Unicameral bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with serous fluid. Four cases of cystic lesion at the upper end of the humerus were revealed to be unicameral bone cyst roentgenographically and microscopically. Two cases were treated with radical curettage followed by homogenous and autogenous bone graft, and one case was treated with radical curettage followed by homogenous bone graft. The other was treated with radical curettage followed by autogenous fibula graft. All cases made uneventful recoveries, and they had no complaints and no evidence of recurrence, A brief summary of literatures is submitted.
Bone Cysts ; Curettage ; Fibula ; Humerus ; Recurrence ; Transplants

Tuberculosis of the vertebral column is a slowly developing disease, characterized by pain, spinal deformity, and occasionally paralysis. The following varieties of vertebral tuberculosis are commonly recognized, such as a central variety, metaphysial tuberculosis (inter-vertebral articular type), an anterior or periosteal variety, appendiceal tuberculosis, and a true tuberculous arthritis. Among these appendiceal tuberculosis is rare. This form of Potts disease may be unilateral or bilateral and may be isolated or present at multiple levels. Disk space changes and deformity are minor features, but large paravertebral abscesses are invariable. Extradural extension may lead to the development of paraplegia. Two cases of destructive lesions at the neural arch of 10th. and 11th. thoracic vertebra were revealed to be appendiceal tuberculosis. All cases treated with antituberculous medication, radical curettage and body jaket casts and made recoveries. Patients had no complaints and no evidence of recurrence. A brief summary of the literature is submitted.
Abscess ; Arthritis ; Congenital Abnormalities ; Curettage ; Humans ; Paralysis ; Paraplegia ; Recurrence ; Spine ; Tuberculosis ; Tuberculosis, Spinal

The stress or fatigue fracture is well known in military medicine, but it is an unusual occurrence in civilian practice. The stress fracture of metatarsal bone is familiar to most, but in the tibia it is unusual. The clinical symptoms of pain, swelling and limping following strenuous activity were seen in the affected lower leg and proceeded radiological evidence of fracture. 17 cases of stress fracture of tibia were investigated in a military hospital between March 1973 and May, 1974. The results of this study are as follows, 1. The fractures mainly occurred in the upper one third of the tibia (13 cases among 17). 2. The cases with only callus formation were more frequent than the cases with fracture line on the tibia (11 cases among 17). 3. If pain occurs in the lower leg after strenuous activity, there should be attention with serial radiological checking.
Bony Callus ; Clinical Study ; Fractures, Stress ; Hospitals, Military ; Leg ; Metatarsal Bones ; Military Medicine ; Tibia

The first fusions of the spinal column were done by Hibb's and Albee in 1911. The great majority of early fusions were done for tuberculosis or arrest of the deformity of scoliosis. With changing incidence of diseases. fusion is now used most often for conditions occuring as a consequence of degenerative processes and is therefore an elective procedure done for relief of pain. The constant and uncontrollable motion of the spinal column has long been recognized as inimical to fusion and most of the modifications of technique have been designed to provide additional temporary stability to the involved vertebrae during the process of healing. More recently methods have been devoloped for placement of grafts between the vertebral bodies and between the transverse processes of the vertebrae. Fusion in the region is not new but it has not come into common usage because of the relative in accessibility of the region. Reports of it's use have been infrequent but optimistic with regard to the success of fusion. Fusion of a single intervertebral joint, most commonly the lumbosacral articulation, fusion by Hipp's seems to be adequate. If, however, two or more levels are fused by the usual methods, solid union will occur in less than 80% of patients. So we prefer the posterolateral technique for initial fusion of all patients requiring arthrodesis of more than one level. For the periods of 3 years from Jan. 1975 to Jun. 1978. 62 cases of diseased spine were treated by posterolateral fusion and the results of follow-up was as follows. 1. Of all 62 cases, 37 patients (59.7%) were male and 25 patients (40.3%) were femlae. 2. The average age was 29.5 years. 3. The etiology of low backache patients i) Spondylolysis
Arthrodesis ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Low Back Pain ; Male ; Scoliosis ; Spine ; Spondylolisthesis ; Spondylolysis ; Transplants ; Tuberculosis

