Forty-five elderly female osteoporotics were given daily dose of 750 mg of calcium and 1.0 microgram of activated vitamin D (1-a hydroxyvitamin D) orally for 24 months to evaluated the effect of drugs on bone mineral density. Bone mineral density was evaluated and repeated every 6 months for 2 years. Average bone mineral density (L (2)-L (4)) and T score were 0.773 (SD 0.120) and -2.90 (SD 0.97) before treatment, and increased to 0.808 (SD 0.121) and -2.59 (SD 0.97) after 24 months of therapy, respectively (p<0.01). During treatment, complications including hypercalcemia, hypercalciuria, or renal stone were not observed, and indicators of renal function were normal. Therefore the activated vitamin D treatment in osteoporosis is effective in diminishing normal decline of bone mineral density, especially in areas with low calcium and vitamin D intake, such as South Korea.
Aged ; Bone Density* ; Calcium* ; Female ; Humans ; Hypercalcemia ; Hypercalciuria ; Korea ; Osteoporosis* ; Vitamin D* ; Vitamins*

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

As the arthroscopic surgery of the knee joint has taken rapid strides recently, the knowledge of the structure and deveIopment of the joint are getting needed more and more. An embryological study about the development of the human knee joint was carried out using a total of 23 knees of human embryos. Serial sections of 23 embryos aged 5-8 postovulatory weeks (12-31 mm C.R.) and 3-dimensional reconstruction were examined. The embryos have been staged according to Carnegie's 'developmental stages'. The femur, tibia and fibula had begun to undergo chondrification by stage 18. The patella had commenced chondrification at stages 23. As the mesenchymal model began to chondrify, concomitant changes occurred in the region of the presumptive knee joint to create the interzone (stage 19-20). The following structures became condensed successively: patellar tendon (18-19), lateral collateral ligament and popliteus tendon (19-20), cruciate ligaments (20-22), meniscus (21-22). In summary, the differentiation from a generalized cellular blastema to a joint resembling the adult in form and arrangement occurred in only a relatively few days. By the end of the embryonic period proper (stage 23, 8 postovulatory weeks), all the elements of the knee joint were present in a form and arrangement closely resembling those of the adult. It seems that the embryological studies are more required to clarify the structures having many variants such as synovial plica, meniscus, and the development of the joint cavity through this study.
Adult ; Arthroscopy ; Embryonic Structures ; Femur ; Fibula ; Humans* ; Joints ; Knee Joint* ; Knee* ; Lateral Ligament, Ankle ; Ligaments ; Patella ; Patellar Ligament ; Tendons ; Tibia

Unicameral bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with serous fluid. Four cases of cystic lesion at the upper end of the humerus were revealed to be unicameral bone cyst roentgenographically and microscopically. Two cases were treated with radical curettage followed by homogenous and autogenous bone graft, and one case was treated with radical curettage followed by homogenous bone graft. The other was treated with radical curettage followed by autogenous fibula graft. All cases made uneventful recoveries, and they had no complaints and no evidence of recurrence, A brief summary of literatures is submitted.
Bone Cysts ; Curettage ; Fibula ; Humerus ; Recurrence ; Transplants

Tuberculosis of the vertebral column is a slowly developing disease, characterized by pain, spinal deformity, and occasionally paralysis. The following varieties of vertebral tuberculosis are commonly recognized, such as a central variety, metaphysial tuberculosis (inter-vertebral articular type), an anterior or periosteal variety, appendiceal tuberculosis, and a true tuberculous arthritis. Among these appendiceal tuberculosis is rare. This form of Potts disease may be unilateral or bilateral and may be isolated or present at multiple levels. Disk space changes and deformity are minor features, but large paravertebral abscesses are invariable. Extradural extension may lead to the development of paraplegia. Two cases of destructive lesions at the neural arch of 10th. and 11th. thoracic vertebra were revealed to be appendiceal tuberculosis. All cases treated with antituberculous medication, radical curettage and body jaket casts and made recoveries. Patients had no complaints and no evidence of recurrence. A brief summary of the literature is submitted.
Abscess ; Arthritis ; Congenital Abnormalities ; Curettage ; Humans ; Paralysis ; Paraplegia ; Recurrence ; Spine ; Tuberculosis ; Tuberculosis, Spinal

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

The ankle is a complex, weight-bearing joint and has an important role in walking. The injuries to the ankle joint complex include not only injuries that cause disruption of the bony architecture of the ankle joint but often significant ligamentous and soft tissue components. The literature on ankle fractures have divergence of opinion on treatment. However, the method used to obtain a good end result of treatment is a matter of differing opinion. One hundred and seventy six patients with one hundred and eighty cases of ankle fractures treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analized in clinical and radiological aspect. The results obtained from this study were as followings: 1. Among the 176 patients, male was 126 patients and female 50 patients (M:F=2.5:1). The average age was 29. 2. Of the 180 cases, the main cause of fractures was traffic accident, 74 cases (41.1%) and the other causes were falling from a height (16.1%), slipping down (15.0%) and sports injuries (12.8%) in order. 3. The fractures were almost closed fractures (84.4%). 4. According to the classification of Lague-Mansen, the pronation-external rotation type (40.6%) was the commonest type. 5. One hundred and twelve cases (62.2%) were treated by open reduction and 68 cases (37.8%) by closed reduction. 6. The average period of the cast immoblization after the open reduction was 8 weeks but the closed reduction was 10 weeks. 7. According to clinical and radioiogical assessment of the result of the treatment, the open reduction was better than closed reduction. 8. The fibular fracture involving lateral malleolus and the diastasis of the distal tibiofibular syndesmosis were very important in ankle stability and were treated by internal fixation for accurate anatomical reduction.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Ligaments ; Male ; Methods ; Walking ; Weight-Bearing

