In 1814, Monteggia first described a fracture of proximal third of the ulna with a dislocation of radial head. The clinical importance of this fracture is that when the ulna is fractured and shortened, the proximal radioulnar joint dislocate. Despite of its importance the reports of this fracture is relatively rare. The authors reviewed twenty-nine Monteggia fractures that were treated at 15 orthopedic institutes of Honam area over a four-year period (1981 through 1984), with particular emphasis on classification, causes of injury, level of fracture, direction of dislocation, treatment and results. The results were as follows: 1. Total 29 patients were 8 children and 21 adults. 2. The male was affected about 2 times more than female (19: 10). 3. Causes of injury were fall in 12, car accident in 12 and machinery injury in 5. 4. Classification into 4 type by Bado's method disclosed that type 1 accounts for 65.5% of cases, type 2 for 6.9%,type 3 for 13.8%, and type 4 for 13.8%. 5. Treatments of dislocated radial head were closed reduction in 24, open reduction in 3, and excision in 2. 6. Locational incidence of ulnar fracture were upper one third of ulna in 11, junction of upper and middle 1/3 in 2, middle one third in 15, and distal one third in 1. 7. Treatment of fractured ulna was different between child and adult. Eight children fracture were managed by closed reduction in 5 and open reduction with K-wire fixation in 3. Twenty one adult fracture were managed by open reduction and internal fixation in 20 and closed reduction in l. 8. Palsy of posterior interosseous nerve was observed in 3 patients (10.4%) and disappeared completely later. 9. The results (Bruce et al criteria) for the 19 patients followed 6 months and more were 8 excellent, 4 good, 1 fair and 1 poor.
Academies and Institutes ; Adult ; Child ; Classification ; Dislocations ; Female ; Head ; Humans ; Incidence ; Joints ; Male ; Methods ; Monteggia's Fracture ; Orthopedics ; Paralysis ; Ulna

No abstract available.

This is to report the histo-pathologic findings of the degenerated inferior alveolar nerves(IAN) causing uncontrollable neuralgia persisted for over 3 years. The patients had sufferred from frequent attack of unbearable pain along the mandibular branches of the Vth nerve. The pain arised spontaneously 5-10 times a day and lasted for 2-5 minutes. The medications including Tegretol were neither so effective to alleviate the pain level, nor enough to keep free from pain all days. The peripheral neurectomies were preceded by diagnostic nerve block, and partial resection of the IAN in the mandibular canals were approached by sagittal split osteomy of the ramus. The histopathologic findings of the resected IAN were as follows ; 1. Special staining with Luxol Fast Blue (LFB) and Masson Trichrome (MT) disclosed marked degeneration of the axons, decreased in number and fibrosis between the nerve fibers. 2. EM study revealed destruction of myelin continuity surrounding axons, degeneration of Schwann cell and endoneureal sheath, and coarse collagen between the destructed axons. 3. The 3 of 6 patients presented again with recurred pain in 2-3 years after the peripheral neurectomies. Excisional biopsy of the retromolarpterygomandibular softtissues disclosed the collateralization neuropathy beside the long-buccal nerves and their neuromatous findings.
Axons ; Biopsy ; Carbamazepine ; Collagen ; Fibrosis ; Humans ; Mandibular Nerve* ; Myelin Sheath ; Nerve Block ; Nerve Fibers ; Neuralgia ; Trigeminal Neuralgia*

The purpose of this study was to evaluate the effect of estrogen receptor on the degenerative change of articular cartilage by observation of different changes of histology, matrix glycosaminoglycan and chondrocyte proliferation. In sixty-four Newzealand rabbits, experimental instability was made to induce degenerative changes by sectioning the anterior cruciate ligament, medial collateral ligament and medial meniscus of the left knees. In the oophorectomy group (32 rabbits), knee surgery was performed at 6 weeks following bilateral oophorectomy. In the non-oophorectomy group (32 rabbits), knee surgery was performed without oophorectomy. Four rabbits were killed at 0, 1, 2, 4, 8, 12, 16, 20 weeks, respectively, after the knee operation. Total immunohistochemical scores of estrogen receptor were evaluated between the two groups. Histologic evaluation of H-E staining was conducted by alcian blue staining. Evaluation of chondrocyte proliferation was carried out by immunohistochemistry using monoclonal antibody to 5-bromo-2 -deoxyuridine. The stainability of each staining was calculated using semi-quantitative analysis and statistical differences were evaluat- ed by ANOVA test and LSD multiple comparison test. Total immunohistochemical scores of estrogen receptor in the non-oophorectomy group were higher than the oophorectomy group (P<0.05). In the non-oophorectomy group, the histologic scores and the histochemical scores of glycosaminoglycan were lower than the oophorectomy group after 4 weeks and 8 weeks respectively (P<0.05). The immunohistochemical score of BrdU was the highest at 2 week and then decreased after 4weeks in both groups. The immunohistologic scores of non-oophorectomy group was significant higher than oophorectomy group between 1 and 4 weeks (P<0.05). Our results suggested that the estrogen might aggravate the degenerative change of the knee joint in rabbits by decreasing matrix glycosaminoglycan and increasing chondrocyte proliferation.
Adult* ; Alcian Blue ; Anterior Cruciate Ligament ; Bromodeoxyuridine ; Cartilage, Articular* ; Chondrocytes ; Collateral Ligaments ; Estrogens* ; Female ; Humans ; Immunohistochemistry ; Knee Joint ; Knee* ; Lysergic Acid Diethylamide ; Menisci, Tibial ; Ovariectomy ; Rabbits

