No abstract available.
Reproduction*

In anterior dislocations of shoulder complicated by fracture of greater tuberosity, the prognosis of shoulder after reduction of dislocation depends upon associated injury of the rotator cuff. Early recognition and repair are thought to be essential if better functions is to be obtained. Among 40 patients with 41 dislocations, 28 cases with fracture of greater tuberosity were managed and treated at the Department of Orthopaedic Surgery, Hangang Sacredheart Hospital, Hallym University, from January, 1985 to December, 1988. The results obtained from this study were as follows: l. Among 40 patients with 41 cases of fracture-dislocation, 27 patients with 28 cases(68.3%) were complicated by fracture of greater tuberosity. Most of these were by traffic accident and occurred at the age of 40s and 50s. 2. According to the Depalma's classifcation, the most common type was type 2(15 cases, 53.5%). 3. Open reduction with repair of cuff was done in 2 cases of type 2 and 4 cases of type 3. 4. Rotator cuff injury was confirmed in eight operatively treated cases and in 3 cases by arthrography and ultrasonography. 5. Five operatively treated cases of fracture-dislocation with rotator cuff injury showed improved function especially in abduction. Therefore in anterior disloations with fracture of greater tuberosity, careful evaluation of anatomic reduction state of fragment after reduction and accompanying rotator cuff injury is necessary. If the fragment retracts under the acromion or still shows displacement more than 8-10mm after reduction, we may assume that a tear of rotator cuff is present and open reduction of fracture with repair of rotator cuff is essential for the better function of the shoulder.
Accidents, Traffic ; Acromion ; Arthrography ; Dislocations ; Humans ; Prognosis ; Rotator Cuff ; Shoulder ; Tears ; Ultrasonography

To cover soft tissue defect, various types of flaps have been used. Although lateral supramalleolar flap has been used as rotation flaps or reversed island flaps to cover defects around the foot and ankle, there has been no report about its application as a free flap. The lateral supramalleolar island flap has proves to be supplied constantly by the terminal branch of the peroneal arterys perforating branch. The free lateral supramalleolar flap has the same skin territory. Its vascular pedicle can be extended to the main peroneal artery and vena comitans, which can be obtained by dissecting the peroneal vessels between the distal tibia and fibula through the interosseous membrane. We have successfully transferred this free flap in eight patients from April 1994 to February 1995. All of the patients had full thickness skin defects which were caused by contact thermal burn, electrical burn, flame burn or traffic accident. There were no complications. From our experience, we feel that this new free flap have some advantages, induding vascular anatomy and long pedicle with large diameter and a relatively thin flap with minimal morbidity of donor site.
Accidents, Traffic ; Ankle ; Arteries ; Burns ; Fibula ; Foot ; Free Tissue Flaps* ; Humans ; Membranes ; Skin ; Surgical Flaps ; Tibia ; Tissue Donors

We report one case of bilateral naviculo-medial cuneiform coalition in ten year old girl. She complained of pain in the medial aspect of the mid-foot related to long periods of standing and activity. Routine roentgenographs, specifically lateral views showed a bony bridge between the navicular bone and medial cuneiform. A biopsy revealed as fibrocartilaginous tissue. The bony bridge consists about one third in lateral view and 30 degree cephalad tilting in the antero-posterior view. Bilateral resection arthroplasty, with interposing flesh muscle fibers of the abductor hallucis, was performed for restoration of motion in the naviculo-medial cuneiform joint and relief of localized pain. Four months after surgery, pain around the mid-foot had almost complete subsided. One year postoperative, neither recurrence nor disability was observed. We will discuss the diagnosis and treatment of this rare case of bilateral naviculo-medial cuneiform coalition.
Arthroplasty ; Biopsy ; Diagnosis ; Female ; Humans ; Joints ; Recurrence

Although several histopathological changes have been developed in frozen shoulder, frozen shoulder is mostly accompanied by the changes of the rotator cuff which has the most important function in movement and has a role in stabilizing the shoulder joint. The changes of the rotator cuff in frozen shoulder have not been reported in Korea yet, but Simon reported that there was an attenuation of the rotator cuff in frozn shoulder. Accordingly, we observed the changes of the rotator cuff in frozen shoulder by ultrasonography, which has no rsdiation exposure and is non-invasive. The authors practiced the shoulder ultrasonography on 36 patients with a pain and limitation of motion in shoulder at the Dept. of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University, from March in 1988 to August in 1988. The results are as follows ;1) Ultrasonography is thought to contribute a great deal in detection of the changes of the rotator cuff, especially of the thickness of the rotstor cuff. 2) Among 36 patients, the thickness of the rotator cuff of 35 patients was 6.494+1.008 mm (M+SD) in the affected shoulder and 6.475+1.052 mm(M+SD) in the unaffected shoulder. In only one pstient, the thickness of the rotator cuff was 1.68+0.58 mm(M+SD) in the affected shoulder and 553+1.16mm(M+SD) in the unaffected shoulder. Theres no significant change in the thickness of the rotator cuff measured by ultrasonography in frozen shoulder. 3) Ultrasonography is an excellent diagnostic method in detecting the rupture of the rotator cuff in frozen shoulder.
Bursitis ; Heart ; Humans ; Korea ; Methods ; Orthopedics ; Rotator Cuff ; Rupture ; Shoulder ; Shoulder Joint ; Ultrasonography

