Total rehabilitation covering medical, educational, vocational and social services for the total disabled population is an ideal goal for any country. However, in reality, only a fractional portion of the disabled people is covered by any part of the rehabilitation process, especially in developing countries. Therefore, W.H.O. recommended each country to take an urgent action to adopt the Community Based Rehabilitation Service System incorporating the prevention of the disability and rehabilitation into the already existing Primary Public Health Network with the total involvement of the community resources : The basic philosophy of the delivery system should be modified in accordance with the political, socio-economical state of each country. The present state and problems involved in rehabilitation set up in Korea are discussed and suggestions are made. The key of the problems at moment appears to be the steam-lining the Rehabilitation Delivery System at every administrative level to devise the most simple, effective and practical Rehabilitation Service Delivery System which is easily accessible to any disabled people. Realizing the present development and trend in the field of rehabilitation, active role of the orthopedic surgeon as a main driving horse in the medical rehabilitation and also as a community leader are emphasized.
Developing Countries ; Horses ; Korea ; Orthopedics ; Philosophy ; Public Health ; Rehabilitation ; Social Work

No abstract available in English.
Hypogonadism ; Mosaicism ; Slipped Capital Femoral Epiphyses

Diastematomyelia is an uncommon congenital malformation of the vertebral axis characterized by a localized longitudinal separation of the spinal cord with an interposed septum. It may be found in association with congenital scoliosis. The Authors experienced a case of congenital scoliosis with diastematomyelia. Diastematomyelia was surgicallv resected and scoliosis was corrected by Dwyer operation 5 months later. The results of both operations were satisfactory in 10 months follow up.
Follow-Up Studies ; Neural Tube Defects ; Scoliosis ; Spinal Cord

Ten cases of unstable spine were treated with various surgical procedures under control of Halo apparatus and following results wen obtained. 1. Six cases of unstable cervical spine were treated with Halo apparatus and were able to obtain solid fusion for permanent stability. 2. Three cases of tuberculous kyphosis were corrected with halo-pelvic hoop on, and were able to obtain mean correction angle of 42 (65%) with little danger. 3. With halo on, staged operations such as anterior and posterior osteotomy, gradual distraction, anterior and posterior fusion of the spine for correcting deformity were carried out securely. 4. Average duration of halo application was eight weeks, no more twelve weeks, and there was no irreversible complication with halo apparatus per se.
Congenital Abnormalities ; Kyphosis ; Osteotomy ; Spine

Injuries to the ligament and other supporting structures of the knee joint are becoming very frequent because of the increasing popularity of sports and the complexity of traffic & industrial accidents in the modern society. There have been much development in undtrstanding the anatomy, function and biomechanics of the knee in recent years. Accurate surgical technique, energetic physiotherapy and appropriate use of brace are essential to obtain the maximum rehabilitation of the injured knees. It is long realized that some sort of knee brace is necessary as a means of stabilizing the injured knee either as a conservative treatment or as a adjuvant treatment treatment pre-or postoperatively before full rehabilitation is attained. We have introuced Lenox Hill Derotation Brace for the first time in Korea, employed in 24 case(26 knees) and found the following advantages. 1. It is light and easy to apply. 2. It is possible to control all kind of the knee instability. 3. It is possible to engage in any activity with the Brace in place without limitation of the knee motion. therefore, we recommend the Brace as a very usefull adjuvant for the proper treatment of the injured knee.
Accidents, Occupational ; Braces ; Knee Joint ; Knee ; Korea ; Ligaments ; Rehabilitation ; Sports

We have experienced 52 intra-articular fractures(24 malleolar, 17 patellar, 11 olecranon) treated with tension band wiring from 1972 to 1981 and the results are as followings; 1. The operative technique is relatively simple and easy. 2. In avulsion fractures without communition, anatomical reduction and rigid internal fixation can be achieved. 3. In comminuted fractures, the fragments can be securely fixed with a few additional K-wires including tension band wiring. 4. In avulsion fractures, where the fragment is either too small for screw fixation or too osteoporotic a tension band wiring can be applied with no difficulty. 5. Early joint motion reduces the functional disability and promote the fracture healing.
Fracture Healing ; Fractures, Comminuted ; Joints ; Olecranon Process

