The purpose of this study is the present the short rerm result of arthroscopic reconstruction for PCL injury. Since January l990, authors have implanted the synthetic polyester ligament (ABC ligament, Surgicraft, U.K) into the substance of ruptured PCL proper under arthroscopic control. The follow up period ranged from 24 months to 61 months (average,35months). The main cause of injuries were traffic accidents in 38. Thirtyfive of patient were men and three were women, range in age from 18 to 70 years (average, 37 years). 18 were acute injury and operated at average 12 days after injury and 20 knee were chronic injury and operated at average 9 months after injury. There were 25 case that had combined ligament injuries (l2 ACL injury, ]0 MCL injury, 8 LCL injury elc). In 15 knees, the tear was in the mid substance area and in 13 it was near femoral attach site and in lO it was near tibial attach site. Postoperative result were evaluated by roentgenographic evaluation of posterior sagging, KT-20 (0 arthrometer and Lysholm knee score. Difference were improved from 12.5 mm (mean: pre.op) to 3.8m (mean: post.op) on posterior drawer test. Both knee showedminimal difference on KT-20N) study (2.l mm on 201b) at the time of follow up. The average Lysholm knee score were 84.7. By Clancy criteria, the result were exceflent 9 case (24%), good in 20 case (53%), fair in 7 case (18'Po) and failui e in 2 case (5%). On based of this study, arthroscopic augmentation with ABC ligament in PCL injury is very effective treatment but more longer follow-up and more case must he needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Ligaments* ; Male ; Polyesters* ; Posterior Cruciate Ligament*

No abstract available.
Femur* ; Hip Fractures* ; Hip*

In the orthopaedic field, some elective surgery such such as joint replacement, spinal surgery and limb sparing procedures for musculoskeletal tumors frequently need various amounts of blood trans- fusion. But homologous transfusion occasionally result in various side effect including allergic reaction, febrile reaction, coagulopathies due to reduced platelets and coagulating factors, graft versus host disease(GVHD) and transmission of infectious diseases such as malaria, syphilis, hepatitis and AIDS. Recently these complications especially in elective surgery might result in medicolegal and social problem. Risks of transfusion could be minimized with autologous blood. So many authors are interested in prebanked autologous transfusion in elective orthopaedic surgery to prevent these problems. But there might be need of additional homologous blood transfusion because of the time limited and low yield of autologous blood. Recombinant human erythropoietin(4-HuEPO) has been shown to increase erythropoiesis. The authors could yield 5 units during 14 days using r-HuEPO without any adverse reactions. Therefore we could performed decompression, posterolateral fusion with pedicular screw fixation in spondylolisthesis without additional homologous transfusion.
Blood Transfusion ; Communicable Diseases ; Decompression ; Erythropoiesis ; Erythropoietin ; Extremities ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Malaria ; Social Problems ; Spondylolisthesis ; Syphilis ; Transplants

The prime objective in treating the intertrochanteric fracture is to achieve bony stability at the fracture site using an appropriate fixation nail plate to maintain a stabilized position. Since the introduction of the Smith-Petersen nail, numerous internal fixation devices have been developed. Complications after surgical treatment of intertrochanteric fractures of the femur though rarely resulting in non-unions or aseptic necrosis of the femoral head, varus deformities or delayed unions are frequent. Recently a compression hip screw is popular because it can provide more secure internal fixation. The authors treated 41 cases of intertrochanteric fractures of the femur during a 5. 5 year period from January, 1975 to June, 1980. 1. Of 41 cases of intertrochanteric fractures, 9 cases were stable fractures, and 32 cases were unstable. 2. Of 4I cases of intertrochanteric fractures, 9 were treated conservatively, and 32 were treated with open reduction and internal fixation. Of the fixation devices, compression hip screws were used in 17 cases, Jewett nail plates in 12 cases, Mclaughlin plate in 2 cases, and a Judet plate in a case. 3. Of the 32 cases treated by open reduction, reduction with medial displacement by the Dimoe- Hughston method was used in 10 cases, 3 of which were fixed with compression hip screws and 7 with Jewett nails. The remaining 22 were anatomically reduced. 4. The average time until weight bearing in conservatively treated patients began was 17. 7 weeks but in the surgically treated patients weight bearing started after 5. 5 weeks, and in patients treated with a compression hip screw patient conld bear weight 3. 7 weeks after surgery. 5. The average fracture union time was 16. 6 weeks in conservatively treated patienta, 16. 3 weeks in operatively treated patients (14. 6 weeks in compression hip screw fixation group, 18 weeks in Jewett nail, 21 weeks in Mclaughlin plate,16 weeks in Judet plate). 6. There were complications in 8 cases; 3 in the conservatively treatment group, and 5 in the internal fixation group. Of 5 internal fixation cases, 2 complications were caused by technical error. 7, After comparison of the result of treatment obtained by 4 different types of iaternal fixation devices, our conclusion is that compression hip screw is the device of choice for treatment of intertrochanteric fractures.
Clinical Study ; Congenital Abnormalities ; Femur ; Head ; Hip ; Hip Fractures ; Humans ; Internal Fixators ; Methods ; Necrosis ; Weight-Bearing

