Methods of treatment of Legg-Calve-Perthes' disease, (L.C.P.D.) are at present generally defined, and the individual approach is now more precise than before. But it is still controversial, particularly in older age groups. We analized the result of intertrochanteric varus osteotomy in 44 hips and innominate osteotomy in 23 hips of L.C.P.D., and compared the former with the later. To find out the influence of the both osteotomies on the femoral head (coxa magna), the relations between the stage and degree of involvement at operation and reult, and the postoperative progression of disease, the cases were analyzed and classified by Elizabethtown's stage and Catterall group. And also the duration of fragmentation stage after osteotomy was observed. Results were as follows: l. At the time of operation 45 hips were in avascular stage, 18 hips in fragmentation stage, and 4 hips in healing stage. 20 hips(29.8%) were classified as group II, 29(43. 3%) group III, and 18(23.1%) group IV. 2. After the osteotmy in case of avasculsr necrosis stage, average duration of fragmentation stage was 6.3 months after femoral osteotomy and 1 year 6 months after innominate osteotomy. 12 among 20 hips were skipped the fragmentation stage, and got into healing stage in case of femoral osteotomy. 3. After the osteotomy at the fragmentation stage, average duration of the fragmentation stage was 9.8 months after femoral osteotomy and 1 year 3 months in case of innominate osteotomy. 4. Regardless of the type of osteotomy, coxa magna was observed more frequently in the case who had surgery at the late stage and severely involoved head at the time of osteotomy. 5. In the case of femoral osteotomy, average preoperative neck shaft angle was 138.5°, and postoperative one was 113.5°. During the follow-up study, 12.0° of revalgarisation took place. 6. The result obtained by femoral osteotomy gave better results than those by innominate osteotomy. Regardless of the type of osteotomy, good results were obtained in case who had surgery at the early stage such as avascular stage, and had mild involvement as such group II.
Follow-Up Studies ; Head ; Hip ; Humans ; Neck ; Necrosis ; Osteotomy

The authors did clinical analysis for 37 cases, ranging from 5 to 13 year old of age and following result obtained. 1. In group I partial involved type had brightful prognosis even in the neglected the cases. 2. Ischeal brace did not give any help to group II & III but in group I, it gave some help to the prognosis. 3. In untreated cases of old age group developed early arthritic changes. 4. The inital radiological bony changes in early L-C-P. cases was the demineralization of the subchondral area and subsequently subohondral vaccum phenomena followed.
Braces ; Humans ; Prognosis

Three cases of Dupuytrens contracture which developed in hands were reported along with review of literatures. Partial fasciectomy was done as the choice of treatment for them to improve impairment of function of the hands. No attributable causes for the developement of the disease were found.
Dupuytren Contracture ; Hand

The authors did a clincal analysis of 95 cases of the osteomyelitis. Among them 72 were hematogenous in origin: 12 were secondary to open fracture: 6 were direct extension from adjascent soft tissue infection: 5 were complicated after open reduction of fracture, who were treated at Dept. of Orthopedics of Catholic Medical College for past 3 years from 1968 to 1971. Through this study following result were obtained: 1. Most of the patient were under age of 16 Years, In acute hematogenous osteomyelitis, over 80% of patient were under age of 12 years. Males were more frequently affected than females. 2. Generally, femur, tibia and humerus were most frequently affected than the others. In acute osteomyelitis, distal femur and proximal tibia were the most frequent site of involvement. 3. In acute osteomyelitis, early decompression, like drilling or fenestration operation gave more satisfactory result than the simple soft tissue drainage. Immediate surgical intervention with massive antibiotics administration is stressed without hesitation when diagnosis is made. The group treated within a week after onset gave relatively good result in this series. 4. Primary closure of the wound in acute osteomoelitis were considered not to be the good method which is usually adopted as procedure in the chronic type. 5. In the chronic osteomyelitis, continuous tube irrigation after saucerization was adopted when the bony defect is large. Primary closure of the wound were adopted in the case when surgical defect is small in size less than 4cm in diameter. 6. Treatment of the osteomyelitis complicated after open reduction of the fracture were generally treated with focal curettage and removal of fixative device when clinical union is evident, also fixative devices were out even in the group which were not united clinically but redisplacement is expected not to take place. In this group external support was given until fracture healing. Bony window was also made for drainage when cavitary change develped around the tip of nail.
Anti-Bacterial Agents ; Curettage ; Decompression ; Diagnosis ; Drainage ; Female ; Femur ; Fracture Healing ; Fractures, Open ; Humans ; Humerus ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Wounds and Injuries

No abstract available in English.
Arm

Congenital dislocation of the hip has been known as one of the most common congenital anomalies in the orthopedic field since the time of Hippocrates (460-357 B.C.). The occurence of C.D.H. in twin babies is extremely rare thus few if any papers have been reported. During the period of January 1971 through June 1976 the authors have treated a total of 49 cases as inpatients. Two of these were twin babies. In both cases the hip was surgically reduced and followed by open reduction and femoral derotation osteotomy. Clinically and radiologically the results were good during the duration of follow-up seven months after operations.
Dislocations ; Follow-Up Studies ; Hip ; Humans ; Inpatients ; Orthopedics ; Osteotomy ; Twins

Roller skating is a sort of sports with high risk which is increaseed in trends. It has become a very popular recreational sports in children, and concomitantly injury caused by it is very variable and sometimes servere. Therefore, adequate preventive garments or additional support for roller skating is essentially recommended to be worn. Authors in this study clinically analysed 24 cases of roller skate injury who were treated at the department of orthopaedic surgery, Kang-Nam St. Mary's hospital, Catholic Medical College and Center, during the 6 months period from May to October 1980. 1. Of 24 patients, 18(10 fractures) had injuries in the upper extremity, and 8(4 fractures) in lower extremity. 2. No unique mechanism was found which reasonably explains various types of injuries encountered In roller skating. 3. Through this study it is said that roller skating is not a benign sports, and the Injury caused by it may be largely preventable with adequate practical Instructions, coaching and wearing protective garments.
Child ; Clinical Study ; Clothing ; Humans ; Lower Extremity ; Skating ; Sports ; Upper Extremity

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

No abstract available.
Spinal Stenosis*

No abstract available.
Fracture Fixation, Intramedullary*