Two cases report on osteogenesis imperfecta tarda and review of literature has been made. The rare genetic disorder, osteogenesis imperfecta tarda is familiar to most orthopedic surgeons because of management of fracture and skeletal deformities, espicially bowing of long bone. Its clinical manifestations are known as bony fragility, blue sclera and deafness less frequently ligamentous laxity but its etiological factor is obscure; The basic defect is thought to involvement some abnormality of collagen. Recently the bony weakness caused by increased bony turnover rate. One case of osteogenesis imberrfecta tarda in 8 year old male was belonged to tarda type 1. (Falvo-classification), who could not walk due to marked anterolateral bowing of right tibia and the another to tarda type II. in 13 year old male with fresh fracture of right femoral shaft. The former was performed corrective multible osteotomy, realignment and intramedullary rod fixation for correction of bowing deformity of right tibia, and the later was managed the fracture of right femoral shaft with Russels traction and hip spica cast. The result of reported therapeutic mesure was good.
Collagen ; Congenital Abnormalities ; Deafness ; Fibrinogen ; Hip ; Humans ; Ligaments ; Male ; Orthopedics ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Sclera ; Surgeons ; Tibia ; Traction

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

No abstract available.
Epidural Abscess*

The results of 17 fractures of tibial shaft treated with Rush nails under the image intensifier and early weight bearing are reported. Thirteen of these fractures were closed. All fractures were united between 12 and 21 weeks clinically, 17 and 26 weeks radiologically after operation. All cases were healed without significant complications, such as fracture disease. The advantages of this method were as follows; 1) normal knee motion and early weight bearingare possible during healing. 2) There is a relatively rapid restoration of bone continuity. This method of treatment for tibial shaft fractures were indicated as follows; 1. Mid-shaft fracture. 2. Segmental fracture of shaft. 3. Expectation of compression force at fracture surface by weight bearing. 4. Open fracture of shaft.
Fractures, Open ; Knee ; Methods ; Tibia ; Weight-Bearing

The Kuntscher nail has been used widely for the treatment of femoral shaft fracture with the advantage of early weight bearing and early joint movement. But it has some disadvantages that are harmful in bone-union by the wide intramedullary reaming, and rotation and bending of the device. Schneider devised four flanged nail to be able to eliminate the disadvantage of the Kiintscher nail. The author have experienced the 16 cases of Schneider nailing in the fractures of femoral shaft at the Department of Orthopaedic Surgery, Ewha Womans University Hospital from Feb., 1982 to Apr., 1984. The following results were obtained. 1. There were common in male (14 cases) and active ages (13 cases). 2. The most common cause was trauma with 14 cases and the other was pathological fracture. 3. Indications of Schneider nailing were wide than those of Kiintscher nailing. 4. Usual intervals between the injury and operation was one week. 5. Mean operating time was one hour and 25 minutes, and blood loss during the operation was 410cc. 6. After treatment, we usually permitted the exercises of quadriceps setting and non-weight bering walking within 1 week, partial-weight bearing walking within 4 weeks and full weight bearing walking within 4 months. 7. The results of 13 cases among 15 cases were better than good. 8. There were no complications such deformities as rotation, shortening and angulation because of specialized structure of Schneider nail. Also, Schneider nailing could prevent the nonunion and infection because there was need of reaming the medullary canal.
Congenital Abnormalities ; Exercise ; Female ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humans ; Joints ; Male ; Walking ; Weight-Bearing

