In the treatment of elderly hip fracture, early mobilization as a means of reducing early postoperative morbiyt and morbidity is mandatory. Even though Ender nailing have many advantages, most serious problems with use of Ender nailing method are distal migration of nails, subsequent loss of fixation and limited knee joint motion. To prevent these difficult problems, we have used distal wiring technique with Ender nailing since 1988. In operation, we performed Ender nailing as usual manner under image intensifier and for the prevention of the nail migration, we performed circumferential wiring through the each Ender nail eye and above the adducter tubercle of the distal femur. Forty six cases were available with minimum follow-up of six months which were healed radiologically and clinically (Mean follow up: 21 months). The mean age was 74 years (Range: 52 years-88 years)and showed 26 cases of famale and 20 cases of male. The radiological morphometry using Singh index showed poor bone quality: 36 cases were below Grade III and the fracture type was classified by Tronzo criteria. In results, patients who had Ender nailing with distal wiring showed no distal migration, however one case of proximal migration was observed at the beginning stage of this technique. So, in elderly trochanteric fracture, to reduce the complication of the Ender nailing, especially nail migration, the authors recommend the Ender Nailing with distal wiring technique.
Aged ; Early Ambulation ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip ; Humans ; Knee Joint ; Male ; Methods

One hundred and forty eight cases of tennis elbow were treated by conservative managements firstly such as rest, medication, immobilization, physical therapy and/or local steroid injection, from Jan. 1985 to Jun. 1994 at Department of Orthopaedic Surgery, National Medical Center. Among the 148 cases, 16 cases who failed conservative managements, were treated with Nirschl & Pettrone operation. The results were summarized as follows, 1. Among the 148 cases, 110 cases(74%) were female, and 61 cases(41.2%) were in the age group 41 to 50 years old, and mean age was 42.3 years old. 2. Ninty nine cases were housewives and only 15 cases were related to sports. 3. The conservative results of one hundred and sixteen patients were graded excellent and good; and of thirty two patients, fair and failure. 4. The operative results of seven patients were graded excellent; of three, good; of four, fair; and of two, failed. 5. Recurence was developed in 18 cases(12.2%), and we obtained excellent and good result in 17 cases with both conservative and operative treatment. Above results suggest that the term, tennis elbow is a misnomer because it occurs more commonly in non-athletes such as housewives than in tennis players. So it seems to be an occupational disease rather that sports injury. Now, we propose to eliminate of the term of tennis elbow and to substitude with new terminology that describes the true understanding and therapeutic orientation of it.
Athletic Injuries ; Female ; Humans ; Occupational Diseases ; Restraint, Physical ; Sports ; Tennis Elbow ; Tennis

Tennis elbow is common, and offen disabling problem even in daily living;conservative treatments commonly make satisfactory results, but recurrence is frequent and discouraging. So, surgical treatments are considered in certain cases. The authors report the retrospective analysis of 15 patients treated by nirschl and pettrone procedure. Patients were evaluated with Nirschl and Pettrone assessment method at an average 10.3 months(range, 5 to 32 months0 after surgery. thirteen of 15(87%) patients had more than fair postoperative rating. Two patients had postoperative complications;one with infection and the other with transient mild limitation of elbow motion. No postoperative deterioration of the clinical state was seen. And biopsy specimens of all case showed degenerative changes. Resection of the degenerated site of tendon origin of the humeral epcondyle(The Nirschl and Pettrone procedure) yield satisfactory results in properly selected patients.
Biopsy ; Elbow ; Humans ; Methods ; Recurrence ; Retrospective Studies ; Tendons ; Tennis Elbow ; Tennis

