No abstract available.

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

No abstract available in English.
Animals ; Dogs ; Spine

Authors clinically analysed the end results of the 56 elderly patients having fresh femoral neck fracture who were treated with osteosynthesis procedures and 23 endoprosthesis replacement surgery. All these 79 patients were treated between 1970 and 1979 at the St. Marys Hospital, Seoul. The indications of primary endoprosthesis replacement surgery in femoral neck fractured patients were in elderly patients over 65 years, displaced, comminuted sub capital or transcervical fractures, irreducible fractures, pathological fractures and patients having generalized diseases or senile psychosis. The results for the operated hip joints were assessed by duration of hospitalization, early and late post-operative complication. and the Jessels hip grading method at least post-operative one and half year later. The results obtained were as follows: 1. The average age of the patients were 65 years in 56 cases with initial osteosynthetic group, and 73 years in 23 cases of initial endoprosthesis group. 2. The slip down was the most common cause of injuries. The transcervical type of fracture was 54% of all cases. 3. The eligibility of ambulation was average 34 days after surgery in cases having initial osteosynthesis and 18 days in cases having endoprosthesis. 4. Early post-operative complications such as pneumonia and urethritis etc. were more common in cases of endoprosthesis than in osteosynthesis. But we think these complications were not related with surgery itself and transient. 5. Late post-operative complications in cases of osteosynthesis were avascular necrosis of head (16%), nonunion (9%), osteoarthritis (4%), and deep wound infection (2%), but in cases with endoprosthesis, leg length discrepancy (12%), acetabular erosion (4%) and loosening (4%) in order. 6. We performed the second operation in 12 cases among the 56 patients of osteosynthesis because of post-operative complications. 7. Good end results were obtained 90% in 56 osteosynthesis and 91% in 23 endoprosthesis. Conclusively, author's observation time was relatively short (11/2–3 years) and it is impressed that long term study for the prosthetic group is necessary for the more accurate evaluation of their hip function.
Acetabulum ; Aged ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Hip Joint ; Hospitalization ; Humans ; Leg ; Methods ; Necrosis ; Osteoarthritis ; Pneumonia ; Psychotic Disorders ; Seoul ; Urethritis ; Walking ; Wound Infection

Patients with rickets frequently are seen by orthopaedic surgeon with complaints of growth disturbance, limb deformity, weakness, and multiple fracture. Among them, bow leg deformity is the most common and difficult orthopaedic problem. In growing child, however, if effective tretment is given sufficiently in early age and early disease process, the deformities usually correct spontaneously and there is little need for orthopaedic treatment other than careful observation. The orthopaedic treatment may be required to correct deformities that cannot be expected to improve with growth. A clinical study was done for 11 cses of rachitic bow leg deformity who were treated at the department of orthopaedic surgery, Catholic medical College and Center from Jan. 1978 to Dec. 1981. Results obtained were as follows: 1. The most common patients age group was in 1 to 2 years of age and there was no sexual difference. 2. Associated deformities with rachitic bow leg were rachitic rosary (5 cases), double wrist (3 cases), coxa vara (1 case), and Harrison's groove (1 case). 3. Low Ca * P solubility product, below the level of 30 (mg/dl)2 suggested active form of rickets in all cases. 4. Laboratory values such as Ca * P solubility product and alkaline phosphatase improved at 3 weeks after administration of vitamin D in 7 cases, 3 at 6 weeks, and no improvement in one case even at 6 months after treatment. 5. Six months after treatment, the average amount correction of tibiofemoral angle was 9° (43.7% of initial angle) in group 1, 13.3° (47.0%) in group II, 4.9° (29.6%) in group III, and 3.3°(25.6%) in group IV. 6. Through this study it is suggested that the more growth correction of the rachitic bow leg deformity in a younger child below the age of 2 is obtained with growth by treatment, whereas a little or no growth correction can be expected after the age of 3 or 4 years.
Alkaline Phosphatase ; Child ; Clinical Study ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Fractures, Multiple ; Genu Varum ; Humans ; Rickets ; Solubility ; Vitamin D ; Wrist

There have been many methods of manual reduction of shoulder dislocation. But each method has its unique complications such as fracture of'humeral neck or shaft as well as vascular and nerve injuries around the shoulder due to excessive pulling and rotation during the maneuver. The present authors devised a method in which the backrest of a chair is used as a fulcrum during manupulative reduction. The dislocated shoulder can be abducted by the backrest rim, when the armpit is placed over the top of the backrest. In this abducted position of the shoulder, minimal adduction force on distal humerus and gentle backward pressure on humeral head are very effective in reducing the anterioly disocated shoulder.
Axilla ; Humeral Head ; Humerus ; Methods ; Neck ; Shoulder Dislocation ; Shoulder

Twenty nine patients who had fracture of tibial shaft were treated with closed Rush nailing and early weight bearing. 1. The average age was 37.8 years (range from 20 to 65), and 21 were men and 8 women. Eighteen cases were open fractures and 11 closed. 2. The time for clinical union was averaging 15.4 weeks. In some cases callus appeared as early as 3 weeks after nailing and in most cases appeared at 8 weeks. 3. Mild angular and rotational deformity of the fractured shaft were developed as complication but did not present any clinical problems. No deep wound infection and pulmonary embolism were encountered. 4. The nails allowed a certain dynamic controlled motion at the fracture site which was probably beneficial to early callus formation. 5. This type of closed nailing method required no medullary reaming, further periosteal stripping and muscle detachment. The allowance of early knee and ankle movements and early weight bearing after surgery could be listed as the advantage.
Ankle ; Bony Callus ; Congenital Abnormalities ; Female ; Fractures, Open ; Humans ; Knee ; Male ; Methods ; Pulmonary Embolism ; Tibia ; Weight-Bearing ; Wound Infection

Complete plantar dislocation of the metatarsal head of the 2nd toe, irreducible by closed methods, is a rare injury. As with similar lesion in the hand, closed reduction is impossible because of interposition of volar plate. So author describes a case treated at Armed Forces Hospital by open reduction after failure of closed reduction, and anatomy of the 2nd M-P joint and pathomechanics of this rare dislocation are described.
Arm ; Dislocations ; Hand ; Head ; Joints ; Metatarsal Bones ; Toes

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