Dysplasia epiphysealis multiplex is a rare syndrome, first discribed by Fairbank in 1935, but numerous publications have made it a well-recognized entity. The syndrome is caused by a congenital developmental error of unknown etiology, characterized by changes in the developing epiphyses, dwarfism and stubby digits in children of normal intelligence. Diagnosis is mainly by roentgenographic apperences of the epiphyses before fusion to the shaft. The centers of ossification of the epiphyses are late in appearing, slow in developing, deformed in shape and irregular in density. The spine is never affected, blood and biochemicaI studies show no abnormality. A case of dysplasia epiphysealis multiplex which revealed typical roentgenographic pictures is presented with a brief review of a literature.
Child ; Diagnosis ; Dwarfism ; Epiphyses ; Humans ; Intelligence ; Spine

One hundred and sixty five cases of the fracture of tibial shaft in adult have been treated and managed in the Department of Orthopedic Surgery, Kyunghook National University Hospital during the period from January, 1965 to December, 1970. Seventy one of 165 patients were analyzed clinically and we came to the following conclusions. 1. Most of the injuries were the results of traffic accident (67.6%). 2. The incidence of trauma was high in the young man, most frequent in the 3rd decade. 3. The closed fractures were three times more than open fractures and the middle third of tibial shaft was the most frequent site of fracture. 4. The average healing period was 16 weeks in mild case and 28 weeks in severe case. 5. Of 71 cases, we experienced 4 cases of non-union, 8 cases of residual joint stiffness at the knee and the ankle and 3 cases of leg shortening (more than 2 cm.) as complication.
Accidents, Traffic ; Adult ; Ankle ; Clinical Study ; Fractures, Closed ; Fractures, Open ; Humans ; Incidence ; Joints ; Knee ; Leg ; Orthopedics

Osteogenesis Imperfecta is a rare affection characterized by fragility of the bones, blue sclerae, and deafness, less frequently by hypermobility of the joints. The etiology is unknown, but it appears to be a mesenchymaldefect. A cases of osteogencesis imperfecta (tarda form) in a 18 yesrs old male is presented with a review of the literatures. The chief complaints were bowing deformity of the all extremites and blue sclera. In this cases, other typical features such as deafness and hypermobility of the joints were not observed. X-ray showed multiple malunited fraeture, of all long bones of extremities except Ieft humerus. For the treatment of bowing deformity of right humerus, multiple corrective osteotomy and intramedullary nailing was performed and the result was good.
Congenital Abnormalities ; Deafness ; Extremities ; Fracture Fixation, Intramedullary ; Humans ; Humerus ; Joints ; Male ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Sclera

It has been known that the inducing factors of low back pain are numerous such as songenitaI anormalies, degenerative, traumatic and inflamatory pricess of the spine and its adjacent structures. Despite many relevant literatures upon low back pain, it has been also known that to differentiate causes of low back pain is difficult but very important for treatment. Exclusive of those who had defenite trauma history of spine, 704 cases low back pain in adult, treated at Dept. of Orthopedic surgery Kyungpook University Hospital during recent 3yr & 4 months were reviewed and analyzed by the X-ray findings of lumbar spine. Anterioposterior and Iateral films of lumbar spine were available in each cases but oblique fiIms and myelography was also available as indicated, The results obtained were as follows. 1. The roentgenograms of the spine of 704 cases were reviewed. 494 cases revealed structual changes of the spine. 273 cases were non specific. 2. Of 494 cases reavold structual changes, 273 cases were disease entities, 190 cases were bony abnormalities, and combined cases were 67. 3. Among 273 cases of disease, disc herniation was most common except osteoarthritis(32cases) Tuberculous, spondylolitis, 23cases and pyogenic spondylolitis was 3 cases. 4. Among 257 cases of Bony afnormalities, spina bifida was most common (128 cases). 5. Degenerative changes of the spine was appeared in 3rd. decades (4.8%) and the incidence and severity increased with age. 6. Among 34 cases of multiple abnormalities, 33 cases were combined with spina bifida.
Abnormalities, Multiple ; Adult ; Gyeongsangbuk-do ; Humans ; Incidence ; Low Back Pain ; Myelography ; Orthopedics ; Spinal Dysraphism ; Spine

No abstract available.