No abstract available.
Acetabulum*

The studies about tibial spine fracture were less frequently reported, especially in its sdult type, had different opinions according to authors. Meyers and McKeever described it had frequedntly occured as isolated injury without associated ligamentous injury of the same knee in children and mainly caused by bicycle accident. They had classified it by three different types according to the shape of it, managed conservatively type I, II,IIIA, and recommanded simple suturing with absorbable materials as operative method. But, in our cases it had frequently occured in adult and combined with ligamentous injury at the same knee including ACL and MCL. Also, it had frequently been caused by major trauma such as traffic accident. Previous method of management including simple stainless steel wiring had scored poor results in these complicated fractures. The author reviewed 24 cases of the tibial spine fracture treated at the Department of Orthopaedic Surgery, National Medical Center from June, 1980, to June, 1988, and the following results were obtained. 1. The most common causes of the injury were traffic accident (12 cases) and associated with rupture of medial collateral ligament in 7 cases. 2. The fracture was classified as four different types according to its pattern and comminution and most commen types were III and IV, scored 8 cases and 7 cases irrespectively. 3. Initially, closed sreduction and cast immobilization was performed in 15 cases, of which 8 cases had poor results with non-union of the fracture and instability. 4. Simple stainless steel wiring in 2 cases scored poor results and distal advancement of ACL with double wiring revealed good results in these cases. 5. One case of type II fracture had persistently positive anterior drawer sign and subjective instability and needed distal advancement of ACL and double wiring. 6. Distal advancement of ACL and double wiring was performed in 6 cases of which 4 cases revealed excellent results and 2 cases did good ones.
Accidents, Traffic ; Adult ; Child ; Classification ; Collateral Ligaments ; Humans ; Immobilization ; Knee ; Ligaments ; Methods ; Rupture ; Spine ; Stainless Steel

Tibial nonunion is often associated with the soft tissue atrophy and the local circulatory disturbance, so it is important to minimize the soft tissue injury and maintain the stability at fracture site for bone union. We reviewed 29 cases of subcortical onlay bone grafts and plate fixations for the nonunion and delayed union of tibial shafts, from Jan. 1988 through Jan. 1994. The results were as follows. 1. Twenty-nine patients who had nonunion of the tibia underwent subcortical cancellous onlay bone graft and plating, and 28 fractures(96.6%) went on to union. 2. Subcortical elevation or shingling of cortical bone fragments of the tibial cortex, is advocated to provide sound biological condition in atrophic soft tissue envelope. 3. Narrow DCP encouraged early motion and reliably promoted obtaining anatomical alignment. So, in treatment of protracted tibial nonunion, especially in an area with deficient soft tissue or unyielding scar tissue, subcortical onlay bone graft and plate fixation is very useful method, result in good union and no skin problem.
Atrophy ; Cicatrix ; Humans ; Inlays ; Methods ; Skin ; Soft Tissue Injuries ; Tibia ; Transplants

No abstract available.
Liver*

It is obvious that adequate nutrition is essential for growth and development of school children, and many elementary schools in this country have already practiced it. Therefore, it would seem apparent that the school feeding program would have a significant effect on the growth and development of school children. This paper presents a two-year experimental school-feeding program from 1973 to 1974, and attempts to evaluate its effects by before-and-after nutrition surveys conducted in two elementary schools, one experimental and the other as a control. The two schools are both located in the same county (Yongin-Kun, Kyunggi-Do), and the families of their students are presumed to share the same socio-economic level. To assess the effect of school-feeding, we measured height, weight, chest circumference and grasping power. Physical examination was done foresigns of nutritional deficiency. A stool examination for parasites and blood examinations for hemoglobin, hematocrit and serum protein were included. Analysis were done for 150 students selected randomly at the beginning of the program. These students attended the school throughout the program period. Results are as follows: 1. The amount of increase of height, weight, chest circumference and grasping power were greater in the experimental school than in the control school, but the differences are not statistically significant. 2. Signs of vitamin deficiency decreased in both experimental and control schools during the two-year program period. 3. At the time of the 1974 post-survey, values of Hb. & Hct. revealed no significant differences between the two schools, but serum protein level was a little higher than that of general Korean rural children of the same age. 4. Infestation rate of parasites had increased in both schools during the two-year program period. 5. Each student of the two schools was classified into three major classes, according to the level of economic condition of his or her parents, namely higher, middle and lower. The results of each class of the experimental school was compared with that of the corresponding class of the control school, expecting the relative magnitude of change largest in the lower economic class of the experimental school. However, change was greatest in the middle class, still not being statistically significant. Finally, the authors concluded that the two-year period for such a program is not sufficiently long for its beneficial effects to be demonstrated and measured. As long as the growth and development of children are concerned, planning with a more distant perspective is required, as well as the development of new methods of evaluation.
Avitaminosis ; Child ; Growth and Development ; Hand Strength ; Hematocrit ; Humans ; Lunch* ; Malnutrition ; Nutrition Surveys ; Parasites ; Parents ; Physical Examination ; Thorax

No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

No abstract available.
Fractures, Open*