Although the incidence of tuberculosis of the bone and joints is being decreased with good nutrition, hygine and the development of preventive medicine, it is still a common disease in our clinic. One hundred and ninty-eight cases of tuberculosis of the bone and joints were studied in the Department of Orthopedic Surgery, Seoul National University Hospital for 10 years from January, 1966 to December. 1975. The results were as follows: 1. Total cases of tuberculosis of the bone and joints were 588 Among them, peripheral bone and joints excluding the spine occupied 198 cases (34%). 2. Sex ratio was 1.7 : 1 (male : female). Age distribution showed the group below 10 years was 78 cases (39%). On the other hand, 7 cases were over 51 years old. 3. More than 50% of patients visited hospital after one year from the onset. 4. One-third of all cases had been given some management before admission and the most common treatment was anti-tuberculous chemotherapy (25%). 5. Erythrocyte sedimentation rate was definitly increased in 41%. 6. Associated tuberculous lesionsoe of extraskeletal system were confirmed in 66 cases (33%). Among them, active pulmonary tuberculosis were 51 cases (77%) 7. Various treatments (conservative, curettage, synovectomy, arthrodesis, etc.) had been carried out. However, surgical managements for saving the range of motion must be considered always before arthrodesis.
Age Distribution ; Arthrodesis ; Blood Sedimentation ; Clinical Study ; Curettage ; Drug Therapy ; Hand ; Humans ; Incidence ; Joints ; Orthopedics ; Preventive Medicine ; Range of Motion, Articular ; Seoul ; Sex Ratio ; Spine ; Tuberculosis ; Tuberculosis, Pulmonary

Twelve neglected congenital dislocations of the hip in ten patients over the age of eight years were treated by open reduction and chiari osteotomy. Reduction was aided by preoperative traction only in two hips, by femoral shortening with preoperative traction in three and by femoral shortening only in seven. The average follow up period in our series is 3 years, ranging from 1 year and 2 moths to 4 years and 5 months. The overall results were good but one case of avascular necrcsis and one case of redislocation were seen. By our experience it is thought that all old and congenitally dislocated hip in the growing age can be reduced by femoral shortening with soft tissue release, and preoperative traction for its reduction is not undispensable. The most problem in the treatment of the old congenital dislocation of the hip is the postoperative partial ankylosis in the affected hip and this problem would be overcome by delicate operative technique and meticulous hemostasis.
Ankylosis ; Dislocations ; Follow-Up Studies ; Hemostasis ; Hip ; Humans ; Moths ; Osteotomy ; Traction

No abstract available.
Hyperparathyroidism, Primary* ; Parathyroid Neoplasms*

No abstract available.
Intestinal Mucosa* ; Macrophages* ; Salmonella typhimurium* ; Salmonella*

Fat embolism is one of a rare catastrophic complication after multiple fraetures and extensive soft tissue injury. Many hypothesis on its pathogenesis has been postulated by many writers, still its exact pathogenesis, definite diagnostic criteria and treatment is not established. Nowadays fat embolism is considered as a respiratory insufficiency syndrome, even disseminated intravascular coagulation rather than isolated phenomena after extensive trauma of musculoakeletal system. Respiratory failure associated with fat embolism is a major cause of death, but is usually seIf-limited and is responsive to intensive treatment. Monitoring of blood gas is required for early diagnosis and respiratory supportive treatment with continued monitoring is necessary until resolution. The writers experienced six cases of fat embolism, at the Department of Orthopedic Surgery, Seoul National University Hospital for the period of three years from June 1974 till May 1977. Respiratory support, parenteral steroid and low molecular weight dextran with other supportive measure was a mainstay of treatment. Of six cases, five was recovered without sequalae and one was expired four days after trauma.
Cause of Death ; Dextrans ; Disseminated Intravascular Coagulation ; Early Diagnosis ; Embolism, Fat ; Molecular Weight ; Orthopedics ; Respiratory Insufficiency ; Seoul ; Soft Tissue Injuries

