Forty children underwent three crossed K-wires fixation after reduction of the totally displaced supracondylar fracture(type IE ) of the humerus from October 1994 to March 1997, were reviewed. The patients age ranged from 3 years and 2 months to 12 years and 7 months, averaging 6 years and 6 months. Preoperatively, five patients(12.5%) had concomitant nerve injury. Three patients(7.5%) revealed ischemic sign on distal part of the fracture. All the fractures were treated within 24 hours after arrival at the emergency room. After general anesthesia, all but one fractures reduced by closed means. Each reduced fracture was fixed by two parallel K-wires in lateral side followed by one crossed medial K-wire under fluoroscopic control. The preoperative distal ischemia of the three patient restored blood supply within 24 hours after reduction. The K-wires were removed after averaging 3.3 weeks after operation in out patient clinic. Five patients revealed neurologic deficit preoperatively recovered completely within 4 months after reduction of the fractures. The followup period ranged from 12 months to 32 months, averaging 17 months. By Flynns functional and cosmetic criteria, 39 patients(97.5%) among forty patients resulted in satisfactory criteria. The one unsatisfactory patient revealed cubitus varus treated by corrective osteotomy. In conclusion, three crossed K-wires fixation is considered as effective and safe method for the totally displaced supracondylar fracture of the humerus in children.
Anesthesia, General ; Child* ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Humerus* ; Ischemia ; Neurologic Manifestations ; Osteotomy

PURPOSE: In order to know the clinical usefulness of the Bioscrew(Linvatec, USA) and the Semi-Fix (Arthrex, USA) technique for femoral fixation in ACL reconstruction using hamstring double loops, we scrutinized and compared the 24 knees. Materials and Methods: We compared Lysholm score, Hospital for Special Surgery(HSS) knee rating scores, Lachman tests, Pivot-Shift tests and KT side to side difference in 24 knees after arthroscopic ACL reconstruction using hamstring double loops from August 1996 to January 1998. We have used fourteen bio-absorbable interference screws and ten Semi-fixs for femoral tunnel fixation. RESULTS: We took the data; the Lysholm score of 96.1 and 94.1; HSS score of 98.6 and 98.1; KT differ- ence of 1.3 +- 2.13(mm) and 1.2 +- 1.89(mm) after ACL reconstruction using Bioscrew or Semi-Fix respec- tively. Femoral tunnel enlargement showed 2.51 +- 1.03(mm) and 1.95 +- 2.33(mm) respectively. And we got the similar results of Pivot-shift test, Lachman test and anterior drawer test after reconstructive surgery. CONCLUSION: Since we got the similar good data in comparative clinical study between the Bioscrews and the Semi-Fix technique, we anticipatd that either the use of Semi-fix technique or the biodegradable interference screws would be bright in the fixation to femoral tunnel in ACL reconstruction using ham- string double loops.
Femur* ; Knee

Water intoxication associated with hyponatremia is a rare and sometimes fatal complication of oxytocin. We report a 18-year-old primigravida who presented with vomiting, seizures, and stuporous mental state after abortion with oxytocin infusion. The serum sodium was 116 mEq/L and serum osmolality was 234 mosm/kg. The serum sodium level as well as clinical symptoms were improved after hypertonic saline infusion. We suggest that the serum electrolytes and osmolarity should be examined in patients who presenting with seizure and altered mental state with history of labour or abortion.
Adolescent ; Electrolytes ; Humans ; Hyponatremia ; Osmolar Concentration ; Oxytocin ; Seizures* ; Sodium ; Stupor ; Vomiting ; Water Intoxication*