In the treatment of elderly hip fracture, early mobilization as a means of reducing early postoperative morbiyt and morbidity is mandatory. Even though Ender nailing have many advantages, most serious problems with use of Ender nailing method are distal migration of nails, subsequent loss of fixation and limited knee joint motion. To prevent these difficult problems, we have used distal wiring technique with Ender nailing since 1988. In operation, we performed Ender nailing as usual manner under image intensifier and for the prevention of the nail migration, we performed circumferential wiring through the each Ender nail eye and above the adducter tubercle of the distal femur. Forty six cases were available with minimum follow-up of six months which were healed radiologically and clinically (Mean follow up: 21 months). The mean age was 74 years (Range: 52 years-88 years)and showed 26 cases of famale and 20 cases of male. The radiological morphometry using Singh index showed poor bone quality: 36 cases were below Grade III and the fracture type was classified by Tronzo criteria. In results, patients who had Ender nailing with distal wiring showed no distal migration, however one case of proximal migration was observed at the beginning stage of this technique. So, in elderly trochanteric fracture, to reduce the complication of the Ender nailing, especially nail migration, the authors recommend the Ender Nailing with distal wiring technique.
Aged ; Early Ambulation ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip ; Humans ; Knee Joint ; Male ; Methods

Acromioclavicular joint injuries are recently increased, but there are still controversies as to the proper choice of treatment. We treated thirty cases of acromioclavicular injuries, among these, twenty five cases were done by operative method and five cases conservatively from August 1979 to June 1988. The results were as follows, 1. The injuries were composed of one case of Type 1, 7 cases of Type 2 and 22 cases of Type 3. 2. The result of conservative treatment consisted of 2 cases of good, 1 case of fair and 2 cases of poor. 3. The final outcome of operative method was better than that of conservative one, which consisted of 16 cases of good and 9 cases of fair. 4. The cause of fair results in operative method was thought to residual lexity of the repaired coracoclavicular ligament. 5. The key point of operative treatment in acromioclavicular separation was firm and strong reconstruction of the coracoclavicular ligament. 6. Modified method of coracoclavicular ligament reconstruction using coracoacromial ligament with bone block has been tried.
Acromioclavicular Joint ; Ligaments ; Methods

No abstract available.
Classification*

No abstract available.
Branchial Region* ; Branchioma*

Fracture of acetabular are relatively uncommon, but when they occur they seem to pose management difficulties for attending surgeon. They are, however, important injuries because they may give rise to disabling symptoms. Furthermore, they are increasing in frequency due to the increasing number of traffic accidents. Forty cases of acetabular fracture were treated in the National Medical Center during the period 1980 to 1987. The short summary of observation were as follows : 1) There was a preponderance of young patients, the majority being in the 31–40 age group(68%). The ratio between males and females was 2.6:1. 2) The most common cause of injury was traffic accident(68%). 3) The most common associated fracture was pelvic bone fracture(48%), and most common associated other injury was abdominal visceral injury(30%). 4) The most common fracture was posterior wall fracture(28%) following to Judet & Letournel's anatomocal clsssification. 5) Twenty-five fracture(63%) were treated by conservative measures, and 15 fractures (37%) were treated by open reduction and internal fixation. 6) The results were as follows : excellent in 13(33%), good in 19(47%), fair in 5(13%), and poor in 3(7%). 7) The complication of acetabular fracture were traumatic arthritis in 6 cases, sciatic nerve injury in 2 cases, avascular necrosis of femoral head in 2 cases. 8) Not only choice of treatment but also determination of surgical approch require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radiologic analysis.
Accidents, Traffic ; Acetabulum ; Arthritis ; Female ; Head ; Humans ; Male ; Necrosis ; Pelvic Bones ; Sciatic Nerve

