PURPOSE: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. MATERIALS AND METHODS: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. RESULTS: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. CONCLUSION: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.
Animals ; Ankle ; Bone Cysts ; Calcaneus ; Chondroblastoma ; Contusions ; Curettage ; Early Diagnosis ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Knee ; Lipoma ; Male ; Medical Records ; Retrospective Studies ; Sprains and Strains ; Talus ; Transplants

The fracture of femoral neck, the unsolved fracture, is a msjor periphersl fracture of our skeleton, and for more than century its treatment and the results hsve been a matter of controversy and inquiry among surgeons, and although the results obtained today show improvement, they are not at all comparsble to those of other fractures. This study was performed to find the characteristics of femoral neck fractures in Korea and to give the direction of further treatment. Through the review of 30 articles reported on Journal of K.O.A., we suggest the followings are essential for further study. l. Epidemiologic study of femorsl neck fractures based on statistical data needs to be performed. 2. The study should be directed not only the frscture itself but also the prevention of the fracture via the study of osteoporosis. 3. The relationship of severity of fracture, time frorn trauma to treatment, and the result of treatment established by our own data is to be established.
Epidemiologic Studies ; Femoral Neck Fractures ; Femur Neck ; Korea ; Neck ; Osteoporosis ; Skeleton ; Statistics as Topic ; Surgeons

Biologic resurfacing of the damaged joints is an area of great interest and clinical promise because of the limited potential ofdamaged articular cartilage healing. Several methods such as spongiolization. joint dehridement and ahrasion of suhchondral hone. perichondral grafts, and osteochondral grafts have heen used to repair cartilage defects, but the results were not satisfactory. Rccently autologous chondrocyle transplantation with a pcrioslcal patch was paid an altention for its advantage , the regeneration with hyalin cartilage. But it have many disadvantages such as too expensive cost. second staged operation, and technically difficult to isolatc chondrocytes from a small volume of donor site, so we performed that a definecl cartilaee delect in the ribbit patella was treated with transplanta1ion of in virto expanded allogenic chondrocvtes and then compared with an autologous chondrocytes transplantation. Adult rabbits were used to transplant autogenously and allogenously and allogenically harvested and in vitro cultured chondrocytes into patellar chondral lesions that had been made previously 3x 3mmin size , extending down to the calcified zone. Chondrocytes were isolated in the femoral condyle of the opposite knee or othe rabbit knee. And then enzymatic digestion ( collagenase A and DNase I ) was performed for 5 hours room temperature in a spinner bottle and cells were seeded in a 25cm2 culture flask in Dulheccos modified essential medium (DMEM), supplemented with l0% fetal hovine serum (FBS). The culture medium was changed twice weekly. After 14 days of culture, the cells were isolated hy irypsinization and transplanted into previously made chondral defects with an autogenous periosteal patch taken from the medial aspect of tibia. Healing ol' the defects was assessed by gross examination, immunohistochemical stain, and light microscope with hematoxylin-eosin stain at 8, 16, and 24 weeks. Allogenic and autologous chondrocytes transplantation significantly increased the amount of newly tormed repair tissue compared to that found in control knees in which the Jesion was solely covered hy a periosteal patch. The repair tissue, however, had a tendency of incomplete bonding to adjacent cartilage. This study shows that allogenic and autologous articular chondrocytes that have heen expanded for 2 weeks in vitro can stimulate the healing phase of chondral lesion. There is no signilicant diffcrence hetween allogenic and autologous chondrocytes transplantation.
Adult ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Collagenases ; Deoxyribonuclease I ; Digestion ; Humans ; Hyalin ; Joints ; Knee ; Patella* ; Rabbits ; Regeneration ; Tibia ; Tissue Donors ; Transplants

The relative incidence of cerebral palsy has increased recently over that of poliomyelitis, due to the improvement in the social, medical, and economic status of our country. It is important to check the pathologic reflexes for diagnosis, treatment and prognosis of cerebral palsy. We studied 84 cerebral palsied patients, between 1 to 13 years old, who were treated at our Crippled Childrens Rehabilitation Center. The motor age and pathologic reflexes were checked, and pathologic reflexes were checked, and the relationship between pathologic reflexes and walking was compared. The following results were obtained. 1) With increasing of chronological age, there was a tendericy to increasing of motor age, but the mean motor age did not increase after 8 years in chronological age, and no more than to about 20 months. 2) With increasing of motor age, a tendency to decreasing of frequency of pathologic reflexes was shown. 3) The followings were the most important pathologic reflexes in non walking group: a) positive supporting reaction b) supine lying c) prone lying d) Moro reflex e) asymetrical tonic neck f) protective extensor thrust.
Cerebral Palsy ; Child ; Clinical Study ; Deception ; Diagnosis ; Humans ; Incidence ; Neck ; Poliomyelitis ; Prognosis ; Reflex ; Reflex, Startle ; Rehabilitation Centers ; Walking

