No abstract available.

Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

No abstract available.
Funnel Chest*

A case of impetigo herpetiformis occurring in a 25-year-old multigravida woman is reported. Superficial grouped pustules on an erythematous base developed on the flexual areas of both extremities and disseminated all over the body with mild pruritus, fever and burning sensation at her 14th weeks of pregnancy. Histopathologic findings showed acanthosis and subcorneal. pogiform pustule. All lesions had gradually improved within 2 weeks after artificial abortior. Our case demonstrates the characteristic features of impetigo erpetiformis, as compared with pustular psoriasis. This, we emphasize the need to preserve it as a separate entity.
Adult ; Burns ; Extremities ; Female ; Fever ; Humans ; Impetigo* ; Pregnancy ; Pruritus ; Psoriasis ; Sensation

We report a case of eczema herpeticum associated with secondry staphylococcal infection in a 19 year-old male patient with Dariers disease during tratment with etretinate. Diagnosis was made by the history, clinical feature and histologic examination with light microscope & electron microscope. This patients condition was improved by the treatment with systemic and topical antibiotics within 1 week of admission.
Acitretin* ; Anti-Bacterial Agents ; Darier Disease ; Diagnosis ; Eczema* ; Etretinate* ; Humans ; Kaposi Varicelliform Eruption* ; Male ; Staphylococcal Infections ; Young Adult

The depth of wound level is as important as the level of the tendon injury itself. And the timing of the operative procedure is an important factor. As a rule, tendons injured outside of the flexor sheath yield much better results than those injured within the sheath. The nutritional supply of the flexor tendons is not completely understood. Many elaborate studies have outilned the vascular anatomy of these tendons, and not all authors are in agreement. It is now clear that synovial fluid within the sheath supplies nutrition to the tendon much as synovial fluid in a joint supports cartilage. With this in mind, the present study was designed to determine the effect of exposing tendons for varying periods of time on the viability of the tendon and sequential morphological changes. The results are as follows: 1. Twelve hours after tendon sheath removal, collagen fibrillar dissociation and irregular surface of the tendon sheath were noted on the chicken flexor tendons by electronmicroscopy. 2. Superficial tenocyte necrosis was created after 24 hours of tendon exposure. 3. At 3 days, inflammatory cell infiltration and thickening of the outer synovial layer were noted. After 7 days, fibrosis of the degenerated tendon started from the exposed surface. 4. The fibrous connective tissue and new blood vessel infiltration into the tendon were progressed after 7 days. From these morphological results, any interference with the synovial environment leads to a regressive change of the flexor tendons immediately. It is suggested that delayed primary wound covering procedure within three days an after exposed tendon injury is ideal, and it should by done at least 7 days after tendon exposure.
Blood Vessels ; Cartilage ; Chickens ; Collagen ; Connective Tissue ; Equipment and Supplies ; Fibrosis ; Joints ; Necrosis ; Surgical Procedures, Operative ; Synovial Fluid ; Tendon Injuries ; Tendons ; Wounds and Injuries

The treatment of intra-articular fractures of distal radius is difficult and has various problems. Maximum recovery of wrist function is dependent on accurate and stable reduction of the radial articular surface. We analysed one hundred and five cases of intra-articular fracture of distal radius followed for more than 6 months at Yonsei University from January 1980 to September 1988 and studied the result according to the type of treatment. The results of this study were as follows; 1. The incidence was high in female who aged over 6th decade, and in male who is active aged. 2. The main cause of this injury was fall down(34.3%). 3. In a group of closed reduction and cast immobilization, the functional result was satisfactory in 45.4%. 4. In a group of closed reduction and percutaneous pinning, the functional result was satisfactory in 50%. 5. In a group of open reduction and internal fixation, the functional result was satisfactory in 83. 3%. 6. In a group of external fixation, the functional result was satisfactory in 33.3%. 7. Overall result was mainly correlated with initial severity of the injury and anatomical reduction of the intra-articular surface.
Clinical Study ; Female ; Humans ; Immobilization ; Incidence ; Intra-Articular Fractures ; Male ; Radius ; Wrist

Compression ulnar neuropathy was predicted by Guyon in 1961,following his anatomical studies of the ulnar tunnel. Nearly a half century later Ramsey Hunt first reported isolated ulnar motor paralysis in the hand, due to chronic occupational trauma. Many authors has tried to describe the etiology of the ulnar nerve compression syndrome at or around the wrist. That is most frequently caused by ganglion, occupational neuritis, thrombosis of the ulnar artery, thickening of volar ligament or different kinds of trauma (e.g. fractures of the carpal bones). Now we experienced a case of the ulnar nerve compression syndrome at distal forearm by an anomalous branch of the ulnar nerve by piercing the distal tendon of the flexor carpi ulnaris.
Forearm ; Ganglion Cysts ; Hand ; Ligaments ; Neuritis ; Paralysis ; Tendons ; Thrombosis ; Ulnar Artery ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve ; Ulnar Neuropathies ; Wrist

It is generaly accepted that displaced phalangeal neck fractures in hands accelerate the onset of degenerative changes, with increasing pain and stiffness of the affected joint. However, reports on the results of surgical treatment in phalangeal neck fractures are relatively few. We have followed sixteen patients, who had operations for phalangeal neck fractures. The average length of follow up was 13 months. The interval between injury and operation ranged from three days to six years, whith a mean of 18 months. The second finger was the most frcquently injured. The phalangeal neck had been displaced with rotation in 9 cases and slightly displaced without rotation in 7 cases. The most common surgical approach was a mid-dorsal incision. Of 16 cases, thirteen required open reduction and internal fixation with a K-wire, either for dorsal displacement and volar angulation of the head or for a 180 degree proximal rotation of the head. The pull-out wire technique was the second most common fixation method. Excellent and good results were noted in 10 cases(62%). Complications were found in seven cases and loss of motion was the most frequent. Late malrotation with angulation occurred in one case.
Fingers ; Follow-Up Studies ; Hand ; Head ; Humans ; Joints ; Methods ; Neck

Locking of the metacarpophalangeal(MP) joint of thumb in mild hyperextension is relatively uncommon problem. The most frequently recognized cause appears that proximal palmar ligament or volar plate were ruptured tranversely with its distal part riding over the volar prominence of the radial condyle of the first metacarpal head. We experienced two cases of locking of the MP joint of the thumb due to volar plate injury. Closed reduction was failed in both cases and open reduction was done by cutting the constricted ligament hundle over the radial condyle of the first metacarpal head. Our description of this mechanism is supported by expeimental evidence that we obtained from the cadeveric specimens. The height of radial side condyle of first metacarpal head is higher than ulna side of that by 1.76mm in both hands of 16 cadeveric specimen. So we are going to report these cases with a review of the literature, and suggest that the preferable location of surgical incision in open reduction is radial side of metacarpal head.
Hand ; Head* ; Joints ; Ligaments ; Metacarpal Bones* ; Metacarpophalangeal Joint* ; Thumb* ; Ulna ; Palmar Plate