, the number of upper extremity was 187 (65.6%) and it was 1.9 times more than that of lower extremity. Right forearm was 1.8 times more than left forearm. 3. Multiple limbs amputation were performed in 83 cases (45.9%). 4. Among 285 stumps, more than one operation were done in 74 stumps because of infection (50%), necrosis of stump end (35.1%), bony overgrowth at stump end (8.1%) and neuroma(6.8%).
Amputation ; Amputees ; Burns ; Extremities ; Forearm ; Humans ; Lower Extremity ; Necrosis ; Orthopedics ; Skin ; Upper Extremity

Metaphyseal Chondrodysplasia is rare, hereditary disease characterized by defective enchondral bone formation with major manifestation at the metaphysis. Jansen originally used the term metaphyseal dysostosis in 1934 to describe a patient who has a short stature with irregular metaphysis of the lower extremity and hands. Schmid reported a milder form of Metaphyseal dysostosis in 1949, which is more common and is transmitted in autosomal dominant trait. Mukusick reported another form of Metaphyseal Chondrodysplasia which is associated with ectodermal abnormalities in 1964. The other different types were reported alos, but they are extremly rare. The basic defect in the disease may be the failure of hypertrophic cells to mature and degenerate, caused by a block in or deficiency of enzymes of glycolytic cycle. The skull and spine are spared. Serum chemistry and kidney function are normal. The only treatment necessary, once adequate diagnosis has been estabilished, is careful observation and properly timed corrective orthopaedic surgery. We experienced one case of Schmid Type Metaphyseal Chondrodysplasia. Corrective osteotomy was performed and satisfactory result was obtained.
Chemistry ; Diagnosis ; Dysostoses ; Ectoderm ; Genetic Diseases, Inborn ; Hand ; Humans ; Kidney ; Lower Extremity ; Osteogenesis ; Osteotomy ; Skull ; Spine

Twenty-four cases of complete acromioclavicular dislocation had been treated surgically by Weaver and Dunn method at Hanil Hospital during the period from March 1976 to March 1988. Among twenty-four cases, we had average 84.4 months follow-up data on fifteen cases with acute complete dislocation and two cases with chronic complete dislocation. The following results were obtained. 1. The transferred coracoacromial ligament had been secured to the resected clavicular end by wire or silk(silk in eleven cases, wire in six). All patients in wire sutured group had to be reoperated on because of breakage of wire. But no significat differences in final clinical function of the shoulder was seen. 2. Calcification was found in the region of the transferred coracoacromial ligament in twelve cases(70.6%). 3. All patients had normal shoulder motion, sixateen(94.1%) were asymptomatic, and only four(23.5%) felt mild weakness of shoulder. 4. On the clinical assessment by the criteria of Imatani et. al., 12 patients(70.6%) were graded excellent, 4 patients(23.5%) were good, and one patient(5.9%) was fair.
Acromioclavicular Joint ; Dislocations ; Follow-Up Studies ; Humans ; Ligaments ; Methods ; Shoulder

The electrical burns constitute a unique type of thermal injury and usually consist of a limited area of cutaneous burn, but associated with deep muscle damage of variable extent. The deep tissue destruction resulting from such injury leads to high incidence of amputation. So electrical burns are different from other types of injuries requiring individualized and varied methods of treatment, such as early fasciotomy, repeated debridement, wound coverage and technique of amputation. During 5 years from Jan. 1988 to Dec. 1992, we experienced 310 cases of electrical burn. We analyzed these cases on the aspects of functional result and necessity of amputation according to the treatment variability. The result showed the extent of burn in amputation group was 11.6%, salvage group 13.1%, with no difference of extent between 2 groups(p>0.05, by qui square test). When the fasciotomy was done earlier than 12 hours after injury showed 39.1% of more than good functional result, when later than 12 hours 7.7% of more than good, that is, earlier fasciotomy resulted in better function(p < 0.05, qui square test). The amputation rate was 23.9% during the last 5 years which was a marked improvment when compared to the previous ten years(32.4%). From these results we concluded that in order to reduce the rate of amputation and to improve the function of patients, early fasciotomy, early repeated debridement and wound coverage is necessary.
Amputation ; Burns ; Debridement ; Humans ; Incidence ; Wounds and Injuries

The percutaneous pinning is a simple, effective method for the treatment of displaced supracondylar fractures of the humerus in children. But there is some controversy in the number of pins used and the method of pin insertion. The cross pinning method provides more stability at the fracture site but the risk of ulnar nerve damage is higher than in lateral pinning method, The senenty-one displaced extension type supracondylar fractures were treated by closed reduction and percutaneous cross pinning from January 1991 to October 1994. Among them, the medial pin was inserted in elbow extension in twenty-eight cases and in forty- three cases the medial pin was inserted in elbow flexion. Ulnar nerve injury occured postoperatively in six cases, in which the pin was inserted with the elbow in flexion position. These results may suggest that when percutaneous cross pinning method is selected to fix the supracondylar fracture of the humerus, it would be safer to insert one or two lateral pins with the elbow in full flexion position followed by one medial pin in extension position in order to reduce the risk of loss of reduction and ulnar nerve damage.
Child ; Elbow ; Humans ; Humerus ; Methods ; Ulnar Nerve

No abstract available.
Metacarpophalangeal Joint* ; Palmar Plate*

Since CT scanning was introduced in the diagnosis of calcaneal fracture, we became to understand more clearly the pathoanatomy of the injury. However we have to determine if we would or would not take CT scanning by simple radiography in the acute setting and most of the surgeons still use simple radiography in evaluating postoperative result. And also we have to determine the accuracy of reduction and position of screws by simple radiography intraoperatively. The purpose of this report is to determine the accuracy of simple radiography in assessing the pathological anatomy of the intraarticular calcaneal fracture by experimental and clinical studies. This is a combined experimental and clinical studies using four below knee amputation specimens and 15 patients with 19 displaced intraarticular calcaneal fractures treated at Hanil General Hospital between Jan. 1996 and May 1997. The lateral view of the foot was the best radiographic view for visualizing the degree of depression of the posterior facet. With regard to the location of a fracture line, findings of Broden views correlated well with findings on CT in 17 of 19 fractures. With regard to gapping between fragments, the axial view was not satisfactory in the majority of cases(15 of 19 cases). There was no case which showed more than 2 mm of discrepancy between the findings on Broden view and CT. We conclude that we may obtain most of the important informations about the pathological anatomy of the intraarticular calcaneal fracture by simple radiography.
Amputation ; Depression ; Diagnosis ; Foot ; Hospitals, General ; Humans ; Knee ; Radiography* ; Tomography, X-Ray Computed