Legg-Calve-Perthes disease is a hip disorder of undetermined etiology, occurring in children and charaterized by necrosis and repair of the proximal femoral epiphysis. Its etiology and treatment continue to command intense interest among orthopaedic surgeons. It is the purpose of this paper to evaluate the result of our experience in the selected patients with Legg-Calve-Parthes disease treated by innominate osteotomy, In this study, six cases of Legg-Calve-Perthes disease treated at Severance Hospital from March 1976 to November 1978 were analysed clinically, and gratifying results were obtained.
Child ; Epiphyses ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Necrosis ; Osteotomy ; Surgeons

Trochanteric fractures frequently occur in the elderly patients and complications such as pneumonia, thromboembolic disease, decubitus ulcer, and urinary tract infection are common. The principle in the treatment of an elderly patient wlth trochanteric fractures have swung from traction to internal fixation due to such complications. Since the introduction of the Smith-Petersen nail, numerous internal fixation devices such as I-beam nail, Thornton plate, Jewett nail, and Holt nail have been developed. Recently compression hip screw is popular because of rigid internal fixation. Also many surgeons such as Evans, Dimon and Hughston, Sarmiento, and Boyd and Anderson have attempted to provide stable fixation of fracture by altering the position of fracture fragments. This report is based on 104 cases of trochanteric fractures who were seen and treated at our orthopedic department during the 13 years period from January, 1965 to December, 1978. The study includes clinical and radiologic observation on our series of trochanteric fractures. The results were summarized as follows: 1. Of 104 cases of trochanteric fractures 79 cases occurred in man, 25 cases in woman and each mean age was 51 years in man, 62 years in woman. 2. The most common cause of fracture was due to traffic accident. 3. Among 104 cases, 73 were treated with open reduction and internal fixation, and 31 were treated conservatively. 4. Of fixation devices, Jewett nails were used in 40 cases, Temple University nails in 9 cases, Mclaughlin nail plates in 5 cases, Moore blade plates in 4 cases, Blount blade plates in 3 cases, Thornton nail plates in 2 cases, Neufeld nail plate in 1 case, Richard compression sliding screw plates in 2 cases, plate and screws in 3 cases, Kuntscher nail in 2 cases, and screws in 2 cases. 5. Of 92 cases of trochanterir fractures, 27 cases were stable fracture and 65 cases were unstable fracture. The method of medial displacement of proximal part of distal fragment in 2 cases with unstable fracture and anatomic reduction in 90 cases with stable and unstable fracture were achieved. 6. The average time to fracture union was 16.6 weeks roentgenologically. There was no significant difference in the union rate between the method of treatment. 7. The average time to weight bearing was 11.8 weeks in operative treatment and 18.3 weeks in conservative treatment. 8. Complicatlon after internal flxation were reduced by early ambulation. 9. The method of medial displacement of proximal part of distal fragment of fracture was achieved in 2 cases of unstable fractures, and obtained satisfactory fracture healing, but had disadvantages such as some limitation of motion of the affected hip, shortening of affected extremlty. 10. Satisfactory result was obtained in 95.5% out of operatlve treatment, and 84% out of non-operative treatment. 11. From a consideration of those series, it was concluded that operative treatment of trochanteric fractures offered the advantages of improved function, economy of hospital beds, less complication, and comfort and early ambulatlon of the patient.
Accidents, Traffic ; Aged ; Clinical Study ; Early Ambulation ; Female ; Femur ; Fracture Healing ; Hip ; Hip Fractures ; Humans ; Internal Fixators ; Methods ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Surgeons ; Traction ; Urinary Tract Infections ; Weight-Bearing

The structures forming the shoulder joint are very complex and the biomechanical effects of them on the joint are not clearly lunderstood. Frequently the long head of the biceps brachii muscle is dislocated naturally and it has been said that the supratubercular ridge, the depth, and angle of medial wall of the intertubercular groove are important. And the angles between the long axis of the humerus and the axis of head and neck are important clinically. So the authors studied them in the 105 specimens of the Korean adults humerus. The results are as follows: 1. The complete type of the supratubercular ridge was present in 22.9% and the partial type was in 53.3% 2. If the ridge was present, the spur of the lesser tubercle was present in 67.5% and if not present, the spur was in 8%. 3. The angle of medial wall of the intertubercular groove was variable, and the angle less than 45 was 13.41°. 4. The angles between the long axis of the humerus and the axis of head and neck were much greater in male than female (P<0.05). 5. The average diameter of the head of the humerus was 4.42±0.4cm in male and 4.4±0.4cm in female (P < 0.05).
Adult ; Female ; Head ; Humans ; Humerus ; Joints ; Male ; Neck ; Shoulder Joint