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

Twenty nine cases of segmental tibial fracture were treated at Ewha Womans University Hopital, Department of Orthopedic Surgery, during the period from January, 1970 to December, 1984. The following results were obtained. 1. Most common fracture level was type I, high middle segment, occurred about 12 cases (41.4%). 2. In view of the higher incidence of open fracture (16 cases, 55.1%) and comminuted fracture (22 cases, 75.9%), fracture was caused by high velocity. 3. Various external and internal fixation methods were applied, but higher union rate was seen in the cases of Küntscher nailing and plating with bone graft. 4. Excluding the cases of type V, average union rate was 28.5 weeks and open fracture (ave. 29.6 weeks) required more longer union rate than closed fracture (ave. 26 weeks). 5. Higher rate of complication (21 cases, 72.4%) was noted than other types of tibial fracture. 6. Good result was obtained for treatment of 5 cases of delayed union or non-union by plating and bone graft than any other methods.
Clinical Study ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Tibia ; Tibial Fractures ; Transplants

There are many procedures for the treatment of acromioclavicular separation but there are still controversies concerning the best management of these injuries. The cases of 20 acromioclavicular separations and 3 distal end fractures of clavicle were treated by conservative method with modified Kenny Howard sling-halter using long arm cast at the department of Orthopedic Surgery, College of medicine,Ewha Womans University, during the thirty six months period from March 1982 to February 1985. The following results were obtained. 1. The average duration of immobilization was 5 weeks at the grade II of acromioclavicular separation and fracture of distal end of clavicle and 6 weeks at the grade III of acromioclavicular separation. 2. The functional results were 17 excellents(73.8%), 5 goods(21.9%), and 1 fair(4.3%). 3. The complications were 3 frozen shoulders(13.0%), 2 subluxations(8.6%), and 1 skin necrosis on the elbow(4.3%). 4. The authors immobilized the upper extremity with long arm cylinder cast of 90° flexion position instead of initial harness, so that it was applied easily and the patient felt very comfortable. 5. When the fracture and severe displacement were occurred at the midthird of the clavicle, it could be reduced and maintained with the long arm cylinder cast and strap.
Arm ; Clavicle ; Female ; Humans ; Immobilization ; Methods ; Necrosis ; Orthopedics ; Skin ; Upper Extremity

Since ossification of posterior longitudinal ligament in cervical spine (O.P.L.L.) was presented at first by Tsukimoto in 1960, many cases have been reported in Japan. But very few cases were reported outside of Japan, including Korea. It is yet unknown what mechanism is the cause and why it is prevalent among the Japanese. And so, there are various theories on the cause. With progression, this lesion cas cause cervical myelopathy and radiculopathy. The treatment of O.P.L.L. is divided into conservative and operative treatment, and the latter is composed of anterior fusion,anterior decompression and posterior decompression. We experienced 3 cases of O.P.L.L. of which two cases were treated by anterior fusion and one tred by anterior decompression with partial removel of ossification mass from March, 1985 to May, 1986. On the follow-up, results were excellent to good. We report our experience in treatment of O.P.L.L. and recommand to be concerned about the lesion.
Asian Continental Ancestry Group ; Decompression ; Follow-Up Studies ; Humans ; Japan ; Korea ; Longitudinal Ligaments ; Ossification of Posterior Longitudinal Ligament ; Radiculopathy ; Spinal Cord Diseases ; Spine

Bone tumor in the trochanteric area is not infrequent and it is important to differentiate the tumors in this area for diagnosis, early settings of therapeutic plans and prognostic previsions. Twenty-one cases of benign bone tumors in the trochanteric area treated at Dept. of Orthopedi Surgery, College of Medicine, Ewha Womans University Hospital, from January 1975 to December 1983 were analysed and following results were obtained. l. of 21 cases, 10 cases were fibrous dysplasia, 6 cases were simple bone cyst, 3 were giant ce tumor and 2 were aneurysmal bone cyst. 2. Pathologic fractures were accompanied in 6 cases; 3 of fibrous dysplasia, 2 of simple bone cy: and 1 of aneurysmal bone cyst. 3. After treatment with curettage, bone graft and instrumentation, 3 cases recurred; 2 cases of fibrous dysplasia and 1 of simple bone cyst. 4. As prognostic factors, completeness of curettage, amount and source of bone graft were considered to be important.
Aneurysm ; Bone Cysts ; Clinical Study ; Curettage ; Early Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Transplants