Ninety six patients treated at Seoul Red Cross Hospital from Jan. 1979 to Dec. 1982 were analized in clinical and radiological aspect. The results obtained from this study were as followings; 1. Among the 96 patients, male was 67 patients and female was 29 patients (M:F=2.5:1). The average age was 32. 2. The causes of the injury were traffic accident, slipping down, falling down and sports injuries in orders. 3. According to the classification of Lauge-Hansen, supination external rotation type (38.5%) was the most common type. 4. 65 cases (67.7%) were treated by open reduction and 31 cases (32.3%) by closed reduction. The better result was obtained by open reduction than closed reduction. 5. Accurate reduction and rigid internal fixation of the lateral malleolus was most important in treatment of the ankle fractures. 6. Classification of Lauge-Hansen was useful in diagnosis and treatment of the ankle fractures.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Female ; Humans ; Male ; Red Cross ; Seoul ; Supination

A total of 16 metatarsal bones were treated for ten with brachymetatarsia using two different methods: single staged lengthening by bone graft(2 cases) and gradual distraction lengthening using unilateral external fixator(14 cases). Three cases of first metatasal bone and thirteen cases of fourth metatarsal bone were operated. All of the cases of the brachymetatarsia were congenital. The average amount of lengthening was 16.1 mm in gradual distraction lengthening while 10.5mm in single staged lengthening. Average percentile increase was 38.8% in gradual distraction lengthening and 23% in single staged lengthening. The average healing index of gradual distraction lengthening was 1.7(months/cm). Although single staged lengthening has advantage of cosmetics, gradual distraction lengthening using unilateral external fixator was thought to be effective functionally for metatarsal lengthening.
External Fixators ; Metatarsal Bones

No abstract available.

Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Periprosthetic Fractures

No abstract available.
Dislocations* ; Shoulder*

No abstract available.

The deformity of hallux valgus is associated with three hasic prohlems: a prominent rnedial eminence, contracted soft-tissue structures on the lateral side of the great toe, and an altered intermetatarsal angle between the first and second metatarsal. We retrospectively have reviewed the results for thirty-one patients(47 feet) in whom a hallux vaigus deformity had heen conected with the release of the distal soft tissues, excision of the medial eminence, plication of the medial part of the capsule, and proximal crescentic osteotomy of the first metatarsal. The patients were followed for an average of twenty months(range, twelve to twenty-eight months). There were nine cases with mild defoimity, twenty-nine cases with moderate deformity, nine cases with severe deformity. The preoperative hallux valgus angle averaged 38.1 degrees, and the immediate postoperative angle averaged 6.7 degrees. The preoperative intermetatarsal angle averaged 17.1 degrees, and the immediate postoperative angle, 7.6 degrees. At the latest follow-up, the hallux valgus angle averaged 19.3 degrees, the intermetatarsal angle averaged 9.9 degrees. We found that the more the deformity, the lesser the congruency. 74.5% of the patients were satisfied with the result of the procedure. They stated that, eiven the same circumstances, they would have the operation again. The most common complication was recurrence of the nallux valgus, which occurred in nine feet(five patients). The other complications included pain under a fibular sesamoid in one foot, severe hypoesthesia on the medial aspect ot the big toe in one foot, and superficial wound infection in one foot.
Congenital Abnormalities ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Hypesthesia ; Metatarsal Bones* ; Osteotomy* ; Recurrence ; Retrospective Studies ; Toes ; Wound Infection

