1. Ten cases of fracture of the carpal navicular were observed and analyzed, which were treated by thumb-including short arm cast in the Department of Orthopedic Surgery, Han Kang Sacred Heart Hospital during the period from November 1, 1977 to May 31, 1978. 2. Of the total ten cases eight cases were between the age of twenty and forty. 3. The sites of fracture were confined to the middle one third in ten cases. The fracture lines were-transverse in six cases. 4. There was little difficulty in confirming the diagnosis initially with clinical symptoms and signs and roentgenologic studies available. But, in one case the frature line was not detected by usual roentgenologic studies including the carpal navicular view. 5. Union was obtained from two cases after ten weeks of cast immobilization, from four cases after twelve weeks and from three cases after twenty weeks. In the remaining one case, however, pain was persistent after twenty-four weeks of immobilization. 6. The results of treatment were excellent in four cases and good in five cases so that nine patients could return to their work.
Arm ; Diagnosis ; Heart ; Humans ; Immobilization ; Orthopedics

A case of hair strangulation on right toe of two months old female patient is reported together with a brief review of references in this paper. This hair strangulation was on the proximal interphanlangeal joint of the right third toe. The distal portion of the hair strangulation was discolored as black, swollon, cold and no evidence of circulation. Amputationon the metatarsophalangeal joint was done.
Female ; Hair ; Humans ; Joints ; Metatarsophalangeal Joint ; Toes

The purpose of this paper is to define the bacterial sources of wound infection after surgery including debridement for open fractures. Total number of patients were 123 during surgery July 1975 to Oct. 1976 at Hangang Sacred Heart Hospital. Out of 123 cases 17 were infected postoperatively. Serial bacterial cultures were performed for specimens taken from the contaminated wound in emergency room and by exposing the Petri-dishes in the operating room. Additional cultures were carried out for 17 specimens taken from the infected wounds postoperatively. Positive bacterial cultures from the initial wounds were obtained in 71 cases (57.7%) out of 123 contaminated wounds in emergency room. Setting monitoring of air contamination in conventional operating room, 51 colonies of bacterial growth per 1 hour exposure were noted and common organisms were colliform bacilli, streptococci and staphylococci in order. Postoperative wound infection rate was 13. 8%. Common pathogens were staphylococcus aureus, coliform bacilli and pseudomonas and kanamycin was most effective antibiotics. The retrospective bacteriological studies for 17 infected cases elucidated following results: 1) Organisms of same species; from initial wound and infected wound postoperatively 7 cases 2) Organisms of same species; from air contamination in the operating room and infectected wound postoperatiyely 5 cases 3) Organism of same species; from air contamination in the operating room, initial wound and infected wound postoperatively 1 case 4) Others (contagious or endogenous origin) 4 cases The results reveal that the initial contaminated open fracture and air contamination during surgery are the main sources of postoperative infection. Four cases which the infectious sources were not determined included in contagious origin dogmaticaIly.
Anti-Bacterial Agents ; Debridement ; Emergency Service, Hospital ; Enterobacteriaceae ; Fractures, Open ; Heart ; Humans ; Kanamycin ; Operating Rooms ; Pseudomonas ; Retrospective Studies ; Staphylococcus aureus ; Surgical Wound Infection ; Wound Infection ; Wounds and Injuries

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and important soft tissues such as collateral ligaments, cruciate ligaments and semilunar cartilages present a variety of problems in treatment and prognosis. Apley, Slee, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually a form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommend anatomical reduction of the fracture as possible and early knee motion. During 7 years period from January 1974 to July 1981, of the tibial condylar fractures treated at the department of orthopaedic surgery, Han Gang Shim Hospital, 41 cases that could be followed have been analysed according to the cause, classification, method of treatment and result. The following results were obtained from the analysis of 41 tibial condylar fractures. l. Of the 41 cases, 34 (83%) were male and 7 (17%) were female. 2. Of the 41 cases, 32 (78%) were due to traffic accident, 25 pedestrian, 7 occupant, 8 (20%) were due to fall from height. 3. Of the 41 cases, 31 (76%) were associated with other injuries. 4. Of the 41 cases, 30 were treated by conservative method with functionally acceptable result in 22 cases (73%) and 11 were treated by open reduction with functionally acceptable result in 9 cases (82%). 5. According to the Hohl and Luck's criteria, acceptable functional result was obtained in 31 (76%) cases.
Accidents, Traffic ; Classification ; Clinical Study ; Collateral Ligaments ; Female ; Hand ; Humans ; Knee ; Ligaments ; Male ; Menisci, Tibial ; Methods ; Prognosis ; Weight-Bearing

