Twenty-seven patients with congenital constriction band syndrome were treated at department of orthopedic surgery, college of medicine, Seoul National University between 1981 and 1989. In order to obtain basic and fundamental information about this syndrome, we have analyzed the clinical records of those patients who were treated at our hospital with above syndrome. Analysis was based on the age at operation, sex distribution, familial history and past-medical history, prevalent sites of constricition bands, associated anomalies and methods of surgical treatments. The results were summarized as follows: l. Average age at operation was 9.3 months and the ratio of sex was 3:2 as male predominant. 2. There was no case with familial history of this syndrome, and serious medical problems of patient's mothers during pregnancy were not experienced except 4 cases who took some medication for URI. 3. The frequency of constriction band was greater distally than proximally, and 91% of these bands were noted distal to knee and elbow joint. 4. About 85% of cases were associated with other anomalies, and among them syndactylism and acral absence were most frequent. 5. For the simple constriction ring, staged excision of the ring and z-plasty of the defects seemed to be a most agreeable recommendation. And other associated anomalies of digits could be treated with combined procedures such as seperation of digits, web construction, transposition of ray, lengthening of digit, skin graft, corrective osteotomy, etc.
Clinical Study ; Constriction ; Elbow Joint ; Humans ; Knee ; Male ; Mothers ; Orthopedics ; Osteotomy ; Pregnancy ; Seoul ; Sex Distribution ; Skin ; Transplants

No abstract available.
Tendons*

The exact etiologies and mechanisms of ischemia in avascular necrosis of femoral head are still under investigation. But this condition seems to be increasing during a few decades with increasing use of steroid and alcohol abuse in Korea. The treatment modalities have been based on the stages of the disease by simple radiographic findings that do not describe the accurate pathological extent or localization. Therefore more sophisticated study is needed to treat the AVN of the femoral head well. Magnetic resonance images, simple radiographs, scintigraphs of 13 patients(22 femoral heads), who were admitted and treated at Seoul National University Hospital from April, 1989 to December, 1989 were correlated, to characterize the type of AVN by extent and location regardless of its stage and reveal the relationship between types and stages. It is the result of this study that the type of AVN as well as stage should be considered in determining the treatment modality.
Alcoholism ; Classification ; Head ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Seoul

Since 1954 when the first biodegradable polymer, polyglycolic acid(PGA), was synthesized, many different biodegradable and tissue-tolerant materials have been invested and studied for internal fixation devices. The use of biodegradable materials for the internal fixation of fractures would avoid the need for later removal of the implant. However, problems of a physical and chemical nature have delayed the development of biodegradable implants applicable to fracture management. The authors reviewed 17 cases in which the absorbable pins made of poly-p-dioxanone were used for internal fixation at Seoul National University Hospital between December, 1987 and September, 1989, and report on 11 patients who had at least 6 months follow-up(average 9.1 months). The results were graded as excellent(5 cases), good(4 cases), poor(0 case), and questionable(2 cases). In the 9 cases where the absorbable pins were used for internal fixation of the intraarticular fractures or defects, satisfactory(excellent or good) results were obtained. In the 2 cases where the absorbable pins were used for intramedullary nailing, the role of the pins was questionable. There were no complications such as wound sinus formation, secondary displacement of the fragemts and delayed union or nonunion.
Absorbable Implants ; Fracture Fixation, Intramedullary ; Humans ; Internal Fixators ; Intra-Articular Fractures ; Polymers ; Seoul ; Wounds and Injuries

OBJECTIVES: The purpose of this study was to evaluate and classify the synovium-like membrane as either inflammatory (foreign body-like) or immune (T-cells present), generated during the development of aseptic loosening in the patients with joint replacement arthroplasties. METHODS: We used the murine air-pouch model, developed in BALB/c mouse, to make artificial synovial cavity and assessed the cytokine responses of the synovium-like membrane to the particulate biomaterials such at pure titanium, Ti6Al4V alloy, CoCr alloy and UHMWPE. Each biomaterial injected into air-pouch of 20 mice respectively. The mRNAs of various cytokines (IL-1 beta, IL-6, TNFalpha, IL-4, gammaIFN) and TCR Calpha chain were extracted from the synovium-like membranes and RT-PCR reactions were carried out using appropriate primers. RESULTS: IL-1beta, IL-6 and TNFalpha showed an increased response to the all kinds of particulate biomaterials. IL-4, gammaIFN and TCR Calpha chain did not show any distinct responses compared to control group and various kinds of biomaterials failed to show any, significant differences from each other in cytosine responses. CONCLUSION: T-cell or immune cytokine responses had not been found in this particle reaction and it seemed to be that the osteolysis in aseptic loosening would be a biologic reaction to the particulate biomaterials due to an inflammatory process.
Alloys ; Animals ; Arthroplasty, Replacement ; Biocompatible Materials ; Cytokines ; Cytosine ; Humans ; Interleukin-4 ; Interleukin-6 ; Joints ; Macrophages ; Membranes* ; Mice ; Osteolysis ; RNA, Messenger ; T-Lymphocytes ; Titanium ; Tumor Necrosis Factor-alpha

Fixation failure is a major complication of intertrochanteric fracture. The causes of fixation failure were assessed in a series of 80 patients with intertrochanteric fractures, which had been internally fixed with either a sliding hip screw or a Gamma interlocking nail. The overall rate of fixation failure was 16.3%, in which the cutting-out of the implant from the femoral head was the only cause of the instance. The cutting-out rate was influenced by the accuracy of fracture reduction, the position of implant placement within the femoral head, and the bone mineral density. Anatomical reduction and the central placement of implant within the femoral head showed the most excellent results compared to other treatment modalities. Age, gender, fracture type and a kind of fixation implant had no significant effect. Our results showed that the intertrochanteric fractures should be reduced as anatomically as possible and it is essential that the central placement of the implant within the femoral head be obtained.
Bone Density ; Head ; Hip ; Hip Fractures* ; Humans

Colon has the highest bacterial concentration in the gastrointestinal tract. When the colon is perforated, the operator has to decide whether to perform primary closure, resection with anastomosis, proximal colostomy, and exteriorizatoion. In this retrospective study, from October, 1993, through July 1998, 56 patient with panperitonitis due to colon perforation were operated at Ewha womans University medical center. The rectal perforation was limited the intraperitoneal portion. Our cases were divided into two groups. Group I included 34 patients who treated with one step operations of primaryrepair or resection anastomosis. Group II included 22 patients who treated with two step operations of proximal colostomy or exteriorization. The one step operations were performed in 34 patients, proximal colostomy in 21 patients, and exteriorization in 1 patient. There was 13.7% in the incidence of motality and 33.3% in the incidence of morbidity. The Chi-square test was used to evaluate the significance of differences between two groups. Independent risk factors for adverse outcomes were compared and used to analyse the probability for adverse outcomes with respect to the mode of treatmen. The mode of treatment was not dependent on the risk factors. These results suggest that one could select positively primary closure or resection with anastomosis for the treatment of patients with panperitonitis due to colon perforation.
Academic Medical Centers ; Colon* ; Colostomy ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

No abstract available.
Humans

No abstract available.
Rhizotomy* ; Scoliosis*