Purpose of this study was to investigate the biomechanical fates of the partial thickness tear of the rotator cuff in rabbit, and try to provide guideline of treatment for the partial thickness tear of the rotator cuff tendon. Infraspinatus tendons of fifty rabbits were used for study. The rabbits were divided into three groups, twenty for one-third resection(superficial partial resection group), twenty for two-thirds resection(deep partial resection group) and ten for control group. Extraarticular portion of the infraspinatus tendons of the rabbits were resected partially with one-third or two-thirds thickness for each experimental group. We sacrificed five rabbits of each experimental group at 3, 6, 9, and 12 weeks after the resections, and five rabbits for the control group at 6 and 12 weeks. Average maximal load per area of the infraspinatus tendons was measured by tension test. There was significant difference between the deep partial resection group, 5.3 and 6.3 N/emat 6 and 12 weeks respectively, and the control group, 13.2 N/mm(P<0.05). There was no difference between the control and superficial partial resection group, 12.8 and 14.1 N/mm at 6 and 12 weeks, respectively. Shallow partial tears might be healed spontaneously. Deep partial tears would not be healed naturally. When surgical treatment is indicated for deep partial tears of the rotator cuff, tendon repair, rather than debridement, would provide more predictable results.
Debridement ; Rabbits* ; Rotator Cuff* ; Shoulder ; Tendons

PURPOSE: The purpose of this study is to determine whether the three-dimensional computed tomography (3D-CT) images would increase the reliability of fracture classification and influence treatment plan of distal radius fractures. MATERIALS AND METHODS: Four independent observers evaluated radiographic images of thirty patients with distal radius fractures. The fracture classification has been performed based on (1) AO classification, (2) Fernandez classification, (3) Frykman classification. And then treatment plan was planned based on (1) closed reduction with Sugar-tong splint, (2) closed reduction with pinning, (3) closed reduction with external fixator, (4) open reduction with plate (volar approach), (5) open reduction with plate (dorsal approach). Two rounds of evaluation were compared regarding: (1) simple radiographs alone, and (2) simple radiographs and 3D-CT together two weeks after that. This cycle was then repeated to assess intraobserver reliability. RESULTS: 3D-CT improved the intraobserver and interobserver reliability regarding the fracture classification and treatment plan. And the addition of 3D-CT to simple radiographs influenced treatment recommendations, resulting in a significantly greater number of decisions for an open approach (p<0.05, McNemar test). CONCLUSIONS: 3D-CT is a reliable tool of fracture classification and improves treatment plan of distal radius fractures.
External Fixators ; Humans ; Radius ; Radius Fractures ; Splints

PURPOSE: The purpose of this study was to present a systematic treatment method for nontuberculous mycobacteria (NTM) infection of the hand and wrist to gain better clinical outcomes. METHODS: 10 patients of deep NTM infection of the hand and wrist were reviewed. Extensive debridement was performed in all cases. When biopsy result suggested mycobacterial infection such as granulomatous inflammation, empirical tuberculosis medication was started. After culture confirmed NTM growth, the species was identified and in vitro sensitivity test was performed. Then medication was switched according to the results. Functional outcomes of the hand and wrist were measured by total active motion of the fingers and by range of motion of the wrist respectively. RESULTS: Diagnosis was tenosynovitis in seven patients, infective arthritis and osteomyelitis combined with tenosynovitis of the wrist in three patients. Two patients had recurred skin ulcer during follow-up period and undergone second debridement. After second operation, no patient had a persistent discharging sinus and all patient were completely healed during follow-up period. Functional outcome of the eight patients who had NTM infection of their hand was excellent in two, good in four, fair in one, poor in one. Mean range of motion of the two patients who had osteomyelitis of their wrist was dorsiflexion 20degrees, volar flexion 15degrees, radial deviation 0degrees, ulnar deviation 15degrees. CONCLUSION: Our standardized treatment protocol can be helpful for treatment of deep NTM infection of the hand and wrist.
Arthritis ; Biopsy ; Clinical Protocols ; Debridement ; Diagnosis* ; Fingers ; Follow-Up Studies ; Hand* ; Humans ; Inflammation ; Nontuberculous Mycobacteria* ; Osteomyelitis ; Range of Motion, Articular ; Skin Ulcer ; Tenosynovitis ; Tuberculosis ; Wrist*