The symptom of tennis elbows is a syndrome of pain and point tenderness localized at either extensor or flexor epicondylar origin at the elbow. One hundred and ninety-seven cases of tennis elbow seen from Jan. 1985 to Dec. 1988 were managed by mean of conservative treatments firstly such as rest, medication, immobilization, P-T and local steroid injection. Among the 197 cases, 32 cases were treated with Nirschl and Pettrone operation. The results were summerized as follows, l. Of 197 cases, 139 cases were female, and 96 cases were in the age group 41 to 50. 2. One hundred and thirty-two cases were housewives. 3. Only 11 cases had history of sports. 4. By Nirsch and Pettrone assessment, the end results of conservative treatment were excellent and good in 117 cases(59.4%), fair and failure in 80 cases(41.2%). 5. Among the 11 cases treated with Nirsch and Pettrone operation, excellent result was obtained in 6 cases, good in 3 cases, fair in one case and failure in one case.
Clinical Study ; Elbow ; Female ; Humans ; Immobilization ; Sports ; Tennis Elbow ; Tennis

The bone mineral densities of 60 middle school boys were measured with dual photon absorptiometry to define the influence of Taekwon-Do. They were divided into Taekwon-Do and control group, each comprising 30 boys. The bone mineral densities of the head, trunk, pelvis, both upper and lower extremities, and body total were measured. The results were as follows. 1. The BMD of head was 1.668 ± 0.153 in Taekwon-Do and 1.554 ± 0.153 0.167 in control. It was significantly increased in aekwon-Do(p <0.05). 2. The BMD of trunk was 0.378 ± 0.153 0.044 in Taekwon-Do and 0.353 ± 0.153 0.053 in control. There was no significant difference(p >0.05). 3. The BMD of pelvis was 1.648 ± 0.153 0.112 in Taekwon-Do and 1.444 ± 0.153 0.215 in control. It was significantly increased in Taekwon-Do(p <0.005). 4. The BMD of right and left legs were 1.597 ± 0.153 0.118 and 1.579 ± 0.153 0.125 in Taekwon-Do and 1.425 ± 0.153 0.115 and 1.421 ± 0.153 0.113 in control group respectively. They were significantly increased in Taekwon-Do(p <0.005). 5. The BMD of right and left arms were 1.184 ± 0.153 0.090 and 1.178 ± 0.153 0.115 in Taekwon-Do and 1.056 ± 0.153 0.095 and 1.066 ± 0.153 0.097 in control group respectively. They were significantly increased in Taekwon-Do(p.<0.005). 6. The total body BMD was 0.932 ± 0.153 0.068 in Taekwon-Do and 0.846 ± 0.065 in control. It is significantly increased in Taekwon-Do(p<0.005). In conclusion, Taekwon-Do increases the total bone mineral density and the mineral densities of the head, pelvis and extremities but not that of trunk. It is thought that continued practice of Taekwon-Do throughout adult life might prevent the senile osteoporosis
Absorptiometry, Photon ; Adult ; Arm ; Bone Density ; Extremities ; Head ; Humans ; Leg ; Lower Extremity ; Miners ; Osteoporosis ; Pelvis

High tibial osteotomy is now an accepted procedure in the treatment of osteoarthritis of the knee. Since the effect of this procedure is to shift the line of weight bearing from one compartment of the other, the procedure is of value in knees with osteoarthritis only when there is predominant involvement of one compartment. The osteoarthritis of knee developed bilaterally in many case, so simultaneous bilateral high tibial osteotomy under one anesthetic was considered. Eight cases of osteoarthritis with genu varum deformity were treated by simultaneous bilateral high tibial osteotomy at the Department of Orthopaedic Surgery of NMC during the,period from January, 1984 to December, 1987. The results were as follows: l. All case were female, and the mean age was 56 years old. 2. Preoperative mean varus angle were 4° in right, 3.4° in left, and postoperative mean valgus angle were 8° in right, 6° in left at final follow-up. 3. The results after average 2.2 years of follow-up were as follows: good in 5 cases(63%), fair in 1 cases(12%), poor in 2 cases(25%) 4. The complications were one proximal tibial fracture, one displacement of distal fragment, and one transient peroneal nerve palsy. 5. Mean immobilization period was 7 wks and mean hospitalization period was 48 days. 6. More rigid internal fixation was recommended in simultaneous procedure to reduce the period of hospitalization and early ambulation.
Congenital Abnormalities ; Early Ambulation ; Female ; Follow-Up Studies ; Genu Varum ; Hospitalization ; Humans ; Immobilization ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Osteotomy ; Paralysis ; Peroneal Nerve ; Tibial Fractures ; Weight-Bearing

No abstract available.
Fractures, Open*

No abstract available.
Caloric Tests*