No abstract available.
Femur Neck*

The treatment of open tibial fracture has become one of the most controversial subjects in orthopedic surgery. Recently flexible intramedullary nails have been used successfully in treatment of Type I, II open fractures of the tibial shaft. In this paper we are reporting our experience with the method in 20 open fractures of the tibia in 18 patients. The results were ss follows. 1. The patients were predominantly more common in male(90%) and the average age was 42.7 years old and the most common cause of fracture was traffic accident. 2. The most common site and shape were at midshaft and comminuted fracture. 3. With early operation the incidence of infection was greatly reduced and wound healing was relatively rapid. 4. The patients were applied with long leg or P.T.B. cast for at least 4 weeks in order to the prevention of re-displacement. 5. The average healing time was 17.7 weeks in 14 cases and union was most rapid at upper third and Type I fractures. 6. The complication was developed in 14 cases, 3 cases of delayed union, nonunion and ankle stiffness was seen respectively. 7. Infection rate was greatly reduced because Ender's nailing procedure was easy to perform, operation time was shortened, good fixation and alignment of fracture fragment was done without periosteal stripping. 8. Ender's nailing is considered to be a good method in the treatment of open tibial fracture associated with soft tissue injurv and multiole iniuries.
Accidents, Traffic ; Ankle ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Leg ; Methods ; Orthopedics ; Tibia ; Tibial Fractures ; Wound Healing

No abstract available.
Femur*

Fracture of the femur during total hip arthroplasty presents the simultaneous problems of prosthetic stability and fracture treatment. The treatment of such fractures can be complex and is one of the major challenges and this complication is associated with a high morbidity and a significant delay in convalescence. Among the 237 cases, who were treated by cementless total hip arthroplasty from Jan. 1986 to Dec. 1992, 13 cases of femoral fracture were experienced. They usually occured during insertion of prosthesis and preparation of the medullary canal. There were 6 cases of type II fracture, 1 case of type III fracture, 5 cases of type IV fracture and 1 case of type V fracture according to AAOS classification. All of the fracture healed, but the prognosis of these cases must be determined by follow up. We recommend that femoral fractures can be prevented by accurate preoperative evaluation of the size of the femoral canal, identification and management of the predisposing factors for intraoperative fractures.
Arthroplasty, Replacement, Hip ; Causality ; Classification ; Convalescence ; Femoral Fractures ; Femur ; Follow-Up Studies ; Prognosis ; Prostheses and Implants

PURPOSE: To evaluate the treatment results of geriatric intertrochanteric fractures by using Asian-Pacific Gamma nails. MATERIALS AND METHODS: From June 1994 to June 1997, 58 cases of the intertrochanteric fractures were treated with Asian-Pacific Gamma nail, particularly compression hip screw fixation complications such as communited fracture involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, and studied complications and intraoperative cautions. RESULTS: The average age was 74.4 years old, the mean duration of follow-up was 17 months, the mean duration of bone union was 14.2 weeks, the average neck-shaft angle was postop. 133+/-2.78 degree and last follow-up was 129.5+/-3.37 degree, and the average lag screw sliding was 4.7+/-3.16 mm. Intraoperative complications were difficulty in distal drilling (posterior drilling) in 4 cases, fracture displacement by nail insertion in 3 cases, and postoperative complications were coxa vara in 13 cases, superior cutting out of lag screw with nonunion in 1 case and superficial infection in 1 case. The entry portal must be formed by awling. The fracture displacement when inserting nail could be prevented by proper reaming after inserting the C-shaped guide pin, and posterior drilling could be avoided by confirming the locking between target device and nail. CONCLUSIONS: We conclude that the Asian-Pacific Gamma nail could appropriately treat the osteoporotic, communited intertrochanteric fracture in elderly patients and we obtained satisfactory results.
Aged ; Coxa Vara ; Femur* ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Intraoperative Complications ; Postoperative Complications

No abstract available.
Spine*

Authors reviewed 42 fractures of distal tibia fixated with Ender nails(24 cases) or Interlocking nails(18 nails) at the Chosun university Hospital from 1986 to 1992. The purpose of this study is to compare the bony union, the complications and the functional results of two groups(Ender nailing group and Interlocking nailing group). The follow-up period was average 19 months(range, 12 to 36 months). The results were as follows 1. The most common causes of the injury were traffic accidents(36 cases). 2. In the Ender nailing group, 8 cases are closed fractures and 16 cases are open fractures. Among 24 cases, 14 cases are simple fractures and 10 cases comminuted fractures. In interlocking nailing group, 7 cases are closed fracture and 11 cases are open fractures. Among 18 cases, 8 cases are simple fractures and 10 cases are comminuted fractures. 3. The average radiologic union was obtained at 19.3 wks in Ender nailing group, and 18.1 wks in interlocking nailing group. 4. Major complication was a delayed union in both group(5 cases-Ender nailing group, 3 cases-Interlocking group). 5. According to the criteria of functional results by Klemm and Borner, we obtained a 87.5% of Excellent and good results in Ender nailing group(21 out of 24 cases) and 94.4% of Excellent and good results in Interlocking group(17 out of 18 cases). 6. There was no significant difference between the two groups in stable fractures of distal tibia, so we suppose that Ender nailing is a good technique in these cases due to its simplicity and the economic price. But in more unstable fractures such as long oblique, spiral and comminuted fractures, we think that intramedullary interlocking nailing is better due to its stability.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Tibia

No abstract available.

Proliferating trichilemmal tumor is a relatively uncommon tumor which develops preferentially as a solitary tumor on the scalp of elderly women. Histologically, the tumor i epresents a proliferation of the outer root sheath epithelium in a characteristic pattern, but the presense of cellular atypia, dyskera.totic cells and mitotic figures may lead to a false impression of squamous cell carcinoma. We report a case of proliferating trichliemmal tumor in a 70-yeiir-old male who presented with a slowly growing tumor on his right inguinal area for 2 years. This case is unusual in that the tumor occurred on the inguinal are anoher than the scalp in a male.
Aged ; Carcinoma, Squamous Cell ; Epithelium ; Female ; Humans ; Male ; Scalp

Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears