The early weight bearing in treatment for tibial fractures was reporded first by Gurd(1940) and in recent by Weissman(1966), Sarmiento(1967), and Brown(1969). 1. One hundred and fifty cases of fractures of the tibia treated at the Orthopedic Department f the 17 th Army Hospital during period of January 1968 to June 1970 were subjected to analysis. Of three groups, first group was applied functional below the knee cast after mannual reduction and started weight bearing on the 5 th weeks from injury, second group was treated with same method as first group except the reduction was achievd surgically, and third group was applied toe-to-groin cast after manipulation with no weight bearing until union. 2. Casting method; The toe-to-groin cast was applied on the day of injury after manipulation and functional below the knee cast was applied tightly after swelling was subsided. Supporting the leg on the table, we could obtain satisfactory alignment in all cases. Especial firm molding over the medial flare of the tibia, Patellar tendon and popliteal space was the most important step in applying this type of the cast. Finally rubber walking heel was held in place throught the tibial axis. 3. Traffic accident was the most common cause of the fractures in this series and it was 78 cases out of 150. 4. The average healing time of the first group was 15.7 weeks, of second group was 19.4 weeks, and of third group was 23.5 weeks. 5. The open and/or comminuted fractures would delay healing time, and prolonged convalescent period. 6. Though slight shortening and angulation was observed in the early weight bearing groups, the final function was excellent.
Accidents, Traffic ; Fractures, Comminuted ; Fungi ; Heel ; Hospitals, Military ; Knee ; Leg ; Methods ; Orthopedics ; Patellar Ligament ; Rubber ; Tibia ; Tibial Fractures ; Walking ; Weight-Bearing

Hemophiliae has the frequent episode of spontaneous hemorrhage into joint and muscle and arthropathy, a major source of disability in hemophilia, ensues in joint, in proportion to the frequency of bleeding. This relation suggests that repeated hemorrhage into joints is responsible for the arthritis. This paper described a case of hemophilia, A type in a managed 22 years who was admitted with pain and limited motion of both kness, ankles and elbow joints. Considerable improvement could be achieved with conservative measures as medication, rest and traction.
Ankle ; Arthritis ; Elbow Joint ; Hemophilia A ; Hemorrhage ; Joints ; Traction

Surgery is the treatment of choice for recurrent dislocation of the patella and many proposed operations can conveniently be grouped into three headings: transposition medially of the quadriceps pull mechanism (Hauser), installment of medial checkrein, either proximal or distal to the patella (Campbell) and patellectomy (West and Sotto Hall). Two cases of the dislocation observed in the young men are reported here, in which the authors performed an operation consisting of Hauser method and in addition the medial checkrein utilizing semitendinosus tendon. The results were successful in both cases, with complete restoration of the knee function.
Dislocations ; Head ; Humans ; Knee ; Male ; Methods ; Patella ; Tendons

The short term result of clinical study was reported here of 16 tibial condylar fractures treated at the Department of Orthopedic Surgery, Kwang-ju Hospital from Jan. 1967 to Dec 1969. The evaluation was done according to the classification of Hohl (1967). Among 16 cases of the tibial condylar fractures, 12 being lateral, 3 bicondylar and 1 medial. 6 were treated by means of closed reduction under anesthesia and skeletal traction and 10 underwent open reduction. The indication of open reduction and reconstructive surgery was the failure of the initial attempt of closed reduction and extremely unstable knee joint owing to ligamentous injuries with fracture. As the associated soft, tissue injuries, 6 of torn collateral ligaments were detected and 4 of torn cruciate ligaments were discovered. In 8 of the 10 patients operated, torn of the menisci were demonstrated indicating that the incidence of injury is almost proportional to the severity of the initial violence. The clinical end results were devided to acceptable 12 (75%),and unacceptable were 4 (25%) respectively. The better prognosis largely depends on the more accurate reduction, soft tissue reconstruction and early mobilization of the joint.
Anesthesia ; Classification ; Clinical Study ; Collateral Ligaments ; Early Ambulation ; Gwangju ; Humans ; Incidence ; Joints ; Knee Joint ; Ligaments ; Orthopedics ; Prognosis ; Traction ; Violence

We have treated three cases of bone abscesses, two in proximal tibia and one in os calcis, by radical excision and filling the remaining bone cavity with autogenous iliac bone graft. We have observed them postoperatively for one to six years. They have not shown any sign of recurrence and they are carrying out their normal daily activity without any restriction. Eventhough it is against the basic fundamental of surgery to lay bone grafts in an infected area, our treatment was successful. We believe that this was resulted from the administration of the broad spectrum antibiotics, complete excision of the diseased tissue, gentle handling of the tissue at the surgery, and relatively perfect postoperative care. When the remaining bone cavity after the surgery of the osteomyeIitis can not filled by the usual method such as muscle pedicle graft, especially in the proximal metaphyseo-epiphyseaI region of the tibia, fresh cancellous bone graft immediately after the radical excision, and primary closure of the operative wound may be tried. It seems that this method brings rapid and permanent heaIing of the chronic osteomyelitis. Thus the patient can leave hospital earlier, pays Iess expense, and returns to his work earlier.
Abscess ; Anti-Bacterial Agents ; Humans ; Methods ; Osteomyelitis ; Postoperative Care ; Recurrence ; Tibia ; Transplants ; Wounds and Injuries

PURPOSE: The purposes of this study are to discribe the high-resolution computed tomographic (HRCT) findings of pulmonary histiocytosis X and to evaluate the relationship between the extent of the lesion on HRCT and pulmonary function test (PFT). MATERIALS AND METHODS: We retrospectively analyzed the HRCT findings of 8 patients with pathologically proved pulmonary histiocytosis X. The morphological pattern and incidence of the lesions were evaluated. The extent of the lesions were correlated with the results of PFT by calculating Spearman correlation. RESULTS: The most common HRCT findings were thick-walled cysts (n=8) followed by nodules (n=7). Other associated findings were reticulation, ground-glass opacification, and conglomerate nodules. The extent of the disease on HRCT was correlated inversely with percent predicted value of functional vital capacity. CONCLUSION: Common HRCT findings of pulmonary histiocytosis X were cysts with irregular wall thickening and nodules. The extent of the disease on HRCT correlated with the severity of restrictive pattern of PFT.
Histiocytosis, Langerhans-Cell* ; Humans ; Incidence ; Respiratory Function Tests ; Retrospective Studies ; Vital Capacity

PURPOSE: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(IPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. MATERIALS AND METHODS: We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40--85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. RESULTS: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower Iobe;10/19, left lower Iobe;5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). CONCLUSION: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the [ocatiaon where the most advanced fibrosis occur.
Carcinoma, Squamous Cell ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Retrospective Studies

PURPOSE: To describe the radiological differences between tuberculous(TBB) and non-tuberculous bronchiectasis(NTBB). MATERIALS AND METHODS: Chest radiographs(n=62), bronchograms(n=18), and CT scans(n=52) of 37 patients with TBB and 25 patients with NTBB were reviewed retrospectively. Diagnostic basis for TBB were positive sputum AFB with or without history of anti-tuberculous chemotherapy(n=35), and radiological findings of pulmonary tuberculosis (n=2). Four of NTBB had a history of severe respiratory tract infection in childhood. RESULTS: Air-fluid levels on chest radiographs were seen in 2% of TBB, and 20% of NTBB. On bronchograms, all patients with TBB had combined focal bronchostenosis, whereas patients with NTBB had tubular(50%), cystic(17%), or mixed(33%) pattern of dilatation without stenosis. On CT scans, focal emphysema was seen in 86% of the patients with TBB, and 38% of the patients with NTBB. Peribronchiolar infiltration were seen in 78% and 44% of patients with TBB and NTBB, retrospectively. CONCLUSION: Basic radiological difference between TBB and NTBB was that the former had coexistent sten.
Bronchiectasis* ; Constriction, Pathologic ; Dilatation ; Humans ; Pulmonary Emphysema ; Radiography, Thoracic ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

PURPOSE: We evaluated the usefulness of quantitative spiral CT to predict postoperative lung function in patients undergoing pulmonary resection. MATERIALS AND METHODS: Fourteen patients in whom pneumonectomy or segmentectomy were performed underwent preoperative chest spiral CT and pulmonary function test(PFT). Six patients underwent postoperative follow-up PFT. Ten patients underwent preoperative radioisotope(RI) lung perfusion scan. Preoperative CT data were postprocessed with contiguous pixel method ranged from -9107HU to -500HU to quantify total functional lung volume(TFLV) and regional volume to be resected(RFLV). Postoperative lung function was predicted by following formula;Predicted postoperative PFT value=preoperative PFT x 1-RFLV/TFLV). CT predicted value was compared with postoperative measured PFT value and those value of RI perfusion scan. RESULTS: CT predicted values were very close to postoperative measured value and RI predicted value, and were correlated well with postoperative measured values (FVC: r=0.988, P<0.001 ;FEV1: r=0.994, P<0.001) and RI predicted values (FVC :r=0.976, P<0.001 ;FEVl: r=0.974, p<0.001). CONCLUSION: Quantitative spiral CT was useful to predict postoperative lung function and could be an effective alternative to RI perfusion scan.
Follow-Up Studies ; Humans ; Lung* ; Mastectomy, Segmental ; Perfusion ; Pneumonectomy ; Thorax ; Tomography, Spiral Computed*

PURPOSE: We applied spiral CT to evaluate the dynamic changes of regional ventilation of the lung in normal subjects and abnormal patients. MATERIALS AND METHODS: This study includes normal subjects (n:5) and patients with chronic obstructive pulmonary disease (n=4), small air-way disease (n=3), diffuse panbronchiolitis (n=4), and tracheobronchial tuberculosis (n=2). Time-continuous scan data at a fixed level during forced vital capacity maneuver (10--12 seconds) were obtained and images were reconstructed retrospectively by using 0.67 second scan data per image. The reconstructed images were displayed in a cine mode. Time-density curves were plotted and were correlated with clinical diagnosis. RESULTS: In normal subjects, mean attenuation difference between full inspiration and full expiration was 145. 8HU and mean time interval between 20% expiration and 80% expiration was 2.04 seconds. In chronic obstructive lung disease, mean attenuation difference between full inspiration and full expiration was 21.2HU and mean time interval between 20% expiration and 80% expiration was 3.63 seconds. In small air-way disease, mosaic-pattern hyperlucency and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 49.8HU and 167.0HU, respectively. In diffuse panbronchiolitis, centrilobular region and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 35.4HU and 79.3HU, respectively. CONCLUSION: Respiratory dynamic CT is an updated technique which enable imaging of the functional status of the lung parenchyma. It may be useful in differentiation and quantitation of variable obstructive lung diseases.
Diagnosis ; Humans ; Lung Diseases, Obstructive ; Lung* ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Tomography, Spiral Computed ; Tuberculosis ; Ventilation ; Vital Capacity