It is generally accepted that trochanteric fractures are best treated by internal fixation as it provide satisfactory reduction and fixation of the fractures allowing early mobilization of the patient thus avoiding general and local complication following this sort of trauma. Fourty-seven cases of trochanteric fracture of the femur were treated at the Department of Orthopedic Surgery, Paik Hospital, Seoul, Inje Medical College from June 1974 to June 1982 and clinical analysis was made with particular emphasis on the comparision between compression hip screw fixation and Jewett nail technique. The result of the analysis are as follows: l. 63% of the male patient belongs to active age group in contrary to common belief in age incidence and the common causes of the injury was traffic accidents and fall from height. 2. By the Tronzo classification of the intertrochanteric fracture, the most common type is type III and type V was predomonant in the traffic accidents group and 87% of all cases belongs to unstable category. 3. Of the seventeen associated injuries, visceral injuries, fracture of the lower extremities, fractures of the upper extremities, fractures of the pelvis were observed in order of frequency. 4. More general complications were observed among the conservatively treated group and local complications occurred mainly in the group treated with Jewett naiL 5. The compression hip screw method seemed to be superior to Jewett nail owi#ng to shorter operation time, less blood loss and less complications. 6. Ender nail appears to be a promising method of treatment in the elderly patient because it had shorter operation time, negligible blood loss, minimal stress to the patient and early mobilization and weight bearing.
Accidents, Traffic ; Aged ; Classification ; Clinical Study ; Early Ambulation ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Lower Extremity ; Male ; Methods ; Orthopedics ; Pelvis ; Seoul ; Upper Extremity ; Weight-Bearing

During the period of 5 years and 5 months, from January 1979 to May 1984, we treated 27 cases(17 patients) of osteoarthritis with genu varum deformity by high tibial osteotomy. The results were as follows: l. In the 27 cases of the high tibial osteotomy, 24 cases were female and 3 cases were male. 2. Of the etiology of the osteoarthritis with genu varum, 14 female patients had primary one and 3 male patient knees were related with infection(2 patients) and trauma (1 patient). 3. Preoperative varus angles, ranging from 0° to 20°, 6.4° in an average and postoperative valgus angles, ranging from 5° to 15°, 8° in an averge. 4. In a review of the high tibial osteotomy, good and fair results were noted in 26 cases (96.3%) of the knees after average 2 years of follow-up. 5. The high tibial osteotomy is found to be useful method in the treatrnent of the osteoarthritic knee with varus deformity.
Clinical Study ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Genu Varum ; Humans ; Knee ; Male ; Methods ; Osteoarthritis ; Osteotomy

Most fractures of the proximal humerus are managed well to simple conservative treatment. But open reduction and interhal fixation of the fragment is definitely indicated in certain types of displaced fractures. Thirty eight cases of fractures of the proximal humerus which were treated at Inje Medical College from January 1980 to December 1985 were analyzed both clinically and radiologically accordingto Neer's classification and the following results were obtained. l. Among the 38 patients, the ratio of male and female was 2.2:1 and the highest incidence was in the fifth decades. 2. The main cause of fracture was traffic accident, 20 cases (52. 6%) and the the next one was falling from a height. 3. According to the classification of Neer, one part acture(52.6%) was the most common type. 4. The common associated injuries were fracture of the lower extremities and forearms. 5. Thirty two cases(84.2%) were treated by conservative treatment and six cases by operative treatment. 6. Thirty eight cases were followed form 6 months to 5 years and 6 months, average 14.3 months, and the results were analyzed according to Neers criteria and 26 cases (68. 6%) showed excellent results. 7. Two cases of limitation of shoulder motion were observed as a complication and one cases of paralysis of deltoid muscle by axillary nerve injury was observed. Excellent functional result could be obtained by a simple external support with early motion in a minimal displacement of proximal humeral fracture. Satisfactory functional result could be obtained by a open reduction and internal fixation with early motion in a severely displaced fracture. But long term immobilization of shoulder could have a poor functional result.
Accidental Falls ; Accidents, Traffic ; Classification ; Clinical Study ; Deltoid Muscle ; Female ; Forearm ; Humans ; Humerus ; Immobilization ; Incidence ; Lower Extremity ; Male ; Paralysis ; Shoulder ; Shoulder Fractures

With the expending use of sublaminar segmental instrumentation, various complication, including paraplegia, paresis, dysesthesia and dural tears, have been reported. These findings suggest that the displacement of sublaminar wires toward the spinal eord during extraction followed by spinal cord damage. The cut surface of Luque sublaminar wire is sharp and has a barb and it may cause damage to the spinal cord. The cut end of Luque wire was inserted into the Intracath (a kind of angiocatheter) 16 gauge and pulled parallel to the lamina. And we found the Intracath followed by Lugue wire in the operating field. Lateral view of spine roentgenogram revealed that the radioopaque Intracath was passed under the lamina in 3 mm in depth. When the Luque wire is removed with inserting into the Intracath 16 gauge and pulled parallel to the lamina, the dura can be protected by the cut end of Luque wire.
Paraplegia ; Paresis ; Paresthesia ; Spinal Cord ; Spine ; Tears