Previously severe multiple injuries associating the segmental fractures of the femurs were reported to be rare, and as a rule were fatal when surgeons did not immediately give or provide excellent care. Recently many patients having those injuries are quite often encountered at the clinic. The reason is high incidence of the mass casualties by road accidents, mine accidents and accidents at the industrial complexes. Also as the other reason, the advanced resuscitative measures which could do many of these patients to survive can be listed. For those severely injured patients associating segmental fracture of the femur, the more positive and efficient diagnostic and therapeutic measures have to be sought. Authors analyzed the 18 cases of segmental fractures of the femurs who were treated at the Orthopedic department of Catholic Medical College & Center from Jan., 1974 to Dec., 1979. The results obtained were as follows: 1. The male patients outnumbered the female in ratio of 13/5, and the most were at their 4th and 5th decade of age. 2. Traffic accident was the main cause of the injury; 13 out of 18 cases. Remaining 5 cases sustained injury by industrial accident. 3. All but one were closed fracture, and segmental shaft fracture was the commonest type of them; 10 out of 18 cases. 4. Thirteen patients accompanied significant injuries to other vital organ and/or other musculoskeletal system. 5. In entire cases the average union time in the proximal fracture was 28.9 weeks, and in the distal one 17.5 weeks. 6. Fractures regardless of their group that needed late bone grafting procedure numbered 7; 6 in the proximal shaft fracture and one in the distal fracture. 7. In 10 cases of the segmental shaft fracture (Group III fracture), bony union in the proximal fracture was obtained at 29.6 weeks in average. Proximal fractures in 4 cases in this group needed late bone grafting. Through these results it is suggested that in the treatment of segmental fracture of the femur, primary bone grafting at the proximal fracture site is beneficial to promote fracture healing or to prevent delayed union or nonunion especially when the proximal fracture is located across mainly the cortical part of the bone. Methods of treatment necessarily have to be selected according to the site and shape of the fracture, and in cases of segmental shaft fracture Kuntscher nailing is preferably recommended although the distal fracture site is not ideal one for the Kiintscher nail fixation.
Accidents, Occupational ; Accidents, Traffic ; Bone Transplantation ; Female ; Femur ; Fracture Healing ; Fractures, Closed ; Humans ; Incidence ; Male ; Mass Casualty Incidents ; Multiple Trauma ; Musculoskeletal System ; Orthopedics ; Surgeons

The fibrosis involved in gluteus maximus causing limitation of flexion and adduction of the hip has become a recognized clinical entity since the first report by Fernandez de Valderrma in 1969. Its most constant and characteristic histologic feature was substitution of the fibrous tissue in the definitive etiology was unknown but presumed to be multiple intramuscular injections. Authors present three cases of the fibrosis involving gluteus maximus. In two cases Z-lengthening was performed on the thickened fibrous bands with good results.
Fibrosis ; Hip ; Injections, Intramuscular

No abstract available.
Orthognathic Surgery

No abstract available.
Paragonimiasis*

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
Cicatrix ; Extremities ; Follow-Up Studies ; Foot* ; Humans ; Leg* ; Linear Energy Transfer ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants

The purpose of this study is to observe histopathologic changes in the bilateral craniomandibular joints after allowing 6 weeks of consolidation by varying the amount of distraction in rabbit mandible. Eight rabbits weighing about 2 to 3kg were used. After corticotomy was performed on the left mandibular body between the first premolar and the second premolar region, a unilateral fixation device was placed. Then, a 7-day period was allowed without distraction of the device. The mandible was lengthened 0.5mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 6-week-consolidation period was allowed. Then, the rabbits were sacrificed, and histologic examination of the craniomandibular joints was performed. Proliferative changes were observed in the craniomandibular joints in all groups. With the increasing amount of distraction, hypertrophy of the cartilage layer became more severe, bone formed was dense and enchondral ossification was clearly shown in subchondral bone. Hypertrophy of the cartilage layer was also seen in the non-distracted side as the distracted side in the experimental group. These results indicate that when physical force is applied constantly to joints, the proliferation of articular cartilage and bone formation are present. When more than 6 weeks of consolidation period is allowed at the time of performing distraction for more than 5mm, articular changes, especially, in the contralateral side should also be noted.
Bicuspid ; Cartilage ; Cartilage, Articular ; Hypertrophy ; Joints* ; Mandible ; Osteogenesis ; Osteogenesis, Distraction* ; Rabbits*