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

No abstract available in English.
Ankle ; Foot

The congenital dislocation of the hip is one of the most common congenital disease of the infants. The diagnosis and treatment of comgemital dislocation of the hip has been developcd since Lorenz published the methods of the closed reduction and immobilization in 1895. By replacing the displaced femoral head in the acetabular socket in early time, the normal development of acetabulum and femoral head were expected. So the early diagnosis and treatment were very important for good results. The authors studied 19 cases of 18 patients of congenital dislocation of the hip at the Department of Orthopedic Surgery of Hanyang University Hospital from June, 1972 to June, 1977. As results of this study, the following concolusion were result reached: 1. The proponderance of girl to boy was 13: 5. 2. The ratio of left side to right was 12:7. 3. The chief complaints were shortening of lower extremity, limitation of hip motion(esp. abduction) below 1 year old age and limping in over 1 year old age. 4. The associated congenital anomaly was abserved in a case of internal tibial torsion and metatarsus varus deformity. 5. In birth history, there was 1 case of breech presentation. 6. The acetabular index was much decreased in involved hip than the sound hip in treatment. 7. The arthrogram was valuable to detect any obstacles of closed reduction. 8. In 16 cases of 15 patients, 13 cases were treated by closed reduction, 1 case was open reduction, 1 case was derotation osteotomy, 1 case was varus and derotation osteotomy. 9. The results of treatment was Excellent:8 Good:8.
Acetabulum ; Breech Presentation ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Early Diagnosis ; Female ; Head ; Hip ; Humans ; Immobilization ; Infant ; Lower Extremity ; Male ; Metatarsus ; Orthopedics ; Osteotomy ; Pregnancy ; Reproductive History

Despite early knowledge that autogenous nerve grafting can be a useful method to overcome large gaps in peripheral nerves, the procedure was generally resorted to only after all other means to obtained end-to-end suturing had failed. Advances in microsurgery techniques prompted Millesi to introduce the concept of interfascicular neve grafting whereby groups of fascicles, and not whole nerve, are connected together. The 17 cases of nerve graft were operated for 3 years from Nevember, 1982 to September, 1985 in the Department of Orthopaedic Surgery of Hanyang University Hospital have followed for clinical up study. The results were as follows: 1. Nerve graft was useful rnethod to repair nerves with gaps. 2. The sural nerve is the first choice as a donor nerve. 3. Severity of soft tissue injuries was important factor influencing results. 4. Postoperative results of cases caused by electrical burns were worse than others.
Burns ; Clinical Study ; Health Resorts ; Humans ; Methods ; Microsurgery ; Peripheral Nerves ; Soft Tissue Injuries ; Sural Nerve ; Tissue Donors ; Transplants

Many injuries of the hand have been occured in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Because of these efforts, the designation of Zone II as“no man's land” is no longer significant and should be called “skilled man's land”. With regard to to secondary reconstructive surgery, in cases without much scarring and few associated lesions, we routinely select the one-stage graft and use early motion in the postoperative programs. This paper aimed to review our experience with 215 patients with flexor tendon injuries in hand who were treated with primary repair or tendon graft with average follow up of 8.5 months from June, 1973 to May, 1987 and the following results were obtained. 1. The most frequent site of injury was Zone V. 2. The over all end result of primary repair was satisfactory in 86.5% by White and Kleinert criteria. 3. The over all end result of tendon graft in Zone Il was satisfactory in 51.0% by White and Kleinert criteria. 4. In Zone lI, primary repair obtained satisfactory result in 36.4% but the tendon graft obtained satisfactory result in 51.0%. 5. In tendon graft, the preoperative stste was supposed to have close relation to postoperative result and the duration from injury to graft was supposed to have little relation to postoperative results. 6. In primary repair, the cases using Bunnells suture technique obtained satisfactory result in 85.1% and the cases using modified Kesslers suture technique obtained satisfactory result in 91.2%.
Cicatrix ; Clinical Study ; Follow-Up Studies ; Hand ; Humans ; Suture Techniques ; Sutures ; Tendon Injuries ; Tendons ; Transplants

BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography ; Arteries ; Glucose* ; Microbubbles ; Rabbits ; Thrombolytic Therapy* ; Thrombosis ; Tissue Plasminogen Activator ; Ultrasonography*

No abstract available.
DNA* ; Laryngeal Neoplasms*

Rupture of Achilles tendon was first reported by Pare, 1575 and thereafter the cause and the diagnostic and therapeutic methods of the ruptured tendon have been described by many workers. Rupture of the Achilles tendon is often wrongly diagnosed and inadequately treated by the doctor who first sees it, with consequent problems of treatment and prognosis. In this paper 24 patients(25 cases)
Achilles Tendon ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Prognosis ; Rupture ; Tendons

Recently, the incidence of open fracture of tibial shaft has risen as a result of rapid increase in automobile and industrial accidents. The open fracture of tibial shaft is extremely difficult to treat and has a greater incidence of osteomyelitis, delayed union and nonunion. One hundred and forty two patients (146 cases) of the open fractures of tibial shaft were treated and managed at the Department of Orthopedic Surgery, Hanyang University Hospital from May, 1972 to May, 1984. The results were as follows; 1. In 43.2% of all cases, ordinary culture test for open wound was positive and staphylococcus was predominant. 2. A relatively same rate of fracture union was shown in any portion of tibial shaft. 3. A better prognosis of the fracture type was shown in the oblique, transverse and spiral fracture than in the comminuted and segmental fracture. 4. According to the classification of Ellis, the higher delayed and nonunion rate was shown in major severity group than moderate and minor ones. 5. In minor and moderate severity group, the relatively same rate of fracture union was shown in conservative or operative treatment, but in major severity group, conservative treatment was better than operative treatment. 6. In upper 1/3 and middle 1/3 of the tibia, the relatively same delayed and nonunion rate was shown in conservative or operative treatment and lower 1/3 of the tibia, the high delayed and non-union rate was shown in operative treatment. 7. In comminuted, oblique and transverse fracture, the high delayed and nonunion rate was shown in operative treatment, but in other type of fracture, the relatively same delayed and nonunion rate was shown.
Accidents, Occupational ; Automobiles ; Classification ; Clinical Study ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Osteomyelitis ; Prognosis ; Staphylococcus ; Tibia ; Wounds and Injuries

The effect of acetabular augmentation with bone graft was reviewed in 12 patients with acetabular deficiency in total hip arthroplasty, performed between 1981 and 1984 at Hanyang University Hospital. Follow-up ranged from 12 to 18 months and averaged 23.3 months. Follow-up radiographs were analyzed. Based on radiography, all grafts were regarded as incorporated and equally successful with autogenous and allograft bone. Long-term follow-up evaluation revealed no evidence of progressive radiolucency or graft resorption. There was one sciatic nerve palsy after operation but recovered at 11 months later.
Acetabulum ; Allografts ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Humans ; Radiography ; Sciatic Neuropathy ; Transplants