To assess the influence of diabetes mellitus on the healing of segmental defect of rat, a defect measuring 5mm was made at right sciatic nerve in thirty-three adult female Wistar rats(control group:17, diabetic group:16). To induce diabetes in rats, Streptozotocin(50mg/kg body weight) was injected into tail vein after dissolution in saline solution. Both proximal and distal nerve ends were connected with 9mm long silicone tube, and the tube was filled with 10µl collagen(Vitrogen 100) solution. Two and 4 weeks after the operation, electromyographic study(latency period and amplitude) and histologic examination(the number of myelinated axon, non-neuronal cell, and vessel at mid-chamber level, the mid-chamber cross-sectional area) after toluidine blue staining were carried out. From the results, we concluded that diabetes mellitus retarded the healing process of segmental defect of sciatic nerve in rat. And we might suggest that if we meet this situation in clinical practice, we have to consider some supportive measures to overcome the bad effect of diabetes mellitus on the healing of nerve defect.
Adult ; Animals ; Axons ; Diabetes Mellitus ; Female ; Humans ; Myelin Sheath ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Sodium Chloride ; Tail ; Tolonium Chloride ; Veins

Between 1989 and 1995, 14 patients with Kienbock's disease were treated with radial shortening or a radial wedge osteotomy. Clinical and radiological changes were classified according to Lichtman's stages and ulnar variance. Seven patients were male and seven were female. The mean age was 45 years, ranging from 29 to 64. The average follow-up period was 29 months, ranging from 12 to 61. Of the ten patients with negative ulnar variance who were treated by radial shortening, two cases were in Lichtman's stage II, six cases were stage III-a and two cases were stage III-b. Of the four patients with zero or positive ulnar variance who were treated by a radial wedge osteotomy, one case was stage 11 and three cases were stage III-a. The results were evaluated in terms of diminished wrist pain, increased grip strength, increased range of wrist motion and radiologic changes of the lunate. Wrist pain had diminished in all patients and grip strength had increased on average from 54% to 70% in the unaffected side. The range of arc of the wrist had increased on average from 59degrees preoperatively to 93 postoperatively. Sclerosis of the lunate improved in 43% of cases, cystic changes of the lunate improved in 57%, fragmentation of the lunate improved in 36% and the carpal height ratio increased in 50%. Of the 14 patients, 13 patients (93%) showed satisfactory results. One patient had an unsatisfactory result, according to Lichtman's criteria. These results suggest that radial shortening or a radial wedge osteotomy is recommended in patients with stage ll, III-a or III-b Kienb ck's disease, according to the ulnar variance. Early wrist pain reduction, increased range of motion and grip strength and improved avascularity of the lunate are all positive outcomes attainable with these treatment methods.
Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Osteonecrosis* ; Osteotomy* ; Range of Motion, Articular ; Sclerosis ; Wrist

Anatomically flexor pollicis longus is different from deep finger flexors. Flexor pollicis longus tendon is unique in that it may be advanced without disturbing its blood supply, since it has no vinculum. From January 1990 to December 1992, 17 cases of patients with laceration of the flexor pollicis longus tendon were treated at Kyungpook National University Hospital. The follow up period ranged from 3 to 36 months. The results were as follows; 1. agents causing the laceration were broken bottles in 10 cases(58.8%), knives in 3 cases(17.6%) and machinary like saw in 2 cases(11.8%). 2. Totally 17 cases, 9 cases of them were located at distal to metacarpophalageal joint. 3. As associated injuries, digital nerve injuries were 4 cases(23.5%) and the recurrent branch of median nerve injuries was 1 case. 4. The surgical treatment was direct suture with or without proximal lengthening in 13 cases(76%) as primary or secondary repair and distal advancement with or without proximal lengthening in 4 cases(24%) as secondary repair. 5. Distal to metacarpophalangeal joint, the surgical treatment was direct suture with or without proximal lengthening in 3 cases as primary or secondary repair and distal advancement with or without proximal lengthening in 4 cases as secondary repair. 6. The result by Urbaniak method was excellent in 8 cases(47.0%), good in 7 cases(41.2%) and fair in 2 cases(11.8%). 7. Based on the results in these patients, it was recommended that secondary treatment for lacerations distal to the metacarpophalangeal at the wrist, as needed is bettewr than free tendon graft.
Fingers ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Joints ; Lacerations ; Median Nerve ; Metacarpophalangeal Joint ; Methods ; Sutures ; Tendon Injuries ; Tendons ; Transplants ; Wrist

