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

Methicillin-resistant Staphylococcus aureus colony variants (SCVs) are frequently auxotrophic for hemin, menadione, thiamine, and CO2 involved in biosynthesis of the electron transport chain element. This phenotype grows slowly, and forms very small, nonhemolytic colonies in routine culture, so it may be led to the misidentification of this organism. We isolated an organism with catalase-positive, gram-positive cocci in cluster from the urine of a 55-years-old woman with persistent and relapsing bladder stone, who had undergone the antibiotic treatment with cefotaxime, ceftizoxime, amikacin, and/or micronomicin, intermittently for three years. The possibility of SCVs should have been ruled out because this organism didn't grow on Mueller-Hinton agar (MHA) for the susceptibility test. It formed small colonies on blood agar plate overnight, and grew only on MHA with supplement of hemin, or with 5% CO2. This organism was coagulase-positive, DNase-positive, manitol-salt positive, and identified as S. aureus with VITEK GPI card. The susceptibility test could be performed after adding hemin(1mg/mL) into bacterial suspension and showed susceptibility against vancomycin, teicoplanin, and rifampin. Because these phenotypes can be misidentifide as other non-pathogenic organisms due to their atypical characteristics, we should consider SCVs in case of small, nonhemolytic colonies with catalase-positive, gram-positive cocci in cluster, showing no growth on MHA. In addition, infections caused by SCVs are recently recognized in relation to persistent and relapsing infection, so they could be isolated from the patients with long-term antibiotic therapy.
Agar ; Amikacin ; Cefotaxime ; Ceftizoxime ; Electron Transport ; Female ; Gram-Positive Cocci ; Hemin ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Phenotype ; Rifampin ; Teicoplanin ; Thiamine ; Urinary Bladder Calculi* ; Urinary Bladder* ; Vancomycin ; Vitamin K 3

No abstract available.
Emergencies* ; Emergency Service, Hospital*

Congenital scoliosis is a structural deformity due to congenital anomaly of the spine. After Winter's report in 1973, congenital scoliosis is said to be progressive in 75% of cases, and 50% are rapidly progressive, serious and demand treatment. And thus, most of them need more aggressive and early treatment compared with idiopathic scoliosis. The prognosis depends on the type, angle and flexibility of the curvature, and the age of patient. The authors reviewed the results of operative treatment for the congenital scoliosis that had been treated from Jan. 1984 to Dec. 1993 at the orthopedic department of Yonsei University College of Medicine, and the results as follows. 1. The age distribution of the patients was from 2 years to 14 years, and the mean was 8.4 years. Five male patients and two female patients were operated. 2. The involved spinal segments of the primary curve were 2 cases of thoracolumbar, 3 cases of lumbar. There were two cases of double major curves. 3. According to MacEwen's classification, the types of vertebral anomaly were 4 cases of hemivertebra, 2 cases of miscellaneous and one case of wedge vertebra. 4. The levels of apical vertebra were each 1 case of T3, T9, Ll, L2, L4 respectively and each 2 cases of T12, L3 respectively. 5. The methods of operation included 1 case of resection of rib, 4 cases of posterior fusion, 1 case of combined anterior and posterior hemiepiphysiodesis and fusion, and 1 case of hemivertebra excision with spine fusion. 6. The curvature of spine on admission ranged form 10 degrees to 63 degrees, and the mean angle was 35.5 degrees. And, we followed up postoperatively from 1 year to 10 years, and the mean follow up period was 32 months. The final correction angles were from
Age Distribution ; Classification ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Pliability ; Prognosis ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

No abstract available.
Congenital Abnormalities* ; Ilizarov Technique*

No abstract available.
Foot* ; Tarsal Bones*

No abstract available.
Toes*

No abstract available.
Gaucher Disease*

We analyzed 27 cases of Legg-Calve-Perthes disease that were treated by operative methods at the Department of Orthopedic Surgery, Yonsei University College of Medicine from 1975 to 1981. The modalities of treatment were innominate osteotomy in 17 patients; subtrochanteric osteotomy of femur in 4 patients; and adductor-iliopsoas tenotomies in 6 patients. Most of the cases were in Catterall group III or IV diseases with two or more of “head at risk”signs in the preoperative roentgenogram. All but one case were aged more than 7 years at the time of surgery. In all cases clinical and radiological evaluations were performed until the affected femoral head had been fully regenerated. The average period of follow-up was 2 years and 11 months. Final result by Catterall's criteria was good in 15 cases (56%), fair in 7 cases (26%) and poor in only 5 cases (18%). Among 17 cases treated by innominate osteotomy, 13 cases (76%) were in good result and there was no poor result; 15 cases (86%) showed normal containment at the last follow-up x-ray. To compare these end results with those of noncontainment treatment reported by many authors, we were encouraged to proceed our current policy of early definitive containment surgery especially in patients with poor prognostic factors. In cases of estabilshed femoral head deformities that can be confirmed by preoperative arthrography, adductor-iliopsoas tenotomies were useful to restore normal range of motion of hip joint and to prevent further subluxation of the femoral head. The significant prognostic factors at the time of surgery were the patients age; stage of disease; involvement of femoral head; and finally early established irregularities of the femoral head. In every cases of Legg-Calve-Perthes disease these factors should be carefully assessed to make proper decision for the choice of the most effective modality of treatment.
Arthrography ; Congenital Abnormalities ; Containment of Biohazards ; Femur ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Legg-Calve-Perthes Disease ; Orthopedics ; Osteotomy ; Reference Values ; Tenotomy

Twenty four patients with gap nonunions of the tibia were treated with the Ilizarov intercalary bone transport method. The purpose of this retrospective study is to evaluate the results and complications in gap nonunions of the tibia treated using the Ilizarov method. There were 22 males and two females with an average age of the 35.8 years(range, 23-63 years). The mean follow up period was 30.2 months(range, 17-70 months). Ten of the 24 patients had no external shortening with bone gap, 13 external shortening with gap and one hemicircumferential defect. On average, the size of bone loss measured 8.2 cm(range, 3-18 cm). Twenty-one of 24 patients were treated by whole segment internal transport(fifteen were proximal fragment transport, five were distal fragment transport, one was proximal and distal fragment transport), one patient by anterior hemicircumferential corticotomy and partial bone fragment internal transport and tow patients by fibula transfer. All patients healed with solid bony union, although twelve patients required bone grafts, eleven at the docking site and one at the distraction site. On average, the healing index was 49 days/cm(range, 18-82 days/cm). There was on relationship between the percentage transport(size of the distraction gap/the transporting fragment length x 100) and healing index. Numerous complications were encountered, most commonly delayed union and pin site infection, Conclusively, the application of Ilizarov techniques to gap nonunions of the tibia was very effective, but required correct technique and careful follow-up examination.
Female ; Fibula ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Male ; Methods ; Retrospective Studies ; Tibia ; Transplants