Degenerative lumbar spondylolisthesis requires fusion of the involved segments and decompression laminectomy because it is mechanically unstahle and usually associated with stenosis of the spinal canal. Transabdominal retroperitoneal approach through small longitudinal pararectal skin incision provides easy and safe access to L3-4 and L4-5 disc spaces with less bleeding. We thought that anterior interbody fusion enable us to restore the disc space and to reduce partially the listhesis with less hleeding and less harvest of graft hone compared to posterolateral fusion, and also without the risk of neural or dural damage which could he occurred in posterior lumbar interbody fusion 4.15.16.17). Thus, authors performed the same-day anterior and posterior spinal surgery (APSS) in 28 patients (30 disc spaces) from 1992 to 1996 and analyzed the clinical and radiological results. The most common site of involvement was L4-5 level (82.1%). The mean follow-up period was 2 years and 2 months (from l2 months to 4 years). Fusion was ohtained at 29 disc spaces (96.7%) within 24 weeks (average, I 6 weeks). The anterior displacement was corrected up to the average of 65.4% (5.8mm) postoperatively and the average of 60.7% (5.2mm) correction remained at last follow-up. The intervertebral disc space was restored up to the average of 96.9% (7.5mm) postoperatively and the average of 86.0% (6.2mm) restoration remained at last follow-up. Twenty-five out of 28 patients (89.2%) showed excellent or good clinical results hy the criteria of Kim, et al6). In conclusion, the same-day procedure of successive anterior interbody fusion, decompression laminectomy and posterior pedicular instrumentation for the degenerative lumbar spondylolisthesis associated with spinal stenosis was thought to be a good method of treatment.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Hemorrhage ; Humans ; Intervertebral Disc ; Laminectomy ; Skin ; Spinal Canal ; Spinal Stenosis ; Spondylolisthesis* ; Transplants

We experienced a case of achondroplasia in 34 month old male infant. Diagnosis was suspected by clinical features and radiologic examination. A review of literature was made briefly.
Achondroplasia* ; Child, Preschool ; Diagnosis ; Humans ; Infant ; Male

Median nerve injury after elbow dislocation is uncommon. The diagnosis of median nerve entrapment is often delayed. Median nerve paralysis is caused by entrapment within the elbow joint. If median nerve paralysis occurs following elbow dislocation or if it occurs following closed reduction, entrapment should be suspected. Optimal management of this problem consists of early surgical exploration and decompression. We report a case of a child who had entrapment of the median nerve in the elbow joint after closed reduction of posterior dislocation with fracture of the medial epicondyle. The diagnosis was made ten weeks after injury at surgical exploration. This case showed a characteristic radiologic sign in the anteroposterior radiograph. We released the entrapped median nerve with a successful result.
Child ; Decompression ; Diagnosis ; Dislocations ; Elbow Joint ; Elbow ; Humans ; Median Nerve ; Paralysis

The ocular tilt reaction (OTR) represents a fundamental pattern of eye hand coordination in roll plane and consists of head tilt, conjugate eye torsion, hypotropia, all toward the same side. OTR can be observed not only in patients with peripheral vestibular dysfucntion but also in these with lesions of the graviceptive pathway, which runs from the vestibular nuclei, crossing the midline at the caudal pons, to the intersititial nucleus of Cajal in the rostral midbrain. We present two patients showed complete OTR with the caudal pontine lesions. The first patient was a 65-year-old woman and the lesions involved the dorsolateral portion of pontomedullary junction and cerebellum which was corn patible with AICA and PICA territorial infarction, a magnetic resonanse image(MRI). The ipsiversive OTR in the first patient might be secondary to the ipsilateral vestibular nuclear lesion. The second patient was a 60 year old man and revealed the infarctions in tegmental portion of caudal pons and cerebellum on MRI. The contraversive OTR in the second patient may be secondary to the pontine tegmental lesion involving medial longitudinal fasciculus which is a structure responsible for ascending crossed contralateral graviceptive pathway. OTR is a sensitive brainstem sign of lateralizing and localizing value and our presenting cases support that OTR represents vestibular tone imbalance in the graviceptive pathways.
Aged ; Brain Stem ; Cerebellum ; Female ; Hand ; Head ; Humans ; Infarction ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Pica ; Pons ; Vestibular Nuclei ; Zea mays

No abstract available.
Female ; Hysterectomy, Vaginal*

Hemorrhagic radiation proctitis is infrequently seen in patients receiving pelvic irradiation. The treatment of hemorrhagic ralation proctitis is often difficult. Many patients need reyeated hospitalizations and blood transfusions. Occasionally patiets will develop severe or recurrent rectal bleeding. In case of massive bleeding requiring excessive transfusion, colonic diversion by construction of a colostomy or excision of the diseased segment may be inevitable. However, surgical procedures in these patients are associated with a high mortality and morbidity. Moreover, medical therapy is usually ineffective. Recently formalin therapy has been introduced as a simple and effective treatment for hemorrhagic radiation proctitis. We experienced a 69 year-old woman patient who developed severe homorrhagic proctitis 1 year after radiotherapy for carcinoma of the cervix. She had not improved by conservative management and required blood tranafusions and repetitive hospitalizations. After local application of a 4% formalin solution in the diseased rectum under caudal anesthesia, the bleeding immediately stopped and the patient was discharged from the hospital, and no recurrence has been observed until now.
Aged ; Anesthesia, Caudal ; Blood Transfusion ; Cervix Uteri ; Colon ; Colostomy ; Female ; Formaldehyde* ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Proctitis* ; Radiotherapy ; Rectum ; Recurrence