No abstract available.
Humans

The head injuried patient with skeletal trauma is a challege to the orthopedic surgeon. The orthopedist initially may face the difficult management of fracture and dislocation in the patient associated with head injury. The management of the injuries to the head takes precedence over extremity injuries initially, but the orthopedist must be managed aggresively with assumption that full neurologic recovery will occur. This report analysed the treatment and results in 85 cases fracture and dislocation with head injury among the 59 patients at the Chungnam National University Hospital during the period ranging from March, 1980 to March, 1983. End result obtained are as follows: 1. The sex ratio between the male and female was 3.9: 1 and the prevalent age distribution was from 21 to 30 years of age. 2. The motorcycle accident was most common cause of the trauma and the next most frequent one was the automobile accident. 3. Type of head injury were contusion or concussion, intracranial hemorrhage, linear skull fracture, depressed skull fracture and open skull fracture. 4. Better result were obtained by operative treatment in femur fracture, especially spastic group. 5. The incidence of delayed diagnosis was 8 cases and the delay in diagnosis ranged from 15 to 95 days with an average of 38 days. 6. We, consulting with neurosurgeon, must assume that full neurologic recovery will take place and so open reduction and internal fixation should be carried out as quickly as possible.
Age Distribution ; Automobiles ; Chungcheongnam-do ; Clinical Study ; Contusions ; Craniocerebral Trauma ; Delayed Diagnosis ; Diagnosis ; Dislocations ; Extremities ; Female ; Femur ; Head ; Humans ; Incidence ; Intracranial Hemorrhages ; Male ; Motorcycles ; Muscle Spasticity ; Neurosurgeons ; Orthopedics ; Sex Ratio ; Skull Fracture, Depressed ; Skull Fractures

During the period from March 1990, through September 1993, 11 patients with moyamoya disease underwent superficial temporal artery(STA)-to-middle cerebral artery(MCA) anastomosis and encephalomyosynangiosis(EMS) bilaterally. The mean follow-up period was 30.6 months(range 17 to 42 months). The most frequent computed tomographic findings were intraventricular hemorrhage in adult patients and cortical infarction in pediatric patients. In all of the patients, confirmatory diagnosis could be made by angiography, and all had typical angiographic finding of moyamoya disease. According to angiographic classification by Suzuki, the most frequent phase was stage three. A modified continuous suture technique was used during anastomosis. The advantages of this microvascular suture technique are saving time for the surgical procedure, lessening bleeding from the anastomotic site and the ease and safety with which anastomosis can be achieved in the deep cranial cavity. Postoperatively, follow-up angiography was taken between 1 year and 2 years after operation. The angiography revascularization rate was 100%, excellent in 6, and good in 5. The typical postoperative angiography findings are as follows : 1) reduction of moyamoya vessels, 2) normalization or improvement of abnormal posterior circulation, 3) visualization of MCA territory through MCA-STA bypass, and 4) dilatation of STA. There were no major complication in patients with surgery, and no poor outcomes. These results indicate that the STA-MCA anastomosis and EMS in moyamoya disease can normalize cerebral circulation and reduce repeat ischemic attack and repeated bleeding.
Adult ; Angiography ; Cerebral Arteries* ; Classification ; Diagnosis ; Dilatation ; Follow-Up Studies* ; Hemorrhage ; Humans ; Infarction ; Moyamoya Disease* ; Suture Techniques

Moyamoya disease is an unusual vascular disorder highlighted by progressive bilateral internal carotid artery occlusion and collateralization of intracranial blood flow. The purposes of the bypass procedures : 1) reduce or arrest of the chance of repeated ischemic attack by making the additional collateral blood flow, 2) decrease the chance of repeated bleeding by reducing the number of moyamoya vessels. During the period from June 1989 through February 1991, 8 moyamoya diseases associated with intraventricular hemorrhage were operated by STA-MCA anastomosis plus EMS. Results are as follows : 1) Slightly female dominancy in incidence(5 : 3), and all of the patients were middle aged(range 32 to 55 years). 2) All of the patients had sudden onset of headache, and most patients whad neck stiffness and vomiting. 3) In all of the patients, confirmatory diagnosis could be done by angiography, and all of the patients had gypical angiographic findings of moyamoya disease. 4) All of the patients had IVH in brain CT scan. 5) All of the patients were surgically treated : STA-MCA anastomosis plus EMS. 6) The postoperative revascularization rate was 89%(8 sides in 9 sides). 7) The postoperative results were excellent in 5, good in 1, and death in 2. The rarity of such lesions in KOrea and their surgical results are reviewed briefly.
Angiography ; Brain ; Carotid Artery, Internal ; Diagnosis ; Female ; Headache ; Hemorrhage* ; Humans ; Korea ; Moyamoya Disease* ; Neck ; Tomography, X-Ray Computed ; Vomiting