Pathologic fracture occurs in a bone with preexisting stuctual weakness. The author reviewed 30 cases of pathologic fractures in which admission record and X-ray finding was well preserved among 53 cases admitted patients in the department of Orthopaedic Surgery, Seoul National Universty Hospital for 10 years from 1967. The results were as follows: 1.Age & Sex incidence showed even distribution. 2. The most frequent involved site was femur (40%) 3. The underlying etiology was as follows: 2 chronic osteomyelitis 1 homophilia 7 benign tumor 20 malignant tumor 4. metastatic tumor was the most frequent cause in 30 cases. 5. Treatment was as follows: Conservative treatment 4 cases Surgery 21 cases.
Clinical Study ; Femur ; Fractures, Spontaneous ; Humans ; Incidence ; Osteomyelitis ; Seoul

The instability of the degenerative spondylolisthetic lumbar spine was clinically evaluated by patients symptoms and serial radiograms. With X-ray films of patients lumbar spine, the lumbosacral angle, the sacral angle, the vertebral height difference between anterior and posterior surface of the 5th lumbar vertebra and the level of intercristal line were analysed. And the results of treatment were analysed too. The Results were as follows: 1) In degenerative spondylolisthetic L3 and L4 spines, facets were arranged in sagittal plane and sacrum was vertically arranged, but in L5 facets were coronally arranged and sacrum and in horizontal plane. 2) The lumbosacral angle was 149.9 and the average difference between anterior and posterior height of L5 vertebral body was 3mm. These results revealed that sacrum was more vertical and the 5th vertebral body was more rectangular, so lumbar lordosis was decreased as a whole. 3) The intercristal line was passed at IA or L4–5 interspace in 72.1% of cases(normal:95.8%), so L4 vertebra was placed in higher level. 4) In group A posterolateral fusion was done in 2 cases. Among group B and C, operation was done in 9 cases;4 cases with laminectomy and 5 cases with laminectomy and posterolateral fusion. Two years after surgery, slipping and instability were far advanced in 2 laminectomized cases for whom posterolateral fusion was followed later. 5) Unstable group of degenerative spondylolisthesis with severe neurological symptoms and claudication must be treated by decompressive laminectomy and posterolateral fusion, especially in patients under 60 years of age. 6) Young woman having flattened lumbar curve without slipping, narrowed disc space of L4–5, high-seated L4 and vertical sacrum is thought to be in prespondylolisthetic stage of degenerative origin; therefore, intensive back muscle exercise to prevent the slipping should be performed and periodic X-ray examinations should be followed up to detect the progress of the disease.
Animals ; Back Muscles ; Female ; Humans ; Laminectomy ; Lordosis ; Sacrum ; Spine ; Spondylolisthesis ; X-Ray Film

No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

No abstract available.
Esophageal Perforation* ; Intubation, Intratracheal*

Experiment of electrical stimulation using direct current on the tibia of normal adult rabbits was performed for the duration of 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, and 8 weeks. The cathodic electrode, Teflon coated Kirschner wire used in clinical work was introduced into the medullary cavity of the proximal tibia from the tibial tuberosity and the anodic electrode was introduced transversely in the metaphysis of distal tibia on the same side. Twenty micro-ampere of direct current was passed continuously through the fixed wires between the proximal and distal tibia on left side. At the end of first week, second week, third week, fourth, sixth, and eighth week, anodic and cathodic electrode were removed and animals were sacrificed and tibia was obtained for specimen, and then X-rays were taken, and the specimens were decalcified and stained with hematoxylin and eosin. The new bone formation in the medullary canal were measured by the degree of filling in the marrow canal as percentage by the point counting method. The results were as follows. First, Endosteal new bone formation is a main feature, and also periosteal reaction was noted in 27 % of cases. Second, In the first week group, new bone formation is minimal and difference between groups, that is, second, third, fourth, sixth and eight week group, the degree of new bone formation is statistically insignificant. Therefore possibility of short term electrical stimulation of duration of two week or four week is contemplated clinically.
Adult ; Animals ; Bone Marrow ; Electric Stimulation ; Electrodes ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Methods ; Osteogenesis ; Polytetrafluoroethylene ; Rabbits ; Tibia