Thirteen cases of concomitant hip and shaft fractures of the same femur are reported. The hip fractures was initially missed in one case. Osteosynthesis of both fractures was performed in twelve cases. One except was 12-year-old boy who was managed hip with two Knowles pins and shaft conservatively. Both fractures healed in all followed for average 5.3 months or more. Osteosynthesis of both fractures is recommended as soon as the patient is in a stable condition, preferably by early fixation with AO principle or IM nailing in selected cases.
Child ; Femur ; Hip Fractures ; Hip ; Humans ; Male

No abstract available.
Animals ; Dogs* ; Patellar Ligament*

No abstract available.
Ankle Fractures* ; Ankle*

We present a prospective, randomized study of acute burst fracture of the thoracolumbar spine. Forty-one patients were treated either by anterior decompression and stabilization with Kaneda device or by posterior distraction instrumentation using the A-O fixateur interne. The mean follow up was 21 months. The result were as follows; 1. The mean preoperative kyphotic angle was 19.2° in those patients treated by anterior surgery and 21.4° in those patients treated by posterior surgery. At last follow-up the mean correction in kyphotic angle was 13.2° in the anterior group and 9.2° in the posterior group. There is no statistically significant difference between those two groups. 2. The mean preoperative midsagittal diameter of the canal compromise 47.4% in anterior group and 49.3% in posterior group. Postoperatively, this was reduced to 2.5% and 7.9%. There is a statistically significant difference between these two groups(P < 0.05). 3. The mean preoperative canal enchroachment 52.)% in anterior group and 47.6% in posterior group. Postoperatively, this was reduced to 3.2% and 6.0%. There is a statistically significant difference between these two group(P < 0.05). 4. Neurologic recovery was 81% in posterior surgery and 85% in anterior surgery. The improvement in Frankel grade was 1 grade in average, and showed no difference between two groups. 5. There was two cases of pedicle screw breadage in posterior group and one case of pyothorax in anterior group but no early or late vascular or neurologic complication.
Decompression ; Empyema, Pleural ; Follow-Up Studies ; Humans ; Pedicle Screws ; Prospective Studies ; Spine

In the treatment of spinal disorder, the introduction of pedicle screw system is an innovation in modern spinal surgery. This kind of new instrumentation provides correction, adjustment, stabilization, firm fixation and short segment fusion. Everybody should know that these complexities of instrumentation will increase the rated of complications, especially postoperative infection. Postoperative infections continue to be a source of frustration for patients and surgeons, and can lead to significant postoperative difficulties. So we analysed the postoperative infection from the 284 cases we operated on during the September 19S8 to August 1992 and obtained following results: 1. There were 17 cases(6.0%) of postoperative infection. Among them Scases(2.8%) were deep infection. 2. Average fused segments were 3.64 and 2. 96 in deep infection and control group respectively. 3. Staphylococcus aureus was the most frequent organism. Other recurring organisms were St. epidermidis, Enterobacter cloacae and so on. Many patients had multiple organisms. 4. Most significant risk factors for postoperative infection were obestity and prolonged surgery. 5. Just preoperative prophylactic antibiotic administation is more valuable than no prophylaxis and too early administration. 6. Postoperative acute deep infection is is not as easily diagnosed. The clinical manifestation such as sudden increase in pain at the operative site is the most valuable sign. 7. Maintaining the instrumentation in place, continuous irrigation system and the appropriate parenteral antibiotics were the choice of treatment.
Anti-Bacterial Agents ; Clinical Study ; Enterobacter cloacae ; Frustration ; Humans ; Pedicle Screws ; Risk Factors ; Spine ; Staphylococcus aureus ; Surgeons

The pedicle instrumentation has become a popular way of spinal fixation. Placement of a screw through the pedicle into vertebral body appears to be a very successful way to accomplish spinal fixation. However, the configuration of the pedicle morphometry must be understood. The measurement includes pedicle width, angle of pedicle axis to the transverse plane, ideal screw length, ideal screw entry point and ideal angle. This study was accomplished using computerized axial tomogram(CT) of 704 vertebrae(T10-L5). The results were as follows. 1. Transverse pedicle diameter were narrowest at T10, widest at L5. 2. The pedicle axis is oriented anteromedially at all levels except T11 and T12, then increase from L1 to L5. 3. Screw lengths are fairly constant between all levels, thus the range of screw lengths need is limited. 4. The incidence of pedicle less than 6 mm in the transverse diameter is most common at T10 and followed by levels L1, T12 and L2. Preoperative determination of transpedicular screw diameter and length can be made, by direct measurement from the patient's CT scan.
Incidence ; Thoracic Vertebrae ; Tomography, X-Ray Computed

PURPOSE: Evaluation of clinical and radiologic results of THR using HA-coated femoral stem. MATERIALS AND METHODS: From Jan. 1991 to Dec. 1992, we carried out 177 cases of Total Hip Arthroplasty using hydroxyapatite-coated implants of 167 patients, and among thses, 153 cases in 144 patients were followed up more than 24 months. The implants used were 74 cases of Mallory-Head Hip system, 41 cases of Omnifit system and 38 cases of Profile system. RESULTS: The average Harris Hip Score was 48.3 points preoperatively, 94.7 points at POD 1 year and 95.7 at POD 2 years. Seven patients(5.2%) complained thigh pain at POD 2 years. On the radiologic findings, cancellous condensation was noted around the hydroxyapatite coating region of femoral stem in 84 cases(54.2%), and radiolucent lines were noted at the non-coating region of distal stem in 102 cases(67.7%), but were less than 2mm and not progressive. There was no statistically significant differences among the groups of these three implants(P < 0.05). Comments : This early result of femoral stems with hydroxyapatite-coating was quite satisfactory, however, long-term follow-up studies will be necessary.
Arthroplasty, Replacement, Hip ; Durapatite ; Follow-Up Studies ; Hip ; Humans ; Thigh

The anterior approach to arthrodesis of the cervical spine has become a widely accepted. However, anterior interbody fusion in the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic deformity or nonunion. As an attempt to prevent this complications, anterior cervical plate after graft placement was introduced. Although, anterior cervical plates provide excellent fixation for the anterior column, potential risk for injury to the spinal cord, soft tissues or screw loosening leading to dysphagia has been reported. Morscher, of Switzerland, has developed an anterior cervical spine locking plate(CLSP) system that attempts to prevent the migration and looseing of screw by using a cross-split screw head that can be locked into the plate. The secondary advantage of this system is the limination of the required posterior cortex purchase. The authors reviewed 42 patients in whom the CLSP system was applied for the treatment of degenerative disease or trauma. With a mean followup of 18 months, all 42 patients went on to fusion. One patient had screws placed in the discal space, hardware failure occurred in two patients. There was no iatrogenic injury to the spinal cord or esophagus. In conclusion, the CLSP system provides a reliable fusion with minimal complications. It should be considered in multilevel anterior cervical arthrosis and cervical fractures.
Arthrodesis ; Congenital Abnormalities ; Deglutition Disorders ; Esophagus ; Follow-Up Studies ; Head ; Humans ; Spinal Cord ; Spine ; Switzerland ; Transplants

A retrospective analysis of eighty-six consecutive patients who underwent stabilization with AO internal fixator for thoracolumbar spine fractures was performed at Wonju Christian hospital between 1988 and 1994. The purpose of this study was to determine the quality of reduction and stabilization with the fixateur interne(F-I) and the effects of limited posterior segmental fixation on neurologic recovery and rehabilitation. The mean wedge angle of the fractured vertebra was changed from 19.2° preoperatively to 8.4° preoperatively, and remained almost unchanged at last follow up(10.2°). Also, the wedge index showed nearly no bony loss of correction within the reduced fracture vertebra(corrected from 0.63 to 0.83 and 0.81 at follow up). The mean kyphosis angle was corrected from 22.3° to 8.3° and 16.9° at last follow up. Most of the change of kyphosis was due to the disc space collapse above the fractured vertebra. Transpedicular cancellous bone grafting for the vertebral body fractures effected a significant improvement in results of fixation. All cases of translational displacement were anatomically reduced. No neurologic or vascular complication occurred. Fixateur interne is capable of achieving three-demensional reduction in unstable thoracolumbar spinal fractures and maintaining sufficient stability until bony healing is achieved.
Bone Transplantation ; Follow-Up Studies ; Gangwon-do ; Humans ; Internal Fixators ; Kyphosis ; Rehabilitation ; Retrospective Studies ; Spinal Fractures ; Spine

No abstract available.
Femoral Fractures*