Many injuries of the hand have been occurred in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Whatever the material, the aim of tendon suture is not only restoration of a strong mechanical union but also sliding function of the tendon. Thus the question has always been after what delay active mobilization can be allowed or encouraged. If immobilization allows fibroblasts to invade the tendon extremities and form a scar mass, its prolong leads to adhesion and loss of normal sliding. On the other hand, one can admit that early passive or active mobilization, even if only over a short distance may distend the adherences and transform them into a kind of mesotenon assuring a better sliding function. Before permiting early motion, several factors must be considered such as tensile strength of the suture material, holding power of the suture for the tnedon, bulkiness of the repair and stress that must be withstood. Thus it is the purpose of this study to analysis and comparing of tensile strength and morphological changes in the healing process of tendon tissues by different suturing methods. For this study deep flexor tendon on third toe of adult chicken with an initial weight of about 2Kg was used. The animals were divided into 4 sutured groups which including different suturing methods. Suturing methods used were interrupted suture, Bunnels lace suture, Kessler suture and end-weave anastomosis, which have been applied frequently in tendon surgery. All suture material used were the same size 4-0 Ethilon which has least tissue reaction but high strength. In the animals, after the sharp dissection of the distal portion of the deep flexor tendon on third toe, the tendon stumps were approximated and sutured by 4 different methods. Then a long leg cast in the position of flexion of the foot and ankle joint was applied. On operation day and fifth, tenth, fourteenth and twenty-first postoperative day; the animals were sacrified and the specimens were gained. The measurement of the tensile strength of the sutured tendon was performed through the use of force transducer with the recording of polygraph for permitting continous monitoring of a progressively increasing load until the failure of tendon repair. Specimens stained with hematoxylin-eosin and Massontrichrome stain were observed during 42 days after operation. The findings are as follows. 1. The tensile strength of sutured tendon groups using interrupted suture, Kessler suture, and end-weave anastomosis were reduced maximally on fifth postoperative fay and the tensile strength of Bunnel's lace suture group was reduced maximally on tenth postoperative day. Thereafter the strength was increased progressively on entire experimental groups. 2. The tensile strength of end-weave anastomosis group was the strongest among all experimental groups during experimental period. 3. Just after the repairs of injured tendon, the order of strength was Bunnel. Kessler and inerrupted suture but the strength was nearly approximated on 21st day. 4. The morphological healing process of interrupted and Kessler suture were better than that of Nunnel and end-weave suture. From these morphological and physical results, it is suggested that Kessler suture is better suturing method in tendon repair.
Adult ; Animals ; Ankle Joint ; Chickens ; Cicatrix ; Extremities ; Fibroblasts ; Foot ; Hand ; Humans ; Immobilization ; Leg ; Methods ; Nylons ; Sutures ; Tendons ; Tensile Strength ; Toes ; Transducers ; Transplants

The term “ganglion” was given by Hippocrates to designate a knot of tissue filled with mucin. A ganglion may be defined as a cystic benign tumor filled with a mucoid material usually surrounded by a thin wall and occurring in the region of the capsule and connective tissue of joints and tendon sheaths. The regions of the wrist, ankle, and knee and the volar regions of the fingers and hand are most frequently affected. The authors experienced a case of ganglion which had occurred at anteromedial aspect of right hip joint and had been connected with hip joint by cord like band.
Ankle ; Connective Tissue ; Fingers ; Ganglion Cysts ; Hand ; Hip Joint ; Hip ; Joints ; Knee ; Mucins ; Tendons ; Wrist

We reviewed 90 cases of popliteal cyst in 88 patients, managed at Department of Orthopedic Surgery, Severance Hospital from January 1976 to June 1985 and the following results were obtained. 1. The average age of the 88 patients was 42 years. There were 23 males and 65 females. Of the all patients, 47 were occured in right side and 39 the left. Two patients were both sides. 2. Of the all cysts, 62 were found to be bursa between the semimembranosus and the medial head of the gastrocnemius muscles(68.8%). 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 4. Communication of the cyst with the joint was apparent in 44 cases(49%). 5. Twelve patients were recurred and associated abnormality of the knee joint was osteoarthritis. Three patients were children and they had no abnormality of the knee joint. 6. Recurrence after primary operation was rare when the stalk of the cyst had been opened.
Child ; Clinical Study ; Female ; Head ; Humans ; Joints ; Knee Joint ; Male ; Orthopedics ; Osteoarthritis ; Popliteal Cyst ; Recurrence

