Limbic bone or persistant epiphysis seen roentgenographically on the anterosuperior aspects of the vertebral bodies represents another form of discal extrusion, seperating a small fragment of bone from the body of the involved vertebra. Lindblom, in 1951, demonstrated the pathophysiology with discography. Anterior herniation of the nucleus pulposus was also revealed by discography by Cloword and Buzaid in 1952. The authors reviewed 3 cases of limbic bone of the vertebrae.
Epiphyses ; Spine

The beneficial effect of the longitudinal traction-either halo-femoral or halo-pelvic and the anterior spinal fusion in some spinal disorders is well documented. This paper is a report of a patient who is suffering from spine tuberculosis with severe kyphosis and incomplete paraplegia. He was treated satisfactorily by applying a Crutchfield tong-femoral traction for four weeks followed by anterior spinal fusion. It is authors concept that the early cases of the active spine tuber-culosis with advancing kyphosis can be effectively treated by using the above mentioned method without introducing more complicated combination of the spinal osteotomy, halo-pelvic distraction and spinal fusion.
Humans ; Kyphosis ; Methods ; Osteotomy ; Paraplegia ; Spinal Fusion ; Spine ; Traction ; Tuberculosis

Kyphosis or scoliosis are developed with various causes. Mild deformity of Spine does not change the cardiopulmonary function while the more aggravate the deformity of spine, the worse the cardiopulmonary function. In 1968, Nilsonne and Lundgren have reported that the mortality in patients with severe spinal deformity was twice as high as in normal person and heart or lung disease was the main cause of death. The problem of cardiopulmonary function should be considered in the treatment of pateints who have the severe deformity of the spine. The author studied the degree of curvature of spine, pulmonary function and its correlation in 18 cases of severe kyphosis or scolissis which deformities were caused from spinal tuberculosis poliomyelitis or idiopathic Scoliosis. The results of this study are as follows; 1. Over all average degree of kyphosis of spine was 101.4; vital capacity was 61. 1% of normal and maximum breating capacity was 84. 4% of normal. 2. Vital capacity and maxmium breating capacity have a significant negative correlation with the increase of kyphosis and scoliosis of the spine. 3. Vital capacity has a positive correlation with maximum breathing capacity in the increase of the kyphosis, but not significant. 4. Timed vital capacity was in normal limit in spite of the change of kyphosis and scoliosis of the spine. 5. Change of pulmonary function after surgical correction of the deformity of spine was discussed.
Cause of Death ; Congenital Abnormalities ; Forced Expiratory Volume ; Heart ; Humans ; Kyphosis ; Lung Diseases ; Mortality ; Poliomyelitis ; Respiration ; Scoliosis ; Spine ; Tuberculosis, Spinal ; Vital Capacity

Various types of arthroplasty has been performed to obtain mobile joint in the treatment of the hip disease. In the view of stabilization and painlessness of the hip joint arthrodesis has been the treatment of choice in many hip problems, especially in unilateral tuberculosis of the hip. There are many kinds of techniques to gain arthrodesed hip: intra-articular only, extra-articular and combined method. The author reviewed the 42 cases of the arthrodesis of the hip performed at Dept. of Orthopedic surgery, SNUH during the period of 1964 to 1972 with following results. 1. Among 42 patients, there were 29 males and 12 females. Age group of predominence was 2 nd and 3rd decade (66.7%). 2. Thberculosis was the most common causative disease (61.9%) and remainders were fracturedislocation and avscular necrosis of femoral head. Average duration of illness was 3.8 years 3. The operative techniques were 21 Ghomley method (50%) and 11 Davis (26.2%). Satisfactory fusion was gained in 25 cases(92.6%) among 27 cases which follow-up study were possibe for more than 6 months. 4. There was no definite difference in fusion rate between Ghomley and Davis techniques. 5. Satisfactory fusion was gained with Davis technique in avascular necrosis of femoral head. 6. The fusion rate was superior in less than 39 years age group (95%).
Arthrodesis ; Arthroplasty ; Female ; Follow-Up Studies ; Head ; Hip Joint ; Hip ; Humans ; Joints ; Male ; Methods ; Necrosis ; Orthopedics ; Tuberculosis