The subluxation of the femoral head is one of important prognostic factors in LCPD and current treatment of LCPD is based on the premise that adequate containment of the vulnerable femoral head within the acetabulum during the process of repair should result in a more spherical femoral head and a more congruous joint than if treatments were not provided.We analised the arthrographic findings of 18 hips in unilateral LCPD in order to determine the changes of the femoral head and acetabulum, degree of the subluxation and containment of the femoral head in various position of hip. The results were as follows: 1. According to the result of sphericity, the femoral head was deformed mainly in coronal plane in LCPD. 2. Average medial joint space of normal hip was about 3.8mm in the AP view of hip, but it was more increased in any position of LCPD. 3. In abduction with internal rotation, average subluxation ratio was 7.5% in normal hip and 10.9% in LCPD. In abduction with external rotation, it was 8.3% in normal hip and 12.4% in LCPD. 4. In normal hip, the containment ratio was more than 1.0 in any position of hip, but the containment ratio was 1.03 in abduction with internal rotation and 0.95 in abduction with external rotation of hip in LCPD. 5. On the basis of these results, efficacy of the Scottish Rite orthosis was doubtful in most hips of LCPD.
Acetabulum ; Arthrography ; Containment of Biohazards ; Head ; Hip ; Joints ; Legg-Calve-Perthes Disease ; Orthotic Devices

In thirteen adult male patient with scaphoid nonunion associated with DISI(Dorsal intercalated Segment Instability) defined as scapholunate angle is greater than 70 degrees of the radiolunate angle is greater than 10 degrees, anterior interpostitional bone grafting has been performed. Surgical procedure: 1) Closed reduction of lunate(reduction of DISI) by volar flexing of the wrist and holding the position by Kirschner wire inserted obliquely through the radial styloid to lunate. 2) Radical curettage of nonunion site and intraoperative measurement of the gap in the scaphoid through volar approach. 3) A bicortical wedge shaped graft from the iliac crest was then impacted between the fragments. 4) Temporary K-wire fixation of the grafted scaphoid from the scaphoid tubercle to prevent distortion of nonunion site and loss of fixation. 5) A Herbert screw was then inserted. Results: Mean patient age was 24.5 years, and mean duration of nonunion before surgery was 19.4 months. Mean follow-up time was 22.6 months. The nonunion involved the middle one-third of scaphoid in 11 patients and distal one-third in 2 patients. The mean postoperative grip strength was 39.4kg by Dynamometer(PC-5303J). The mean postoperative range of motion was volar flexion 50.5 degrees; dorsiflexion 47.3 degrees. The scaphlunate angle decreased from a mean of 78.8 preoperatively to 52.9 degrees postoperatively. The radiolunate angle was decresed from a mean of 16.8 degrees prope- ratively to a mean of 1.8 degrees postoperatively. Union was obtained in all 13 cases, According to Herbert and Fisher's formulation, 2 excellent, 10 good and 1 fair results were obtained from our study. The results of the series suggest that treatment of scaphoid nonunion associated with DISI by this method is an effective method that reconstitutes scaphoid anatomy and promotes excellent wrist function.
Adult ; Bone Transplantation ; Curettage ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Methods ; Range of Motion, Articular ; Transplants ; Wrist