The old flexor tendon injury in the hand seen after 4 weeks from damage and associated with crushing injury, heavy scarring, fracture and infectious state has the difficulty to deliver the flexor tendon through fibro-osseous sheath and the pulleys. Treatment method depends on the circumstances of the injured flexor tendon and surgeons' judgement. We have treated twenty-three fingers of twenty-three cases, who had old flexor tendon injury, by advancement and tenolysis in 1 each, tendon graft in 5, and staged tendon graft in 16 from March 1989 through February 1994. The result was summarized as follows. 1. The old flexor tendon injury most commonly occurred in the fifth finger(11 cases, 47.8%)and in zone II (16 cases, 69.6%). 2. The most common cause was glass injury(15 cases, 69.6%). 3. 21 of 23 cases(2 thumbs excepted)were evaluated according to the original Strickland system. 14 cases of the staged tendon graft showed excellent(6 cases, 42.9%), good(5 cases, 35.7%)and fair(3 cases, 21.4%). 5 cases of the tendon graft showed excellent(2 cases, 40%), good(1 case, 20%), and fair(2 cases, 40%). 1 case of adhesiolysis and 1 case of advancement showed excellent and good results each. Little difference is observed in the method between the staged graft and tendon graft. 4. The degree of the associated soft tissue injury should be evaluated by the experienced hand surgeon before surgery and the delicate balance between protection and mobilization during the postoperative weeks is important as well as the surgical skill.
Cicatrix ; Fingers ; Glass ; Hand ; Methods ; Soft Tissue Injuries ; Tendon Injuries ; Tendons ; Thumb ; Transplants

Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

Fractures of the proximal humerus occur more frequently in older patients but are seen in all ages and emerge epiphyseal separations. The objectives of treatment are restoration of all involved structures to normal anatomical state and a completely functional limb in the shortest time possible. One part and two part fractures were indicated in conservative treatment and surgical treatment in most of three, four part fractures. The results of treatment of forty four cases according to Neer's classification were analysed at the Department of Orthopedic Surgery, Chonbuk National University Hospital from Mar. 1978 to Dec.1985. The results were as follows. 1. The prevalent age distribution was third and fifth decade(48%) . 2. The most common cause of injury was slip down(14 cases, 32%). 3. The most frequent cases of the fractures in Neer's classification were two part fractures(22 cases, 50%). 4. Thirty one cases(71%) were treated by conservative treatment, twelve cases(27%) by open reduction and 1 case(2%) by prosthesis. 5. Good results were in 23 cases(52%) of one and two part fractures, fair in 17 cases(39%) and poor in 4 cases(9%) of two, three and four part fractures.
Age Distribution ; Classification ; Clinical Study ; Extremities ; Humans ; Humerus ; Jeollabuk-do ; Orthopedics ; Prostheses and Implants ; Shoulder Fractures

The treatment of acetabular fractures is composed of operative and conservative methods, however, they are still controversial. Generally, because the acetabular fracture involves the joint surface and one sequalae such as post-traumatic arthritis can follow treatment, therefore an accurate reduction and postoperative early mobilization to obtain the prevenation of joint stiffness and arthritis are required. In order to achieve these purposes, we have studied and done a comparative survey between conservative and operative treatment on 55 patients with acetabular fractures, who were treated at our department from Jan. 1982 to Dec. 1988. Results were obtained as follows. 1. The prevalent age was the third decade and the cause of injury was traffic accidents in the majority. 2. The most common type of fracture was a posterior wall by Letournel classification. 3. Satisfactory results of operative treatment were 76% and conservative treatment 47%. 4. The complications were post-traumatic arthritis, ectopic ossification, peroneal nerve palsy and skin infection. 5. In the majority of displaced acetabular fractures, ORIF was recommended.
Accidents, Traffic ; Acetabulum ; Arthritis ; Classification ; Early Ambulation ; Humans ; Joints ; Ossification, Heterotopic ; Paralysis ; Peroneal Nerve ; Skin

Simple posterior hip dislocations requiring open reduction is very few and reported approximately 3% of all posterior hip dislocations and we have little comments of the various causes preventing or blocking a concentric reduction following traumatic posterior hip dislocation. In a review of eleven cases of posterior dislocation requiring open reduction, we divided two groups, one is a failed closed reduction group, the other is a nonconcentric reduction group. A concentric reduction was prevented from an inverted limbus or an osteocartilagenous loose body from acetabulum or femoral head.
Acetabulum ; Dislocations ; Head ; Hip Dislocation ; Hip

PURPOSE: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. MATERIALS AND METHODS: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. RESULTS: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. CONCLUSION: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.
Extremities ; Foot ; Forearm ; Hand ; Head ; Hemangioma ; Logistic Models ; Neck ; Recurrence ; Risk Factors

PURPOSE: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. MATERIALS AND METHODS: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. RESULTS: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. CONCLUSIONS: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.
Alcoholism ; Arteries ; Compliance ; Female ; Follow-Up Studies ; Humans ; Lacerations ; Male ; Median Nerve ; Retrospective Studies ; Spouses ; Suicide ; Tendons ; Ulnar Artery ; Ulnar Nerve ; Wrist

PURPOSE: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. MATERIALS AND METHODS: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. RESULTS: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. CONCLUSIONS: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.
Adult ; Amputation ; Arteries ; Female ; Fingers ; Follow-Up Studies ; Hemorrhage ; Heparin ; Humans ; Injections, Intravenous ; Joints ; Male ; Mouth ; Nails ; Perfusion ; Range of Motion, Articular ; Replantation ; Veins

No abstract available.
Humans ; Plasma* ; Tranexamic Acid* ; Urticaria*

We report a case of cutaneous metastasis of thymic carcinoma in Korean. A 44-year-old female, who had been diagnosed as thymic carcinoma and treated with total thymectomy and post-operative radiation therapy, presented grouped erythematous papules on the left chest. CT scans revealed metastatic lesions in the left pleura and abdominal cavity. Histopathologic examination of skin biopsy showed extensive infiltration of malignant cells in dermis and subcutis. The morphology of infiltrating cells was similar to that of tumor cells from primary thymic carcinoma specimen. The results of immunohistochemical study for skin biopsy were consistent with the features of non-neuroendocrine thymic carcinoma. Histopathologic and immunohistopathologic similarity between cutaneous lesion and previous tumor suggested that malignant cells in the skin lesion could originate from progressing thymic carcinoma.
Abdominal Cavity ; Adult ; Biopsy ; Dermis ; Female ; Humans ; Neoplasm Metastasis ; Pleura ; Skin ; Thorax ; Thymectomy ; Thymoma* ; Tomography, X-Ray Computed