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Animals ; Dogs ; Spine

The growth plate is responsible for longitudinal bone growth and is involved in 6–15% of children's fracture. Of these injuries, 25–35% have been reported to result in some shortening or deformity, but in only 10% are the deformities sufficiently severe to lead to functional problems. The problem of repair of a demaged growth plate in children has never been adequately solved. The purpose of this study is to clarify that allograft of cultured chondrocytes can survive in the growth plate defect and can prevent the angular deformity by avoiding the formation of bone bridge. The chondrocytes were obtained from the rib cartilage of rabbit weighing 500g. The chondrocytes were cultured by socalled micromass culture method. The rabbits were divided two groups; the group I in which medial proximal tibial growth plate was destroyed, and the group II in which the cultured chondrocytes were transplanted into the right medial proximal tibial physeal defect. Each group has 10 rabbits. The tibial growth was observed grossly, radiologically and histologically until 16 weeks after graft. The angular deformity was observed from 3 weeks after operation and histologically the fusion of growth plate was observed in all of group I. In group II, there were no angular deformity and no fusion of growth plate in 7 out of 10 rabbits. Allografted cultured chondrocytes survived and produced matrix in the physeal defects. Through this study it was inferred that allograft transplantation of cultued chondrocytes in the iatrogenical physeal defect is a useful method to keep the physeal growth without cessation. However, further studies will be necessary to prove that the longitudinal growth potential resides in the transplanted chondrocytes as growth plate cartilage.
Allografts ; Bone Development ; Cartilage ; Child ; Chondrocytes ; Congenital Abnormalities ; Growth Plate ; Humans ; Methods ; Rabbits ; Ribs ; Transplants

Experiences with four cases of untreated clubfoot in adults are reported. Three of these were congenital and one was secondary to poliomyelitis. Difficulties encountered in the corrective surgery of the cases are presented and the pathogenesis of tibial torsion and contribution of the talus in the development of congenital clubfoot are discussed along with review of the literature.
Adult ; Clubfoot ; Humans ; Poliomyelitis ; Talus

Five cases of osteogenesis imperfecta are reported, and the available literatures concerning to its clinical pictures and treatments are reviewed.
Osteogenesis Imperfecta

Tuberculosis of the spine still remains an as important problems in Korea, There is much controversy over the advantage of indication for surgical versus medical treatment, and the correct answer probably lies between the two extremes. Recently focal debridement is widely accepted operation method, andmany reports dealing with this subject have been published. Because of limited vacancy of the hospital and poor economy, a large group of patient with tuberculous lesion in spine have been treated conservatively with anti tuberculous medication and aspiration of abscess and immobilization by plaster shell etc. Authors than attempted a clinical analysis on a patient-group (40cases) treated at Pusan University hospital and Pusan Children Charity hospital, and obtained the results as follows: 1. The kyphosis of the spine tends to be aggrevated with collapse of vertebra. 2. Kyphosis aggrevated in 67.5% of cases: 18.7 degree of increase in whom plaster jacket was additionally applied, while 27.5 degree of increase in the cases without plaster. Time of aggrevation of kyphosis after institution of treatment was variable as 3 to 18 months. 3. Pathological reflexes were found in 16 cases, which were disappeared in 18 months after the treatment. 4. Psoas abscess was completely absorbed in 3 rd to 9 th month after treatment by repeated aspiration with one month interval. 5. Regression of paravetebral abscess shadow on the X-ray film was observed very slowly from 2 nd month to 30 th month, mainly disppeared in 6 th month after conservative treatment. 6. Thirty four cases had back muscle spasm, paraparesis in the lower extremity with difficulty of walking, and recovered within 15 months with complete relief of back muscle spasm.
Abscess ; Back Muscles ; Busan ; Charities ; Child ; Debridement ; Humans ; Immobilization ; Korea ; Kyphosis ; Lower Extremity ; Methods ; Paraparesis ; Psoas Abscess ; Reflex ; Spasm ; Spine ; Tuberculosis ; Walking ; X-Ray Film

