In general, arthroplasty in the hand is divided into three categories, namely fusion, soft tissue arthroplasty and interpositional arthroplasy, each of that having some problems and limited indications. Frequently orthopedic surgeons fall into difficulties in deciding the treatment for the ankylosed joints of the hand in young adults. We now report a case of living joint transplantation from the M-P joint of 2nd toe for post-traumatic ankylosis of that of index finger. The follow-up shows improved range of motion and good pain relief.
Ankylosis ; Arthroplasty ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Joints ; Orthopedics ; Range of Motion, Articular ; Surgeons ; Toes ; Young Adult

Hand injuries in the industries have been steadily increasing in this country in recent years. All structures are damaged when a hand is caught in punch presses, gears or under falling objects. Irreversible loss of blood supply to the part is only real indication for primary amputation. Statistical observations were carried out on 240 patients of hand injuries who were treated at the Deparement of Orthopedic Surgery, College of Medicine, Hanyang University from May, 1972 to April, 1977 and following results were obtained. 1. The peak incidence was in the age group from 11 to 20 years in 83 cases(38.4%) and of the 226 patients, 204(85.0%) were male and 36(15.0%) were female. 2. In general, the incidence of hand injuries per year was annually increased and was much more occurred on April than other months of year. 3. The injured ratio of both hands was almost equal and main causes of hand injury were industrial accident (72.1%), traffic accident(12.9%) and electric accident(6.3%). 4 Most of hand injured patients(81.7%) arrived at our hospital within 6 hours after accidents 5. Of 240 injuries, 78(32.5%) were crushing injury with open comminuted fracture, 39(16.2%) were open fracture and 30(12.5%) were closed fracture. 6. Of injured fingers, 126(51.2%) were mondigit and the remained were polydigits. 7. The most frequency of monodigit injury was index finger(32.5%) and of polydigits injury was middle finger(28.2%) 8. In mondigit amputation, index finger were generally amputated at metacarpo-phalangeal joint and middle finger at proximal phalangeal level. 9. Of 457 injuries with facture, 213(46.6%) were treated by debridement and primary suture, and 94 (20.6%) by debridement and open reduction with Kirschner wire fixation. 10. Of 240 patients, 46 cases(19.2%) were infected and the main causative organisms were pseudomonas aeruginosa (41.3%), Staphylococcus aureus(17.3%) and Alkaligenus fecalis(10.9%).
Accidental Falls ; Accidents, Occupational ; Amputation ; Clinical Study ; Debridement ; Female ; Fingers ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hand Injuries ; Hand ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Pseudomonas aeruginosa ; Staphylococcus ; Sutures

It is well known that the incidence of revision arthroplasty for the loosened total hip has been progressively increasing recently. And the problem is that the loosening rate of revision arthroplasty for the failed total hip replacement is much higher as compared with that of primary total hip replacement. In revision arthroplasty, Amstutz, in 1982, reported 9% incidence of mechanical failure and 43% incidence of femoral and 61% incidence of acetabular progressive radiolucencies with follow-up for an average of 2.1 years, and Pellicci, in 1985, reported 29% incidence of failure for total hip replacement that have been revised once in the radiolucent zone with the follow-up for an average 8.1 years, and Kavanagh, in 1985, reported that probable loosening occurred in 25% of revised acetabular components with follow-up for an average of 4.5 years. Cementless total hip replacement is successful in more than 90 of the primary cases for the last 5 years in our department. Therefore, not only in primary total hip replacement but also in the revision, it seems to be reasonable to perform the cementless total hip replacement as an alternative, particularlly, in young age group. During the period from April 1982 to December 1984, we have revised 12 loosened total hip replacement with cementless type. Average follow up was 1 year and 7 months. The age range of the patients was 23 to 64. The results are very promising without any evidence of loosening in all cases.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Humans ; Incidence

Carpometacarpal dislocations occur in less thsn 1% of osseous hand injuries. Sine Dec. 1987, two cases of multiple carpometacarpal dislocations were treated at Hanyang University Hospital. All of these were successfully treated by closed reduction and percutaneous pinning with K-wires. Follow-up periods were 6 months and 5 months respectively. All patients were asymptomstic, but one patient had occasional discomfort and diminished grip strength.
Carpometacarpal Joints ; Dislocations ; Follow-Up Studies ; Hand Injuries ; Hand Strength ; Humans

Only several stages of conventional operation have been able to treat the open fracture of the limb with extensive bone and soft tissue loss. So we, authors, reviewed 25 cases of vascularized osteocutaneous fibulat transfer which were performed to the extensive bone defect of the limb and associated soft tissue injury(from May 13, 1982 to September 30, 1988). In 25 cases, one case was a chronic osteomyelitis combined pseudocarcinomatous epithelial hyperplasia of surrounding soft tissue, the other(24 cases) were the open comminuted fractures with the extensive bone and soft tissue loss of the limbs. The average size of the skin flap was 12.33 × 5.83cm, the average length of vascularized fibula was 16.5cm in length. The complications were fractures of grafted fibula, partial necrosis of both ends of the skin flap and uncontrolled infection of proximal end of grafted fibula. During postoperative period, the patency of the anastomoses were monitored by observing the color of the skin of buoy skin flap. The average amounts hypertrophied fibula at 12 months after operation were 20.6cm. And the following remarkable result were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In roentgenogram, as compared with conventional bone graft, grafted bone was not resorbed and early united. 4. In adult, free fibula can be obtained and grafted as 23cm as long and the skin flap with fibula can be obtained and grafted as 21 × 7cm as large in or experience. 5. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses was monitored indirectly by confirming skin flap. 6. The fractured fibula was united early by cast immobilization, and it was hypertrophied at the fracture site. 7. The vascularized osteocutaneous fibula transfer is also useful in application of the other long bones.
Adult ; Extremities ; Fibula ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Humans ; Hyperplasia ; Immobilization ; Microsurgery ; Necrosis ; Osteomyelitis ; Postoperative Period ; Skin ; Transplants

