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

No abstract available.
Patella*

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

Autologous Transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs in very limited, however, because of concern over the possibility of inducing premature labor or causing fetal distress by blood volume change or vasovagal reactions. We describe our experience with pregnant women in this program. The incidence of vagovagal reactions of autologous donation was 9.5% (2.21). After entry into this program, 17pastients received a total 37pints, which consist of 19 Autologous and 18 Homologous. Homologous transfusion was avoided in 30% of patients receiving blood. The values of the mean hematocrits before and after hpebotomy were 34.1% and 31.8% respectively. It was stastically significant (p<0.01). We recommended that autologous blood donation by pregnant women in third trimester is safe for mothers or infants and it should be strongly encouraged for patient with placenta previa and repeated cesarean section.
Blood Donors ; Blood Volume ; Cesarean Section ; Female ; Fetal Distress ; Hematocrit ; Hemorrhage* ; Humans ; Incidence ; Infant ; Mothers ; Obstetric Labor, Premature ; Placenta Previa ; Pregnancy ; Pregnancy Trimester, Third ; Pregnant Women* ; Surgical Procedures, Operative

No abstract available.
Femur* ; Hip*

No abstract available.
Metacarpophalangeal Joint* ; Palmar Plate*

No abstract available.
Hip* ; Pyomyositis*

Purpose: With the increasing incidence of recompression fractures after vertebroplasty or kyphoplasty, this study analyzed the risk factors that affect the occurrence of recompression vertebral fractures, such as cement distribution, existence of avascular necrosis (Kummell’s disease), type of procedures, bone mineral density, sex, and age. Materials and Methods: Two hundred and thirty-eight patients who underwent vertebroplasty or kyphoplasty at the author’s clinic from 2005 to 2015 were enrolled in this study. The patients were divided into four groups according to the distribution of injected cement. The patients were classified as type 1 and type 2 when injected cement was contacted only to the upper or lower endplate of the body respectively. They were classified as type 3 when both the upper and lower endplates were contacted by injected cement. When neither the upper nor the lower endplate was contacted, the patients were called type 4. This study statistically evaluated the effects of the risk factors, including the cement distribution on the incidence of recompression vertebral fracture after vertebroplasty or kyphoplasty. Results: There were 59 cases (24.8%) of recompression fracture after vertebroplasty or kyphoplasty, among the 238 cases. According to the analysis, the recompression of the vertebral body after vertebroplasty or kyphoplasty occurred more often when the compression fracture was accompanied by osteonecrosis at the body (p<0.05). The patients who had injected cement distributed at both upper and lower plate simultaneously (type 3) had a lower incidence of recompression fracture of the vertebral body after vertebroplasty or kyphoplasty (p=0.008). In addition, the kyphoplasty group had a lower incidence of recompression after the procedure than vertebroplasty group (p=0.02). Conclusion Careful attention should be given to these patients with osteonecrosis at the compression fracture level through a preoperative evaluation. In addition, if the injected cement does not contact both the upper and lower endplates, careful observation is required during the follow-up period based on the high incidence of vertebral recompression fractures proven through this study. Further technical and biomechanical research and efforts will be needed to make the cement contact both endplates.

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. RESULTS: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter-mediate groups. CONCLUSION: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in malnourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross-sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.
Alkaline Phosphatase ; Anthropometry ; Body Weight ; Chemistry ; Cholesterol ; Creatinine* ; Cross-Sectional Studies ; Dialysis ; Humans ; Incidence ; Malnutrition ; Mortality ; Nitrogen ; Nutritional Status ; Peritoneal Dialysis, Continuous Ambulatory* ; Protein-Energy Malnutrition ; Serum Albumin ; Transferrin ; Triglycerides ; Urea*