We experience still a number of cases of residual polipmyelitis with severe deformities which have not been treated for more than 10 years in Korea. During the period of January to August in 1970, 40 cases of residual poliomyelitis had corrective operations performed at Department of Orthopedic Surgery, Pusan National University Hospital. Among those Two cases showed extreme deformities of hips and knees, having not been treated at all for past 18 years. There were flexion contractures of hips 50/80(Rt/Lt) and knees 90/90 in case 1 and flextion contractures of hips 75/90 and knees 80/100 in case 2. Various controversial methods of surgical treatment have been described since 1914 when Soutter introduced a procedure for flexion contracture. In case 1 the procedures of Soutter and Yount, division of the hamstring tendons and posterior capsulotomy of knee were performed by the authors. The bilateral contractures were not corrected completely and the residual deformities remained. In case 2 a compelet correction was obtained by release of iliopsoas insertion and supracondylar osteotomy combined with the operations done in case 1. From this clinical observation the authors reached to the conclusion that the release of insertion of iliopsoas muscle and supracondylar osteotomy are the essential procedures for correction of flexion contracture of hip and knee.
Busan ; Congenital Abnormalities ; Contracture ; Hip ; Knee ; Korea ; Orthopedics ; Osteotomy ; Poliomyelitis ; Posterior Capsulotomy ; Tendons

The diaphysectomy of a large tubular bone is occasionally done as a method of treating chronic osteomyelitis. Obliteration of the bony gap with stable complete reunion by periosteal new bone formation is rare in adult and is usually not expected to be complete. Therefore, the bony defect generally is replaced or refilled to bridge the gap by massive bone graft after complete subsidence of the inflammatory signs, The authors report a case of chronic osteomyelitis of tibial shaft which was treated by diaphysectomy and healed with complete and stable periosteal new bone formation in the gap of diaphysectomized tibia without graft or replacement in a healthy young adult.
Adult ; Humans ; Methods ; Osteogenesis ; Osteomyelitis ; Reunion ; Tibia ; Transplants ; Young Adult

A case of the bilateral idiopathic aseptic necrosis of the femoral head which was treated by a Colonnas arthroplasty and was followed by an Austin Moores prosthesis on the other hip joint satisfactorily is reported with review of literatures. A 44-year-old woman has a long history of steroid therapy for allevation of pain which started in hips for many months and also had an indigestion secondary to chronic hepatic disease. Diagnosis of the idiopathic necrosis of the femoral head was made by the typical roentgenologic findings and the clinical symptoms, and it was confirmed by the operative findings. The choice of treatment in bilateral idiopathic necrosis of the head of the femur is considered to be cup arthroplasty, but circumstances under which cup and instruments are not available certain another surgical procedures should be considered such as other metalic replacement or non-metalic arthroplasty. Here in this case Colonnas arthroplasty without metalic replacement in a hip and the prosthetic replacement in the other joint were thought to be the best procedure. Bilatal Colonnas arthroplasty is not chosen because they develop bilateral abduction deformity of the hips. She was discharged from the hospital with a pair of crutches in good function in her hips without any complication.
Adult ; Arthroplasty ; Congenital Abnormalities ; Crutches ; Diagnosis ; Dyspepsia ; Female ; Femur ; Head ; Hip ; Hip Joint ; Humans ; Joints ; Necrosis ; Prostheses and Implants

Clinical observation was made on 6 cases with Acromioclavicular separation who were treated conservatively at the Department of Orthopaedic Surgery, Pusan National University Hospital. 1) The authors experienced good functional results in those cases with conservative treatment. 2) Closed method is desirable for grade I & II acromioclavicular separation as primary treatment and also, even for grade III depending upon the situation. 3) The authors recommended the convenient Kenny-Howard sling halter as a conservative treatment in Koreans who refuse operation.
Busan ; Methods