On the length, strength, free lateral motion, and perfect mobility of the thumb, depends the power of the human hand. The thumb is called pollex because of its strength and that strength is necessary to the power of the hand being equal to that of all the fingers."So stated Sir Chales Bell in the fourth Bridgewater Treatise, first published in 1833. Morrison and O'Brien advocated reconstruction of the thumb with a free wrap around flap from the big toe to recreate a stable, sensate and functional digit including the nail in 1980. From March, 1982 to July, 1988, Twelve thumb reconstructions were performed using the wrap around procedure at Hanyang University Hospital;12 successful thumb reconstructions were reviewed at an average of 16 months after surgery. There were several complications;these included skin necrosis(4), malunion(1), resorption of the bone graft(7). We considered that cosmesis and function were good;pinch grip averaged 68% of normal, sensibility returned in all patients as assessed by two-point discrimination(average 9.5mm). Over all the results are as follows. 1. The wrap around technic provides a good method of reconstruction. 2. The wrap around technic is one stage operation and can be used in the level of metacarpal amputation. 3. The surgeon should be familiar with microsurgical technic.
Amputation ; Hallux ; Hand ; Hand Strength ; Humans ; Methods ; Skin ; Thumb

No abstract available.
Arthritis* ; Knee*

No abstract available.
Kidney Transplantation* ; Pancreatitis*

BACKGROUND: As co-factors of metalloenzymes, zinc(Zn) and copper(Cu) have a considerable effect on nearly all the metabolism that takes place in organs of the body, including the skin. OBJECTIVE: The purpose of this study was to evaluate zinc and copper status in alopecia areata patients. METHODS: We measured serum levels of zinc and copper in 30 cases of alopecia areata patients and 10 normal individuals by atomic absorption spectrometry. Furthermore, we studied the significance of the ratio between serum levels of the two metals. RESULTS: The serum levels of zinc were significantly lower in alopecia areata patients than in healthy controls. The serum levels of copper were slightly lower in alopecia areata patients than in healthy controls. Ratios of Cu/Zn were slightly higher in alopecia areata patients than in healthy controls. But their differences were not statistically significant. CONCLUSION: We suggest that a serum Zn assay should be included in the chemical assessment of patients with alopecia areata.
Absorption ; Alopecia Areata* ; Alopecia* ; Copper* ; Humans ; Metabolism ; Metals ; Skin ; Spectrum Analysis ; Zinc*

Vasectomy has become increasingly popular as a method of male fertility control in humans because it is simpler than other methods for a woman. In spite of numerous studies on the effects of vasectomy on reproductive organs and their functions over varying periods of time, a lot of problems remained such as histological and functional changes of the reproductive organs. Recently the vasovasostomy has been developed under the requiring of succeeding an offspring or other problems, but it has not proved to be consistently i reliable in reversing previously performed vasectomies. Results in most of the investigations indicate that sperm is present in the ejaculate of 95 per cent of the operated cases. However, pregnancy occurs in only 40 per cent of the partners. It also has been demonstrated that antisperm antibodies occur in the serum of approximately half of the patients who have undergone vasectomy, and the immunologic consequences of vasectomy have been investigated extensively in a variety of laboratory animals and in man, but opinions vary as to whether such antibodies may be responsible for infertility after vasectomy. A second, also less information about phenomenon is formation of antisperm antibodies. Some have postulated that sperm granuloma formation is a mechanism for sensitization of the host to his own sperm, but other have concluded that sperm granuloma formation does not necessarily result in humoral sperm autosensitization. In an attempt to observe the effects of seminal vesiculectomy on structure and function of the testes and epididymides in vasectomized rats, this study was performed. The results as follows: 1. Spermatogenesis in the testicular tissue seems to be much inhibited in vasectomized rats after seminal vesiculectomy. 2. Absorptive activity of the rat epididymides may be accounted to be decreased after seminal vesiculectomy. 3. Sperm granuloma occurred around the epididymides of 90 per cent in the vasectomized rat after seminal vesiculectomy: Large one was measured by 2.5 x 1.5cm., but 50 per cent in the vasectomized rat with large one measured by 1.5 x 0.6cm. in size.
Animals ; Animals, Laboratory ; Antibodies ; Contraception ; Female ; Granuloma ; Humans ; Infertility ; Male ; Pregnancy ; Rats* ; Spermatogenesis ; Spermatozoa ; Testis* ; Vasectomy ; Vasovasostomy