One hundred and forty eight cases of hip fractures experienced in the Department of Orthopedic Surgery of Seoul National University Hospital were analyzed, and following results were obtained. 1. Femoral neck fractures were 79 cases and trochanteric fractures were 69 cases 2. The most common cause of the hip frsctures was fall-down or slip-down (96 cases-65%). 3. Incidence of the femoral neck fracture was most frequent in the 6th decade, and that of the trochanteric fracture was in the 8th decade. 4. Sex ratio (male: femalein) incidence was 2.9:1 in the age groups before 50 years, and 1:1.8 after 50 years. 5. In classification of the hip fractures, transcervical fracture was most common (74%) in femoral neck fractures. And type 3 & 4 was 57% according to the method of Tronzo in trochanteric fractures. 6. Metals for internal fixation were S-P nail, S-P nail & plate, Knowles pin, Jewett nail, and compression hip screw etc. Especially we performed endoprosthesis frequently in old femoral neck fractures. 7. Significant delayed post-operative complications were head penetrations of the metals (15.5%), avscular necrosis (37.9%), nonunion (15.5%), and varus deformity (20.7%) in femoral neck fractures.
Classification ; Congenital Abnormalities ; Femoral Neck Fractures ; Femur ; Head ; Hip Fractures ; Hip ; Humans ; Incidence ; Metals ; Methods ; Necrosis ; Orthopedics ; Seoul ; Sex Ratio

Infection is one of the most serious complications following total hip replacement arthroplasty. Many modifications of procedures have been advocated in order to reduce the rate of infection with varying success. Incorporation of antibiotic to bone cement is one such approach. However, there still remains some reluctancy to adopt this method on account of dubious antibiotic effect at the expense of weakening of physical properties. Possible emergence of resistant organisms and hypersensitivity are additional drawbacks to be considered. The present experiments were undertaken to study the effectiveness of antibacterial activity of cement-antibiotic admixtures in vitro and in vivo as well as change of physical properties produced by the incorporation. As conclusions, antibiotic-mixed bone cements have evident effects on growth of inoculated organisms sensitive to added antibiotics whereas cured bone cement itself has been proved not to have any antibacterial activity. The leaching of antibiotics occurs fairly soon, the great majority of the amount within several days. The rest shows slow, delayed leaching over period of three weeks. The weakening of physical properties was not so significant to forbid the application. Resistance to tensile and bending stress was more reduced than that to compression stress. The mixing of two antibiotics(Cephaloridine and Gentamicin powder) together to bone cement revealed double-edged effectiveness to either of gram-positive or negative organisms without any significant illeffects on hardness of cured cement, It is suggested that mixture of two antibiotics to bone cement renders broader blind coverage to unknown causative micro-organisms of postoperative deep infection of total hip replacement arthroplasty.
Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Cements ; Gentamicins ; Hardness ; Hypersensitivity ; In Vitro Techniques ; Methods ; Microbial Viability ; Polymethyl Methacrylate

One hundred and ninety-five cases of Orthopedic infection with positive bacteriology were reviewed with respect to their causative organism and sensitivity to antibiotics from Jan. 1974 to Dec. 1978 in Orthopedic Department of Seoul National University Hospital. The results were also compared with previous reports of our Department. The following observations were made ; 1) The identified causative microorganisms were 13 species. The Staphylococcus aureus continues to be the most frequent offender occupying 65.9% of total, which seems slight increasing tendency. 2) The increasing tendency of resistant Staphylococci to variable antibiotics was evident and Penicillin-resistant strains were proved in 82.8% of this series. 3) Of the antibiotics used during past two decades, the least resistant and cheap antibiotics to the Staphylococci were Chloramphenicol and Kanamycin. 4) The Streptococci occupied only 4.7% of total, suggesting decrease in incidence and also suggesting increase in incidence of Gram negative Bacilli. 5) The antibiotic sensitivity of Streptococci and Gram negative Bacilli were not changed significantly as compared with previous reports at our Department.
Anti-Bacterial Agents ; Bacteriology ; Chloramphenicol ; Criminals ; Humans ; Incidence ; Kanamycin ; Orthopedics ; Seoul ; Staphylococcus aureus