The authors clinically analyzed 53 cases of patients beyond 18 years of age with closed solitary femoral diaphyseal fractures, and 24 cases of patients with multiple long bone fractures including closed femoral diaphyseal fracture. All theses 77 cases were followed for more than 1 year, during 1988. 1
Clinical Study ; Femoral Fractures ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Fractures, Multiple ; Humans ; Methods ; Sex Distribution ; Transplants

The major blood supply to the femoral head is probably damaged by the fracture of the femoral neck especially when it is a displaced fracture. Complications such as delayed or nonuion of the fracture and avascular necrosis of the femoral head are common. Revascularization after reduction and internal fixation appears to be a slow process and in many patients late segmental collapse occurs. Various techniques have been proposed to restore the blood supply or to improve the circulation to the femoral head. Hereby we performed internal fixation and an autogenous muscle-bone pedicle graft composed of the quadriceps femoris muscle in 3 cases of old, neglected displaced femoral neck fracture. The results seemed to be good in regard to bony union in all 3 cases but it would be needed further follow up study for developing of any avascular necrosis.
Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Necrosis ; Quadriceps Muscle ; Transplants

Delayed diagnosis of the compartmental syndrome and subsequent delay in performing the fasciotomy can result in needless loss of function and possible amputation of the involved extremity. Unfortunately early evidence of this syndrome is difficult to assess. A direct measurement of the tissue pressure within a closed compartment has been developed which provides physicians with reliable information for determining the need for fasciotomy. In the 27 cases of the tibia fracture, tissue pressure was measured directly by method of the needle manometer in the Department of Orthopedic Surgery, Han Kang Sung Sim Hospital from March, 1979 to August, 1979. The results were as follows: 1. The highest mean tissue pressure per hour was 28 mmHg in anterior compartment at 24 hours after trauma, and 28.4 mmHg in deep post compartment at the same hours. 2. The highest pressure measured in all cases was 38 mmHg in anterior compartment at 24 hours and 39 mmHg in deep posterior compartment at 48 hours after trauma. 3. The return of increased tissue pressure to less than 10 mmHg took 122.6 hours in anterior and 124.4 hours in deep posterior compartment. 4. Tissue pressre was higher when there was associated fibula fracture. 5. Tissue pressure was higher in displaced fractures than in undisplaced fractures. 6. Tissue pressure was higher when fracture was in its upper one-third. 7. Tissue pressure was higher in comminuted fracture than simple fracture.
Amputation ; Delayed Diagnosis ; Extremities ; Fibula ; Fractures, Comminuted ; Methods ; Needles ; Orthopedics ; Tibia

No abstract available.
Carcinoma, Renal Cell*

No abstract available.
Congenital Hypothyroidism*

The finger flexor injuries are very difficult to treat satisfactorily. It is usually said that the earlier the treatment performed, the better result obtained. But the delicasy of the hand anatomy and its function as well as the absence of the hand surgeon in the first aid care make the problem more complex. Even if we made the primary treatment to the flexor tendon injuries, some disabilities are often remained. We have treated fifty eight cases of old flexor tendon injuries in forty eight patients, the results can be summarized as follows. 1. The cause of the tendon damage is due to the laceration injury in the majorities of the cases. T,he tendon injuries are especially common between the late second and the early third decade. 2. In the injury of the Zone II with pulley distortion, the pulley reconstruction using palmaris longus or fascia from other sites will prevent bowstring and help the tendon function. 3. The Zone II can be subdivided into two subspecific areas. The proximal area is from the distal palmar crease to the midoprtion of porximal phalanx and the distal one is from the midportion of the proximal phalanx to the insertion of the sublimis tendon. In the proximal area one can repair the injured tendon directly after removal of the A1 and about proximal half of the A2 pulley without any subsequent bowstring if the tendon and its tunnel is relatively well preserved. Thus one can convert this proximal portion of Zone II to Zone III. So the proximal area of the Zone II should be differentiated from the remaining distal part of the Zone II. 4. At six months after the operation the result of the operation was analyzed by the percentage of the recovery, which was calculated by the postoperative active range of the interphalangeal joints divided by one hundred seventy five degrees that means the available total range of motion of normal interphalangeal joints. Excluding the cases with the tenodesis or arthrodesis, the total result revealed good or excellent in about ninty percentages with this method. 5. There were two fingers that showed a postoperative lumbrical plus state in Zone II, which were recovered spontaneously within three to four months postoperatively. So it is considered that the relative shortening of the lumbrical muscles can be treated and overcome conservatively by the active use of the fingers, and there is no need to perform an lumbrical tenotomy to correct this kind of muscle imbalance.
Arthrodesis ; Fascia ; Fingers ; First Aid ; Hand ; Humans ; Joints ; Lacerations ; Methods ; Muscles ; Patella ; Patellar Ligament ; Range of Motion, Articular ; Tendon Injuries ; Tendons ; Tenodesis ; Tenotomy ; Tibia