In 1984, Gustilo subgrouped type III open fracture into III a, III b and III c according to the severity, soft tissue damage and vascular injury. Type III c open fracture presents serious problems especially possible amputation due to vascular insufficiency, so emergency vascular surgery with bone fixation by using plate, IM nail fixator is mandatory. We reviewed 10 cases of type III c open fracture of the forearm and evaluated the bone healing process according to fixation method, intramedullary nailing and plating treated at Orthopaedic Department of Sung-Ae General Hospital from Feb. 1986 to Aug. 1988. The folliwing results were obtained: l. All cases were industrial accidents, 9 cases in right, and the mean age was 24.1 ranging from 17 to 34. 2. There were 4 cases of the radial & ulnar artery rupture and 6 cases of the radial artery rupture, 7 cases were treated end to end anastomosis and 3 cases with vein graft. 3. The fracture level of ulna & radius was same in all cases, 7 cases in distal one-third, 2 cases in middle one-third and 1 case in proximal one-third. 4. The average time of union was 14.1 weeks in the radius and 14.5 weeks in the ulna. 5. The fixation methods were plating in 7 cases and IM nailing in 3 cases. 6. The complications were non-union in 1 case, osteomyelitis in 2 cases and refracture in 1 case. 7. The functional result was excellent in 1 case, satisfactory in 3 cases, unsatisfactory in 5 cases, and failure in 1 case according to the rating system of Anderson.
Accidents, Occupational ; Amputation ; Emergencies ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Open ; Hospitals, General ; Methods ; Osteomyelitis ; Radial Artery ; Radius ; Rupture ; Transplants ; Ulna ; Ulnar Artery ; Vascular System Injuries ; Veins

Fractures of the tibia are frequently encountered in mordern civilized society. Especially, those in distal 1/3 of the tibia have so many problems, such as angular deformity, osteomyelitis and nonunion because of anatomically scanty soft tissue. Many modalities of the treatment of fracture of distal 1/3 of the tibia were introduced. Among them, interlocking IM nailings were considered as one of the best modality. But, in interlocking IM nail, reaming of the medullary canal which destroys the endosteal circulation and causes thermal necrosis of the inner aspect of the cortical bone results in delayed union. And also, procedure for distal screw fixation is difficult and time-consuming. As for using flexible IM nails for fractures of distal 1/3 of the tibia, it was considered as not so satisfactory method due to lack of stability of fixation. However, the stability of fixation can be strengthened with fanning of the nails in distal fragment, using more than 3 nails and delay the protected weight bearing. Authors studied 25 cases of fractures of distal 1/3 of the tibia treated with closed flexible IM nailing at Sung Ae General Hospital, from July., 1987 to July., 1989, and obtained following results: 1. Among 25 cases, 4th decades were most common and males were more commonly involved. 2. Traffic accidents were the most common causes of injury and majority of 16 open fractures and 19 comminuted fractures, were caused by high energy mechanism. Among open fractures, type II were most common. 3. Two angular deformities less than 10 degrees, one proximal migration and one checkrein deformity were observed as complications, but, no clinically significant complications were noted. 4. The time for radiological union were 14.5 weeks in group without fibular fracture and 15.1 weeks in group with fibular fracture, and 14.0 weeks in closed fracture group and 17.2 weeks in open fracture group, and average in 15.6 weeks.
Accidents, Traffic ; Clinical Study ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Necrosis ; Osteomyelitis ; Tibia ; Weight-Bearing

No abstract available.
Bursitis*

No abstract available.

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.
Child ; Hip Joint ; Hip ; Humans ; Inflammation ; Prospective Studies ; Synovitis ; Ultrasonography

No abstract available.
Anterior Cruciate Ligament* ; Knee*

No abstract available.
Tibia*

Acute massive pulmonary embolism after intracerebral hemorrhage (ICH) is rare but associated with a high mortality rate. A 44-year-old man presented with acute pulmonary embolism on 38th day after onset of ICH. We tried off-pump pulmonary embolectomy with CPB on stand-by. But, hemodynamic deterioration occurred when right pulmonary artery was clamped after removal of some clots, therefore CPB was rapidly instituted under normothermic beating heart with full heparinization. On pump beating, heart pulmonary embolectomy was performed successfully without adverse events. On postoperative 2nd day, the patient was started on anticoagulation therapy and recovered favorably without any neurologic sequelaes.
Adult ; Cerebral Hemorrhage ; Embolectomy ; Heart ; Hemodynamics ; Heparin ; Humans ; Pulmonary Artery ; Pulmonary Embolism

No abstract available.
Chondroma*

Objective: : To evaluate the interactions among differentially expressed autophagy and mitophagy markers in subarachnoid hemorrhage (SAH) patients with delayed cerebral ischemia (DCI). Methods: : The expression data of autophagy and mitophagy-related makers in the cerebrospinal fluid (CSF) cells was analyzed by real-time reverse transcription-polymerase chain reaction and Western blotting. The markers included death-associated protein kinase (DAPK)-1, BCL2 interacting protein 3 like (BNIP3L), Bcl-1 antagonist X, phosphatase and tensin homolog-induced kinase (PINK), Unc-51 like autophagy activating kinase 1, nuclear dot protein 52, and p62. In silico functional analyses including gene ontology enrichment and the protein-protein interaction network were performed. Results: : A total of 56 SAH patients were included and 22 (38.6%) of them experienced DCI. The DCI patients had significantly increased mRNA levels of DAPK1, BNIP3L, and PINK1, and increased expression of BECN1 compared to the non-DCI patients. The most enriched biological process was the positive regulation of autophagy, followed by the response to mitochondrial depolarization. The molecular functions ubiquitin-like protein ligase binding and ubiquitin-protein ligase binding were enriched. In the cluster of cellular components, Lewy bodies and the phagophore assembly site were enriched. BECN1 was the most connected gene among the differentially expressed markers related to autophagy and mitophagy in the development of DCI. Conclusion : Our study may provide novel insight into mitochondrial dysfunction in DCI pathogenesis.