It is obvious that the examination of nerve conduction as a diagnostic tool is a relatively new field of interest with a state of still undergoing evaluation and improvement. Problems of technique and interpretation notwithstanding, determination of nerve conduction has progressed to a level where it is now used routinely as a part of the electrodiagnostic examination. The present study has been undertaken to determine the normal range of the motor nerve conduction velocity, distal motor latency, amplitude of the muscle action potentials, sensory nerve conduction velocity, distal sensory latency, amplitude and duration of the sensory nerve action potentials of median and ulnar nerves in healthy Korean. One hundred twenty healthy subjects (sixty male and sixty female) were examined. Their ages ranged from 5 to 69 in years and the subjects were arranged in three age groups of 5–9 years, 10–49 years and 50–69 years. The results obtained were as follows: l. In median nerve, mean values for motor nerve conduction velocity, distal motor latency, and amplitude of the muscle action potantials were 56.57± 4.55 (45.2–69.4) m/sec, 3.02±0.48 (1.6–4.5) msec, and 14.2±5.0 (4–28) mV, respectively. 2. In ulnar nerve, mean values for motor nerve conduction velocity, distal motor latency, and amplitude of the muscle action potentials were 58.60±5.06 (43.5–71.4) m/sec, 2.35±0.50 (1.3–4.1) msec, and 11.7±3.7(4–22) mV, respectively. 3. In median nerve, mean values for sensory nerve conduction velocity, distal sensory latency, amplitude and duration of the sensory nerve action potentials were 63.50±5.63 (53.1–75.9) m/sec, 2.37±0.38 (1.0–3.4) msec, 45.5±16.9 (13–120)u V, and 1.68±0.29 (0.9–2.5) msec, respectively. 4. In ulner nerve, mean values for sensory nerve conduction velocity, distal sensory latency, amplitude and duration of the sensory nerve action potentials were 65.34±5.16 (50.6–78.1) m/sec, 2.09±0.38 (1.3–3.2) msec, 45.6±17.5 (12–118) uV, and 1.54±0.32 (0.8–2.5) msec, respectively. In comparison of the obtained values of two nerves. 5. A significant difference was observed between motor nerve conduction studies of the median and ulnar nerves. 6. A significant difference was observed between sensory nerve conduction studies of the median and ulnar nerves except amplitude of the sensory nerve action potentials. 7. Nerve conduction velocity was significantly faster in sensory nerve than in motor nerve. In comparison of conduction velocities among 3 age groups. 8. Motor nerve conduction velocity of the median and ulnar nerves was slow in age groups of 5–9 years and 50–69 years as compared with that of age group of 10–49 years. 9. Sensory nerve conduction velocity of median nerve was slow in age groups of 5–9 years and 50–69 years as compared with that of age group of 10–49 years, and sensory nerve conduction velocity of ulnar nerve was slow in age group of 50–69 years as compared with that of age groups of 5–9 years and 10–49 years.
Action Potentials ; Healthy Volunteers ; Humans ; Male ; Median Nerve ; Neural Conduction ; Reference Values ; Ulnar Nerve

As a decompression means, the fasciotomy has been of good evaluation in many diseases such as impending V.I.C., ischemic myositis due to CO poisoning, snake bite, burn, anterior tibial compartment syndrome, carpal tunnel syndrome and gas gangrene, etc. From 1966 to 1973, 7 cases of snake bites and 5 cases of the ischemic myositis due to CO poisoning were treated at the Orthopedic Department of Seoul National University Hospital and the results were as follows; 1. All cases of the snake bites had got good results without any complication after the fasciotomy, while the fasciotomy performed in the ischemic myositis due to CO poisoning were not effective. 2. The time elapsed from the snake bite to the fasciotomy had a close relation to the prognosis. 3. In the 4 of 5 cases of the ischemic myositis due to CO poisoning, infections were superimposed on the fasciotomy sites. 4. The inappropriately continuous use of the tourniquet for hours after the snake bites caused worse prognosis.
Burns ; Carpal Tunnel Syndrome ; Compartment Syndromes ; Decompression ; Extremities ; Gas Gangrene ; Myositis ; Orthopedics ; Poisoning ; Prognosis ; Seoul ; Snake Bites ; Tourniquets

Rickets is a syndrome, characterised pathophysiologically by a failure of normal mineralization of bone and epiphyseal cartilage and clinically by skeletal deformity in growing children. The four principal causes of rickets are; vitamin D deficency, renal tubular insufficiency, chronic renal insufficiency, and hypophosphatasia. Of these, vitamin D resistant rickets may result from primary defect in function of the renal tubular reabsorption for phosphorus, later accompsnied with secondary hyperparathyroidism. We experiened a rare case of hypophosphstemic vitamin D resistant rickets accompanied with secondary hyperparathyroidism in adolescence.
Adolescent ; Child ; Congenital Abnormalities ; Familial Hypophosphatemic Rickets ; Growth Plate ; Humans ; Hyperparathyroidism, Secondary ; Hypophosphatasia ; Miners ; Phosphorus ; Renal Insufficiency, Chronic ; Rickets ; Vitamin D ; Vitamins