Congenital muscular torticollis is a distinct entity, in which the primary pathologic picture is limited to the sternocleidomastoid muscle. Associated deformities of the face, head and cervical spine are secondary in character, resulting from an abnormal position of the head both prior and subsequent to birth. The etiology of congenital muscular torticollis is not clear yet. There are various opinions about adequate age and methods for treatment. From January 1970 to December 1984, 53 cases of congenital muscular torticollis were treated surgically at the Department of Orthopedic Surgery, Severance Hospital. From January 1980 to December 1984, 10S cases of congenita muscular torticollis were treated conservatively at the same hospital. Totally, 161 cases were studied and analyzed retrospectively and the results are summerized as follows: 1. Among the 161 cases, thers were 88 males and 73 females. The lesion was on the left side in 89 cases. 2. There were 85 cases of normal spontaneous vaginal delivery and 58 cases of complicated labor including 34 cases of breech delivery. 3. There were 6 cases associated with other congenital anomalies; one of them was combined with congenital subluxation of the hip joint. 4. Results of conservative physiotherapy were good under 1 year of age and results of surgical correction were good under 6 years of age. 5. The failure of conservative physiotherapy did not influence the results of surgical correction performed later. 6. The results of reoperation, when the initial surgical correction failed, were not as good. 7. Facial asymmetry correction results were especially good under 6 years of age when much growth potential remained. 8. There were no differences in results according to the various kinds of cervical braces although the results were good when the cervical brace was worn over 3 months. 9. On pathologic examination, there was no hemorrhagic reaction. The muscle was atrophied and was replaced by fibrous bands. Therefore, congemtal muscular torticollis is thought to be caused by abnormal intrauterine position rather than by birth trauma, and it is expected to get a good result by treating congenital muscular torticollis as early as possible.
Braces ; Clinical Study ; Congenital Abnormalities ; Facial Asymmetry ; Female ; Head ; Hip Joint ; Humans ; Male ; Orthopedics ; Parturition ; Reoperation ; Retrospective Studies ; Spine ; Torticollis

No abstract available.
Dislocations* ; Head* ; Hip* ; Necrosis*

To investigate retinal hemodynamics in diabetic retinopathy, the perifoveral capillary leukocyte velocity for retinal microcirculation was measured in eyes of 16 control. 12 non-proliferative diabetic retinopathy(NPDR) and 10 proliferative diabetic retinopathy(PDR) on the video fluorescein angiogram using a scanning laser ophthalmoscope(SLO 101, Rod-enstock, Munich, Germany) in 20 degrees retinal field. And the times of arm to retinal circulation, arterio-venous circulation and venous lamina flow for retinal macrocirculation were also measured in eyes of 18 control, 16 NPDR and 10 PDR in 40 degrees retinal field. There was not any statistically significant difference between control eyes(140.62 +/- 34.11 pixels/see, 1.21 +/- 0.29 mm/sec) and NPDR eyes(133.98 +/- 31.85 pixels/sec, 1.15 +/- 0.27 mm/sec) in mean perifoveal capillary leukocyte velocity(p=0.60). But it was significantly decreased in PDR eyes(108.80 +/- 26.19 pixels/see, 0.94 +/- 0.23 mm/sec) compared with control(p=0.01) and NPDR eyes(p=0.05). The were not any significant differences in the times of arm to retinal and arterio-venous circulation respectively(p>0.05) among the eyes of control(12.09 +/- 1.41 sec, 2.41 +/- 0.86 sec), NPDR(12.66 +/- 1.42 see, 2.32 +/- 0.96 sec) and PDR(12.90 +/- 1.51 see, 2.54 +/- 0.94 sec). But the venous lamina flow time was significantly decreased in eyes of NPDR(6.91 +/- 2.32 see, p=0.02) and PDR(7.03 +/- 1.89 sec, p=0.01) compared with that of control(5.46 +/- 1.18 see). These results indicate that a significant retinal microcirculatory deficit exists in the eyes of PDR, and venous lamina flow time may be a good index of retinal macrocirculatory deficit in diabetic retinopathy.
Arm ; Capillaries ; Diabetic Retinopathy ; Fluorescein ; Hemodynamics* ; Leukocytes ; Microcirculation ; Ophthalmoscopes* ; Retinaldehyde*