Eleven cases of the free vascularized bone graft have been performed in the Department of Orthopaedic Surgery, Yonsei University Hospital during the period of 30.9 months from February 1981 to December 1985. Follow up ranges from 8 to 62 months. The indication for the procedure was reconstruction of extensive bony defect after acute trauma in 3 cases, osteomyelitis in 3 cases, chronic nonunion 3 cases, bone tumor in one case and congenital pseudoarthrosis in one case. The results were obtained as follows; 1. To reconstruct the lower extremity the vascularzed bone graft has much more advantages than the other conventional method and the technique may be very useful in the management of certain difficult reconstructive problem of the lower extremity. 2. In the defects of bone and skin, even infected, composite bone and soft tissue transfer can be filled by one stage operation and made the infection heal more rapidly. 3. In children the vacularized fibular graft was hypertrophied and similar to thickness of tibia.
Child ; Follow-Up Studies ; Humans ; Lower Extremity ; Methods ; Osteomyelitis ; Pseudarthrosis ; Skin ; Tibia ; Transplants

BACKGROUND/AIMS: The caudal anesthsia is most commonly used for benign anorectal surgery, The combination of long-acting anesthetics and opiates has been used for longer duration and successful control of postoperative pain. But the side effects of peridural anesthesics and morphine have commonly occured in caudal anesthesia. This study was performed to assess the difference in clinical effects between peridural mepivacaine and bupivacaine with morphine. METHODS: We evaluated the clinical effects in 60 patients who had anal operation with Jack-Knife position under caudal anesthesia. We divided randomly these 60 patients into two groups, M and B groups (in each group, 30 patients included). Group M (n=30) was given 2% mepivacaine 20 ml with morphine 2 mg caudally, and Group B (n=30) was given 0.5% bupivacaine 20 ml with morphine 2 mg in the same manner. We measured the onset time, duration, postoperative analgesia, and side effects including urinary retention. RESULTS: The onset time for analgesia was significantly shorter in group M than in group B. The duration of postoperative pain complaints was significantly longer in group M than in group B. The postoperative analgesic effects and side effects were not significantly different between two groups. CONCLUSIONS: Caudal mepivacaine and morphine mixture is effective for control of postoperative pain without significant side effects.
Analgesia ; Anesthesia, Caudal* ; Anesthetics ; Bupivacaine* ; Humans ; Mepivacaine* ; Morphine* ; Pain, Postoperative ; Urinary Retention

These are 2 cases report of the Characot-Marie-Tooth disease. One patient is a 21 year-old female with gait ataxia, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her older and younger brothers and younger sister showed same symptoms and signs which is rather milder. On neurologic examination, there were atrophy, high arched feet, and steppage gait. There were decreased pain, temperature and touch sensation, and absence of position and vibration, and absence of DTR in lower extremities. On sensory nerve conduction velocity study, the amplitude of evoked action potential is very low. On motor NCV, there are markedly prolonged distal latency and markedly decreased conduction velocity. On EMG study, there are dencervated potentials at rest and reduced interference pattern at maximal contraction. The other patient is 62 year-old female with gait disturbance, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her father, 2 younger brothers and her 3 nephews showed same degree or rather mild degree of symptoms and signs. The findings on physical, neurologic examination and EMG with NCV study are compatible with Charcot-Marie-Tooth disease.
Action Potentials ; Atrophy ; Charcot-Marie-Tooth Disease* ; Clubfoot ; Fathers ; Female ; Foot ; Foot Deformities ; Gait ; Gait Ataxia ; Humans ; Lower Extremity ; Middle Aged ; Muscular Atrophy ; Neural Conduction ; Neurologic Examination ; Sensation ; Siblings ; Vibration ; Young Adult