Recently we performed a modified sternum-splitting approach in surgery for anterior space-taking lesion in the upper thoracic region. In contrast to the original trans-sternal approach introduced by Cauchoix, we cut only the manubrium and split it using vertebral spreader. After reaching the anterior surface of the cervico-Thoracic vertebrae, the central portion of the vertebral body was removed with air-drill under an operating microscope. The longitudinal bone defect of the vertebral bodies was filled with a bone graft obtained from the iliac bone. Removal of the space-taking lesions in the cervico-thoracic junction and upper thoracic region can be performed safely by utilizing the modified sternum-splitting approach. This approach can be applied also to endarterectomies at the origins of the vertebral arteries and the subclavian artery.
Endarterectomy ; Manubrium ; Microsurgery ; Spine ; Subclavian Artery ; Transplants ; Vertebral Artery

Paget's disease is a disorder of middle or older aged persons in which abnormal osteoclastic and osteoblastic activity spontaneously occurs within the affected portion of any particular bone or bones. This causes a gradual gross structural alteration through continuous remodeling. The occurance of Pagets disease is extremely rare in China, Japan, Middle East, and Africa. We have experienced one case of Paget's disease of bone affecting the spine and femur, which is reported in this paper with brief review of literature.
Africa ; China ; Femur ; Humans ; Incidence ; Japan ; Middle East ; Osteitis Deformans ; Osteoblasts ; Osteoclasts ; Spine

In 1868 Charcot described the joint in tabes dorsalis, which since then has been designated as Charcot neuroarthrophathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthrophthy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indifference of pain, leprosy, and intra articular use of steroid, etc. Authors present a case of Charcot spine due to tabes dorsalis.
Diabetes Mellitus ; Joints ; Leprosy ; Spine ; Syringomyelia ; Tabes Dorsalis

The authors has been reviewed the 123 cases, 119 patients of ankle fracture that were treated through the admission and outpatient Department of Orthopedic Surgery, Chungnam National University, from September, 1974 to January, 1982. The summary of the' results were follows: l. Among the 123 cases, male was 94 cases(76.4%), female was 29 cases, and the average age of the patients was 34.9 years. 2. The causes of the injury was traffic accidents, fall or slip downs and sports injuries in orders. 3. By the Lauge-Hansens classification, pronation-external rotation ty'pe and supination-adduction type were more common than the others. 4. Open reduction and internal fixation were more commonly used in its treatment than that of the closed method. 5. The better radiological assessment could be achieved by. obtaining the anatomical reduction and the reduction was more satisfactorily by the use of the key role of the lateral malleolus. 6. The overall results were more supported by the radiological results than the clinical results.
Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Chungcheongnam-do ; Classification ; Clinical Study ; Female ; Humans ; Male ; Methods ; Orthopedics ; Outpatients

The Clufoot is still controversial in the etiology, the pathology, and the method of the treatment. Turco issued one stage posteromedial soft tissue release in 1971, which is still widely used. But the Turco's procedure is not satisfactory results in forefoot adduction and ankle motion. McKay and Simon were performed one stage complete subtalar soft tissue release and reported better results compared with those who had posteromedial release. So we performed Turco's posteromedial release with lateral release by Cincinnati incision in 12 patients (20 feet) and analysis the results from Oct. 1987 to Jul. 1989 at the department of orthopaedic surgery of CNUH. The results were as followings ; 1. The mean age of the patient at first examination was 1 year 9 months (range from at birth to 5 year 10 months) and the mean age at operation was 2 year 1 month (range from 4 months to 5 year 10 months). 2. The clinical results were excellent in 2 feet, good in 14 feet, fair in 3 feet and unsatisfactory in 1 foot. 3. The radiological results were satisfactory in 18 feet and unsatisfactory in 2 feet. 4. Forefoot adduction was corrected in 14 feet (70%) as normal range, 3 feet as acceptable, and 3 feet as unacceptable 10' over the normal range. 5. Two feet of hind foot overcorrection result was operation as McKay's method. 6. The Clincinnati incision was favorable to visulization and release of the posteromedial, anteromedial and posterolateral structure of the foot.
Ankle ; Clubfoot ; Foot ; Humans ; Methods ; Parturition ; Pathology ; Reference Values

No abstract available.
Decompression* ; Head* ; Osteonecrosis*