A case of pathological hip dislocation in a child, aged 2 years 6 months, who had surgical treatment, is reported. The boy has history of osteomyelitis of right ilium at age of 10 month, which ended up with the right hip dislocation. Postoperatively cephalocotyloid relation of the right hip was very well reestablished during five years of postoperative observation. Through this case, it is reconfirmed that a child hip has a natural remodelling power even in case of hip joint destruction.
Child ; Dislocations ; Hip Dislocation ; Hip Joint ; Hip ; Humans ; Ilium ; Male ; Osteomyelitis

Congenital pseudarthroses and non-unions have been recognized as some of the most challenging problems in orthopaedic surgery. with a standard surgical procedure, such as bone grafting, nailing, plating or a combination of these, it was frequently failed to unit. After repeated surgical failures, amputation has been the main course. With the advent of an electrical control of osteogenesis, however, this dismal outlook is brightening. The earliest report of the use of electrical energy to directly stimulate bone healing seems to be in 19th century, but it was not reliable. In this century, the electrical properties of bone were first described by Yasuda et al in 1953. After then, several investigators have shown that the application of small amounts of the electrical current to bone stimulates osteogenesis at the site of the cathode. Clinical trials using various froms in the treatment of delayed union, non-union, and congenital-pseudarthrosis began early in the 1970's. Constant direct current, pulsed current, and electromagnetically induced current have all been used clinically to heal bone defects with varying degrees of success. But, to-this date it is unknown what is the mechanism of stimulating bone healiag with electricity, and which from of electricity is most efficient in stimulating osteogenesis. We have experienced direct current stimulation to promote osteogenesis in 9 cases of non-union and 4 cases of congenital pseudarthses of the tibia from august, 1978 to december, 1980. Of 9 non-unions, 7 (77.8%) achieved solid bony union. We had obtained bony union in 4cases of non-union only with the electrical stimulation. In 4 cases of congenital pseudarthses of the tibia, all cases achieved solid bony union with the electrical stimulation and bone graft, but in 3 cases, refractures were occurred. At this moment, our conclusions from this study are as followa. I. Direct current stimulation is one of the reliable methods inducing ostengenesis. 2. Regular follows-up and determination of the stimulator integrity are essential steps in the electrical stimulation. 3. Combined treatment with the electrical stimulation and bone graft have markedly improved the success rate. 4. In direct current stimulation of congenital pseudarthsis, the mechanically sound bony alignment, massive bone graft and protection using long leg brace seem to be mandatory procedures.
Amputation ; Bone Transplantation ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Humans ; Leg ; Magnets ; Osteogenesis ; Pseudarthrosis ; Research Personnel ; Tibia ; Transplants

No abstract available.
Diagnosis* ; Osteoma, Osteoid*

The experience of a replacement surgery of ankylosed elbow joint by the Shiers chrome-cobalt hinge prosthesis is introduced with a brief review of literatures.
Arthroplasty ; Elbow Joint ; Elbow ; Prostheses and Implants

To evaluate the effect of a new topical anesthetic cream (EMLA : Eutectic mixture of local anesthetics) on reducing pain associated with DPT vaccination, we conducted a clinical observation on eighty infants who were brought to well baby clinic of Yeungnam University Hospital for DPT vaccination. 80 Infants, who were between 2 months and 8 months in age, were divided into two groups. EMLA treated group and control group. Male to femle sex ratio was 1.4 to 1. EMLA cream was applied 60 minutes before DPT vaccination, the effect of reducing pain was assessed by using McGrath's face scale, Oucher pain scale and modified behavioral pain scale (MBPS) and also evaluated by measuring the duration and time of crying (the time of the first crying after iniection, duration of the first crying, total duration of crying). The scores of those scales were lower in EMLA treated group than in control group significantly (P<0.01 in McGrath's face scale. MBPS and p<0.05 in Oucher pain scale). There was no difference in the time of the first crying after vaccination in both groups. The duration of the first crying was shorter in EMLA treated group than control group of crying was also shorter in EMLA treated group (EMLA treated group 9.0±12.5 sec, p<0.05). Transient skin erythema was noted in 5 infants after EMLA application, but no other adverse effects were observed. We conclude that the application of EMLA cream before vaccination seems to be an effective and safe way to reduce the pain from vaccination, but it takes usually 60 minutes to get the anesthetic effect of EMLA and it is expensive, so EMLA cream can not be recommended in routine vaccination in infants now.
Anesthetics ; Crying ; Erythema ; Humans ; Infant ; Male ; Sex Ratio ; Skin ; Vaccination* ; Weights and Measures

A new balloon dissector, a modification of a Foley catheter, was devised and it can be used either as a dissector or a tissue expander. Since most operating time was spent in balloon manipulation (inflation/deflation), the duct for saline injection was made to be wider than the Foley catheter. As a result, the balloon could be inflated faster than before. In order to reduce the scar at the donor site, harvest of the sural nerve using endoscopic technique is currently applied, but utilization of this method is technically difficult and requires a long operating time. For these reasons, new our method of using a balloon dissector was devised. The balloon dissector can also be used for immediate intraoperative tissue expansion for the reconstruction of small skin defects without distortion. We have found that the advantages of using the new balloon dissector include a reduction in operating time, preservation of the perforating vessels, and primary closure with less tension. In addition, this simple and inexpensive instrument is cost-beneficial to patients.
Catheters ; Cicatrix ; Humans ; Skin ; Sural Nerve ; Tissue Donors ; Tissue Expansion ; Tissue Expansion Devices

No abstract available.
Animals ; Cats* ; Laminectomy* ; Spine*

No abstract available.
Bone Matrix* ; Rabbits*

Authors presented the gratifying result of treatment of chronic osteomyelitis with overlying skin defect and/or poor skin condition, which developed the wide skin necrosis after saucerization and resulted the second skin graft necessary. Five cases were treated by primary extensive saucerization of tibia which left a cavity with bleeding walls. The exposed bony surface with bleeding walls was covered by delayed free skin graft when the good granulation covered the bony surface. Through this experience, delayed free skin graft is justified the best procedure in these cases to cover the post-surgical raw bone surface and to have primary healing of the bone infection. A method of hemicylindrical pedunculated skin graft to obliterate the deeply excavated surgical bony defect is introduced.
Hemorrhage ; Methods ; Necrosis ; Osteomyelitis ; Skin ; Tibia ; Transplants

Ultrasonography is suited for screening patients with a mass in the soft tissue because of its safety, low cost, apparent sensitivity and non-invasiveness. But the application in orthopaedic surgery is insufficient. Authors examined 102 patients who had a palpable soft tissue mass of extremities and trunk with ultrasonography. Location, internal echogenicity, margin, and extent of soft tissue involvement, especially neurovascular bundle by tumor were evaluated. The diagnosis of mass was confirmed by histopathology after excision or biopsy of the mass. The ultrasonography correctly identified and differentiated the cystic lesions of 34 cases. The sonograms of all 16 malignant lesions showed ill-defined margin and heterogenous internal echo. The extent of soft tissue involvement, especially neurovascular bundle was confirmed exactly with ultrasonography. Therefore, in malignant tumor, after confirmation of no neurovascular involvemment with ultrasonography, limb-salvage operation could be considered and planned. In one case of abscess, percutaneous biopsy was done under guidance of ultrasonography. Therefore, ultrasonography can be used as a guide for percutaneous biopsy without exposure to radiation.
Abscess ; Biopsy ; Diagnosis ; Extremities ; Humans ; Mass Screening ; Ultrasonography