Supracondylar fractures of the humerus is the most common elbow fractures in children. Many papers has been published about the treatment of the supracondylar fractures of the humerus in children and prevention of both Volkmann's ischemic contractures and nerve injuries associated with these fractures, however, unfortunately it is still one of the most difficult fractures to manage. After successful reduction, the late complications of loss of elbow motion, the change in carrying angle, myositis ossificans, and progressive ulnar nerve palsy still lie ahead. For the period of 5 years from January 1975 to December 1979, 110 patients who had been treated for supracondylar fractures of the humerus at Severance Hospital, Yonsei University Coilege of Medicine were studied and analyzed retrospectively and the results are summerized as follows: 1. The age of the patients varied from 1 to 26 years, the majority (80.0%) being between 4 to 11 years and the fractures were on the left side in 71.8% and males comprized 75.5%. 2. The extension type comprized 94.5%. 3. Most common complications were cubitus varus deformities. 4. Percutaneous pinning and open reduction and internal fixation elicited rare cubitus varus diformities. 5. Limitation of motion was most frequent camplication after open reduction and internal fixation. 6. All cases which showed cubitus varus deformities were initially medially displaced fractures. 7. Four median nerve injuries were associated with posterolateral displacement and one radial nerve injury was associated with posteromedial displacement. 8. Finally, with prompt and adequate treatment, there were no Volkmanns ischemic contractures seen in this study.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Ischemic Contracture ; Male ; Median Nerve ; Myositis Ossificans ; Radial Nerve ; Retrospective Studies ; Ulnar Neuropathies

Early detection of skeletal disorders was very important role in establishing therapeutic modality and prevention of complications. Since Tc-99m-phosphates derivatives used in bone scan agent, remarkable improvement was noted in effectiveness, cost, radiation hazard to patient and image quality than previously used agents such as strontium or fluoride. Bone scan with Tc-99m-MDP was done in 155 cases for early diagnosis of skeletal disorders at Severance Hospital, College of Medicine, Yonsei University from August, 1980 to May, 1982 were analyzed both clinically and radiologically, and the following results were obtained. l. Among 19 cases of avascular necrosis, positive cases were 17 (89.5%) in bone scan and 6(31.6%) in X-ray. Positive pattern could be classified into 3 types and the radionuclide uptake in the femoral head was decreased in 3 cases which was negative in X-ray and duration of their symptoms was within 4 months. 2. Fifteen among 17 hip fractures or dislocations were positive in bone scan. In 12 (80.0%) among 15 cases, complications were revealed and positive cases in X-ray were 7(58.3%), which were all positive in bone scan. 3. In 20 bone scans for early diagnosis of acute osteomyelitis, positive in bone scan were 17 and 14 (82.4%) of 17 cases were finally diagnosed as acute osteomyelitis. Among 15 cases diagnosed as acute osteomyelitis, positive in X-ray were 8(53.3%) and sensitivity of acute osteomyelitis in bone scan was 93.3%. 4. In 25 cases of the suspected infection of the joint, 15 were positive in bone scan and among them, cases diagnosed as pyogenic arthritis were 12 (80.0%) and positive in X-ray were 2 (16.7%). Only one of 10 cases of transient synovitis of the hip joint was positive in bone scan. 5. In rheumatoid arthritis, 13 of 15 cases were positive in bone scan and 10 among them were revealed the diffuse uptake of the radionuclide in the joint. In degenerative arthritis, 7 of 8 cases were positive in bone scan and they were revealed the focal uptake of the radionuclide in the same site where the bone was changed in x-ray. 6. Among 28 cases showed spine fracture in X-ray after trauma, 15 (53.6%) were positive in bone scan. In spine fracture, it was difficult to differentiate fresh fracture from old fracture with bone scan. The positive duration of bone scen in fracture of weight bearing bone was longer than in spine fracture. Rib fracture which was not found in X-ray could be diagnosed with bone scan.
Arthritis ; Arthritis, Rheumatoid ; Clinical Study ; Cost-Benefit Analysis ; Diagnosis ; Dislocations ; Early Diagnosis ; Fluorides ; Head ; Hip Fractures ; Hip Joint ; Humans ; Joints ; Necrosis ; Osteoarthritis ; Osteomyelitis ; Rib Fractures ; Spine ; Strontium ; Synovitis ; Weight-Bearing

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