Congenital high scapula, more commonly referred to as Sprengel's deformity, was first described by Eulenberg in 1863. Usually other congenital anomalies are associated such as absent or fused ribs, chest wall asymmetry, Klippel-Feil syndrome, cervical ribs, congenital scoliosis, cervical spina biffida was treated with the excision of the elongated acromion and the resection of prominent elongated acromion to be described is an extremely rare malformation. We experienced one case of congenital high scapula associated with anomaly of the acromion, which was treated with the excision of the elongated acromion and the resection of prominent supermedial border of the scapula for the purpose of the cosmetic and functional correction. After 1 year follow up, abduction was improved by only 10 degrees in the glenohumeral joint with the definite cosmetic improvement.
Acromion ; Cervical Rib ; Congenital Abnormalities ; Follow-Up Studies ; Klippel-Feil Syndrome ; Ribs ; Scapula ; Scoliosis ; Shoulder Joint ; Thoracic Wall

The juvenile Tillaux fracture and the triplane fracture of the distal end of the tibia in adolescents are considered uncommon injuries and the mechanism of both injuries has been uncertain. It has been postulated that both fractures probably are caused by external rotation of the foot. We atempted to evaluate the mechanism of injury as well as to conform the role of the external rotation of the foot for the juvenile Tillaux fracture and triplane fracture. From 1983 to 1988 at the department of orthopedic surgery, college of medicine, Hallym University, we evaluated the cases of nine adolescent patients with the juvenile Tillaux fracture and nine patients with the triplane fracture of the distal tibial epiphysis. We confirmed that external rotation force produced the triplane fracture as well as juvenile Tillaux fracture. And we could postulate that the triplane fracture needed further external rotation force, less closure of the distal tibial epiphysis, and more complicated mechanism of injury than the juvenile Tillaux fracture. The knowledge of these mechanism of injury enables us to use a rational manipulative approach to reduce these fractures.
Adolescent ; Clinical Study ; Epiphyses ; Foot ; Humans ; Orthopedics ; Tibia

No abstract available.
Epilepsy* ; Vigabatrin*

In the fractures and dislocations of the carpus, prompt and accurate diagnosis is the prime prerequisite for restoring function to this most complicated joint in the body. And then, early precise reduction and continuous maintenance of the reduced position until ligamentous and bone healing is complete provide the best chance of achieving a satisfactory restoration of function. We analysed forty five cases of fractures and dislocations of the carpus which were treated for 5 years from Jan. 1984 to Dec. 1988 at the Department of Orthopedic Surgery, College of Medicine, Hallym University. The following results were obtained; l. Of the total 45 injuries, scaphoid fractures were seen in 32(71.1%), other carpal bone fractures except scaphoid in 13 patients(28.9%), and carpal bone dislocation and fracture- dislocations in 11 patients(24.4%). 2. Carpal scaphoid fracture 1) 19 of the 32 patients(59.4%) had an associated ipsilateral upper extremity injury. 2) This fracture was common in the young male. 3) A union rate(95.6%) was achieved using a usual conservative treatment for undisplaced racture(14), operative treatment for displaced(18). 4) The mean time to radiological union for all fractures was 11.1 weeks. Old fracture by SotoHall classification took the longest time to union(18.2 weeks), subacute fracture 13 weeks, and acute fracture 9 weeks. 5) 10 cases were treated for nonunion, 5 of 10 nonunions were classified as type (50%). 2 cases showed ultimately nonunion in spite of various sorts of treatment, which belonged to waist fracture. 3. Other carpal bone fractures except scaphoid were seen in 13(15 bones) of 45 injuries, and pisiform(4) and triquetrum(4) fractures were common. 4. Carpal dislocation and fracture-dislocations were seen in 11 of the 45 injuries and dorsal transscaphoid perilunate dislocations(4) were common. These were treated by C.R. and cast immobilization or O.R. and K-wire fixation relatively good results were obtained.
Carpal Bones ; Classification ; Clinical Study ; Diagnosis ; Dislocations ; Humans ; Immobilization ; Joints ; Ligaments ; Male ; Orthopedics ; Upper Extremity

The distal tibial physes begins its closure about 18 months prior to complete cessation of the tibial growth, closing first in its midportion, then medially, and finally, laterally. So the patterns of the ankle fracture during this period would be different from those of the adult or the children before this period. During the six year period from 1983 to 1988 at the department of orthopedic surgery, college of medi-cine, Hallym University, we found and analysed 54 adolescent patients with the ankle fracture which developed before the closure of the distal tibial growth plate, which were followed up more than 1 year. The results were as follows 1. During the 6 year period of this study, the adolescent ankle fracture comprise 4.4% (54 cases) of all the ankle fractures(1158 cases). Injury occurred more often in male than in female(44 versus 10). The mean age was 13.7 years. 2. The most common cause of injury was traffic accident being in 26 cases(48.1%), the next was slip down accident in 11 cases, and the third was sports activity in 10 cases. 3. The incidence of the adoescent ankle fractures using the Salter-Harris classification revealed 20 (37%) type II, 7 (13%) type III, 5 (9.3%) type IV, and 4 (7.4%) type I and that using the Dias and Tachdjian classification revealed 14 (25.9%) Supination-Inversion, 10 (18.5%) Supination-External rotation, 7 (12.7%) Pronation-Eversion-External rotation, and 1 (1.9%) no adjustable fracture. There were 9 (16.7%) Tillaux and 9 (16.7%) triplane fractures, which were belonged to both classifications 4. The treatments performed were closed reduction and cast immobilization for 28 cases (51.9 %), open reduction and internal fixation for 20 cases (37%), and closed reduction and percutaneous pinning for 6 cases. 5. There were complications experienced in 9 cases, which were 3 premature epiphyseal closure, 3 joint surface incongruity, 2 angular deformity, and 1 leg shortening. 6. For the prevention of the complication, the treatment of the adolecsent ankle fracture should be treated like as adult fracture.
Accidents, Traffic ; Adolescent ; Adult ; Ankle Fractures ; Ankle ; Child ; Classification ; Clinical Study ; Congenital Abnormalities ; Growth Plate ; Humans ; Immobilization ; Incidence ; Joints ; Leg ; Male ; Orthopedics ; Sports

Even though closed treatment of Colles' fracture leads to satisfactory clinical results, many patients who have had such a fracture are found to have permanent disability and poor function of hand and wrist. Malunion occurs frequently following Colles' fracture and there is considerable disability, pain and deformity associated with this lesion. Such deformity of wrist can usually be prevented by proper treatment, but if deformity developes, better function and a normal appearing wrist can be restored by a corrective osteotomy. The authors experienced 6 cases of malunited Colles' fracture which had been treated by corrective osteotomy, Darrach resection, and osteoclasis, etc.
Colles' Fracture ; Congenital Abnormalities ; Hand ; Humans ; Osteotomy ; Wrist

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

No abstract available.

No abstract available.
Humans ; Hypocalcemia* ; Infant, Newborn ; Prognosis*