In the treatment of malleolar fracture, anatomical reduction and rigid internal fixation are essential to prevent the complications such as infection, malunion or nonunion, traumatic arthritis, skin necrosis and joint contracture. But it is often difficult to obtain rigid fixation for medial malleolar fracture because of its comminution or thin cortex with osteoporosis. Generally, two operative methods are available for medial malleolar fracture, which are malleolar lag screw fixation and tension band wiring. The purpose of this paper is to analyze which operative method is better for anatomical reduction and rigid fixation and has less postoperative complications for medial malleolar fractures. From March 1992 through March 1995, 88 patients had undergone surgical intervention for medial malleolar fractures. The patients were divided into 2 groups according to operative method for medial malleolar fracture. For one group, malleolar lag screw together with or without a K-wire was used in 48 patients, and for the other group, tension band wiring was used in 40 patients. The average follow-up periods were 14 months in screw fixation group and 13 months in tension band wiring group. The average union time were 15.4 weeks (8-17 weeks) in screw fixation group and 12.2 weeks (6-15 weeks) in tension band wiring group. 27 cases (56%) showed excellent result in screw fixation group and 30 cases (75%) in tension band wiring group. In the patient over 50 years old, 2 (15%) in 13 cases showed excellent result of screw fixation group, while 5 (45%) in 11 cases of tension band wiring group. We concluded that tension band wiring is a better method for medial malleolar fracture to obtain early union and to prevent postoperative complications, especially in the elderly patient.
Aged ; Arthritis ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Middle Aged ; Necrosis ; Osteoporosis ; Postoperative Complications ; Skin

The coronary artery cross sectional area (CSA) is proportional to LV mass. We have measured the cross sectional area of the left and right coronary arteries in patients with ischemic heart disease to see whether it is related to the change in the LV mass. The following results were obtained ; 1) There were no significant difference in mean CSA of coronary arteries and LV mass determined by echocardiography and cineangiography between control and ischemic heart disease. 2) There were significantly increased ratio of left ventricular mass by cineangiogram to CSA of left anterior descending coronary artery in patients with myocardial infarction as compared with control group. 3) A linear relation between LV mass by cineangiogram and CSA of left coronary artery was noted in control group (r=0.53, P<0.05) and ischemic heart disease group (r=0.51, P<0.05). 4) A linear relation between LV mass determined by echocardiography and CSA of left coronary artery was noted in control group (r=0.55, P<0.05).
Cineangiography ; Coronary Vessels* ; Echocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia

No abstract available.
Rhabdomyosarcoma*

The use of pure titanium and titanium alloys have been increased recently in fixed, removable prosthodontics and implant fields as a framework. But when they were used for superstructures of implant of metal framework of removable prosthesis, welding is necessary to reconnect the fracture site to control the casting distortions. To overcome the difficulties in soldering the titanium due to high oxidation property, much effort have been devoted. In this study, some of mechanical properties were compared between pure titanium and Ti-6Al-4V alloy by usingl aser welding, electron beam welding technique and tungsten arc welding. Mechanical properties such as tensile strength, yield strength, elongation and microhardness were measured. And, in order to compare the effect of welding site and surrounding metal tissue according to the welding condition, SEM photographs were taken an element distribution was observed by Wave Dispersion Spectroscopy. Through analyses of the data, following results were obtained; 1. In items such as tensile strength, yield strength and elongation according to the welding techniques of pure titanium, only tungsten arc welded group showed significant lower value than other groups(P<0.05). 2. In items such as tensile strength and yield strength according to the welding techniques of Ti-6Al-4V alloy, control group and tungsten arc welded group showed significant difference among all the groups(P<0.05). 3. Ti-6Al-4V alloy exhibited significantly greater elongation than control group when the laser welding method and electron beam welding method were used, and elongation showed increasing tendency. 4. Pure titanium specimens exhibited increasing tendency of microhardness regardless of the welding technique applied, and especially tungsten arc welded group demonstrated a great increase of microhardness than parent metal. 5. There was no hardness change in laser welded group and electron bean welded group of Ti-6Al-4V ally, but in tungsten arc welded group, hardness changed greatly from parent metal to weld seam. 6. Through the metallographic examination and scanning electron microscopy, laser welding caused central fusion and recristallizations were formed and tungsten arc welding caused localized fusion to 0.3-0.7mm from the surface.
Alloys ; Hardness ; Humans ; Microscopy, Electron, Scanning ; Parents ; Prostheses and Implants ; Prosthodontics ; Spectrum Analysis ; Tensile Strength ; Titanium* ; Tungsten ; Welding*

PURPOSE: This study evaluated the initial stability of different implants placed above the bone level in different types of bone. MATERIALS AND METHODS: As described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Branemark System(R) Mk III TiUnite(TM), Straumann Standard Implant SLA(R), and Astra Tech Microthread(TM)-OsseoSpeed(TM)) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis. RESULTS: In the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Branemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants. CONCLUSION: The initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.
Linear Models