Many different methods have tried for the treatment of fractures of the calcaneus in order to search for better results. But there was no general agreement on the treatment of the fracture of the calcaneus, especially involving the subtalar joint. Thirteen displaced intra-articular fractures of the calcaneus(in eleven patients) were treated by open reduction and internal fixation with a plate and screws, or Steinmann pins using a lateral and when needed, a medial approach, followed by early motion. From Feb. 1985 to June 1987, 13 feet in 11 patients of calcaneal fractures involving the subtalar joint were treated by open reduction and internal fixation at the Dept. of Orthopedic Surg., Chonbuk National University Hospital and the results were ss follows : l. Of 11 patients, 9 patients were male and 2 were femsle. 2. The main cause of frscture of calcaneus wss a fall from a height in 81.8% of cases. The spine fractures were associsted in 3 patients. 3. Of these displaced intra-articular frsctures, 3 fractures were tongue type and 9 fractures were joint depression type by Essex-Lopresti classificstion. 4. The tongue type fractures were treated with Steinmann pin and joint depression type fractures were treated with plate and screws. Anatomic reduction was obtained by open reduction snd internal fixation. 5. The average Bohler's angle was 8.1 before reduction and the aversge bohler's angle was 22.1 after open reduction. So, Bohler's angle was 14 increased. 6. After sverage seventy-two months follow-up, the assessment of result by Salama was satisfied in 76.9%-excellent in four(30.8%), good in six(46.1%)-and unsatisfied in 23.1%-fair in two(15.4%), poor in one(17.7%). 7. The surgical approach was used usually lateral approach and, when needed, a medial approach, followed by early motion. 8. The most common complication after treatment was pain on the heel snd subtalar joint.
Calcaneus ; Depression ; Follow-Up Studies ; Foot ; Heel ; Humans ; Intra-Articular Fractures ; Jeollabuk-do ; Joints ; Male ; Orthopedics ; Spine ; Subtalar Joint ; Tongue

No abstract available.
Birth Rate* ; Maternal Age* ; Parturition*

No abstract available.
Pregnancy, High-Risk* ; Rheology* ; Umbilical Arteries*

The acardius occurs with an incidence of one in 35,000 births and is presumed to result hom vascular anastomosis between the arterial circulation of the hemodynamically larger ""pump"" twin and that of the recipient ""perfused"" twin. The perfused twin displays severe anomalies, typically referred to as acardia, that are incompatible with life. The pump twin, because of its expanded cardiac demand, may also deveolp cardiac failure, with a mortality risk of 50-70%. We experienced one case of acardiac-acephalus twin gestation diagnosed by antenatal ultrasonography, and presented this.
Heart Failure ; Humans ; Incidence ; Mortality ; Parturition ; Pregnancy ; Twins* ; Ultrasonography*

Forty-six patients (fifty hips) underwent revisions of a total hip arthroplasty that had failed but was not associated with infection, Three of these patients had a third revision. The mean length of follow-up was approximately two years. Thirty patients reported that their condition was improved. On final roentgenographic examination showed, two loosening of the acetabular components and five of the femoral components in which there was one sympto matic loosening (moderate severe pain and probable roentgengraphic loosening) noted. The extralong stems are not necessary in all revision cases, cortical defects at the tip of standard stem obviously should require bypass the stress riser with a longer stem. If the stability can be achieved with host bone, Revision may be carried out with a relatively short stem. Significant postoperative complications as subsidence and progressive loosening were noted in seven out of the forty-six patients. We consider that extensive porocoated cementless stem or standard flute stem seem to be a better outcome in revision arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Humans ; Postoperative Complications

The patellar tendon is known as the strongest material for the substitution of anterior cruciate ligament. There are many technical difficulties in reconstruction of the ligament with this tendon since patellar aponeurosis is weak, and the length of the tendon is restricted, and the adquate insertion in proper place is difficult. Authors harvested the middle 1/3 of patellar tendon c bone block of tibial tubercle and patella with the superficial layer of the quadriceps tendon left attached. The large triangular tibial tubercle piece was impacted into the femoral tunnel from distally to proximally, of which the orifice is the very place of the middle of the original anterior cruciate ligament. Two bundles of 0-dexon sutures made at the tibial tubercle portion, were pulled through to different outlet of femoral condyle during this procedure and were tied over the cortical bone of lateral supracondylar region. The tendon twisted 180°(clockwise for the right knee and counter-clockwise for the left knee) to adapt to screwhome movement. The patellar piece was fixed at the isometric point in full flexion and extension, which is usually the middle point of original tibial insertion c one or two barbed staples made at the original position of tibial insertion of the ligament. We tried this methods in 26 knees (12 vascularized grafts and 14 free grafts) and was followed for more than one year and the results was compared with those of 12 knees of original McIntosh operation (follow up period: 16-72 months, average 34.3 months). The instability were evaluated c Lachman test and OSI sagittal knee tester. The knee of negative Lachman test & pivot shift test was defined as "normal" The results were as follows;l. In modified McIntosh operation group negative Lachman test was noted only in 6 knees (50.0 % ) and there were 2 knees (16.7% ) of GI, II & III, respectively. 2. In vascularized bone block patellar tendon graft group II out of 12 knees (91.7%) showed negative Lachman test and only one knee (8.3%) revealed G II. 3. In free bone block patellar tendon graft 13 out of 14 knees (92.9%) showed negative Lachman test and the other one knee (7.1%) revealed GI. 4, The overall success rate (normal) of bone block patellar tendon graft was 92.3%. The success rate of patellar tendon bone block operation was significantly higher than that of modified McIntosh operation (χ²=6.48, df=1, P=0.0109) and there was no statististical difference between vascularized and free graft group (χ²=0.39, df=l, P=0.5322).
Anterior Cruciate Ligament ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Sutures ; Tendons ; Transplants

No abstract available.
Arthritis, Rheumatoid* ; Elbow Prosthesis* ; Elbow*

No abstract available.
Rectal Neoplasms* ; Recurrence*

No abstract available.
Mitral Valve*

CT is a valuable diagnostic modality in evaluation of bladder injury, extension of paravesical hematoma, pelvic bone fracture or injury of adjacent soft tissue although the diagnostic accuracy of bladder injury itself is lower than that of retrograde cystography. We analized CT findings in thirty cases of bladder injury or paravesical hematoma due to blunt lower abdominal or pelvic trauma and compared them with operation fildings in eight cases. IVP in eight cases and cystography in fifteen cases. The types of bladder injury were classified as contusion, intraperitoneal bladder rupture, extraperitoneal bladder rupture and combined rupture. The locations of paravesical hematoma were classified as perivesical, prevesical or combined. There was no close relationship between the types of pelvic bone fracture and distribution of paravesical hematoma. The paravesical hematomas in fifteen patients without bladder injury were located in prevesical space only. Perivesical hematomas were noted in nine of fifteen patients with bladder injury and were not noted in patients without bladder injury. Thus, we concluded that the presence of perivesical hematoma on CT is a diagnostic sign of bladder injury even though extravasation of contrast from the bladder is not identified, and if there is extraperitoneal hematoma, possibility of bladder injury or other pelvic trauma should be considered.
Contusions ; Hematoma ; Humans ; Pelvic Bones ; Rupture ; Urinary Bladder