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

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

The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

A case of osteomalacia is presented. A 46-year-old woman had had complaints of pain in low back and both knee joints for four years. A bell shaped thorax with kyphoscoliosis was noted. She was diagnosed as an osteomalacia by roentgenograph and laboratory examinations. Treatment by medication was followed with good results.
Female ; Humans ; Knee Joint ; Middle Aged ; Osteomalacia ; Thorax

Thirty nine cases (38 patient) of acetabular fracture and fracture-dislocation were treated in our hospital during the period 1973 to 1977. The short summary of the observation were as follows; 1. Among 39 cases (24 were male and 15 female), the most common cause of acetabular fracture and fracture-dislocation was traffic accident. 2. The acetabular fractures and fracture-dislocations were treated by conservative measures in 25 cases and by open reduction in 14 cases. The results were as follows; excellent in 12(30%), good in 19(48%), fair in 5 (15%) and poor in 3 cases (7%). 3. Among 3 cases of poor results, secondary traumatic arthritis and limitation of motion were observed in two cases and aseptic necrosis of the femoral head, in one case. 4. The result of conservative treatment was satisfactory if the stability of the hip joint and the congruity of the superior weight bearing dome of the acetabulum was well preserved.
Accidents, Traffic ; Acetabulum ; Arthritis ; Head ; Hip Joint ; Humans ; Male ; Necrosis ; Weight-Bearing

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