The treatment of the established compartment syndrome in the forearm varies along the degree of the severity. We reviewed 17 cases of the established compartment syndrome in the forearm treated at Seoul National University Hospital from February 1979 to July 1985. Follow-up was performed more than one year in 14 cases. And the mean follow-up period was 30 months. Out of 17 cases operated on, mild involvement were found in 5 cases. Moderate and severe involvements were observed in 6 and 6 cases respectively. Tenolysis-tendon lengthening was done for 7 cases and proximal release (muscle-sliding operation) was performed in 8 cases. In two cases, living muscle and skin were transfered using microsurgical technique. In mildly to moderately affected, functional improvements can be obtained in most cases. The proximal release was superior to the tenolysis-tendon lengthening in this category of involvement. However, in severely involved group, the functional gain after the operation is slight in spite of the time consuming, difficult surgery including free muscle transfer. The neurological problems could be gradually improved without treatment in almost all cases.
Compartment Syndromes ; Follow-Up Studies ; Forearm ; Seoul ; Skin

The beneficial effect of the longitudinal traction-either halo-femoral or halo-pelvic and the anterior spinal fusion in some spinal disorders is well documented. This paper is a report of a patient who is suffering from spine tuberculosis with severe kyphosis and incomplete paraplegia. He was treated satisfactorily by applying a Crutchfield tong-femoral traction for four weeks followed by anterior spinal fusion. It is authors concept that the early cases of the active spine tuber-culosis with advancing kyphosis can be effectively treated by using the above mentioned method without introducing more complicated combination of the spinal osteotomy, halo-pelvic distraction and spinal fusion.
Humans ; Kyphosis ; Methods ; Osteotomy ; Paraplegia ; Spinal Fusion ; Spine ; Traction ; Tuberculosis

258 feet of patients with flatfoot were evaluated in this paper. The incidence of flatfoot is about 0.6% of the general population. The longitudinal arch was depressed in all of our cases of flatfoot, and there have been many patients suffering from pain after some kinds of heavy work. But there were no definite correlations found between the depression of the longitudinal arch and clinical symptom. The sag in the naviculo cuneiform joint is the most common X-ray finding in this series (93%), followed by the talo-navicular sagging (27%), Degenerative arthritis of the inter-tarsal joints was frequently found after the adolescent period. The talo-navicular joint was involved in arthritic changes in 60% of the cases, the subtalar joint 46% and the naviculo-cuneiform joint 42%. The prevalence of these changes was not increasing with the increasing age, so it is poatulated that the degenerative changes begin early in adolescent period. Accessory tarsal bones were more frequently seen in patients with flatfoot than in normal population. and the neck of the talus was usually deviated inferomedially. Now that the arthriric changes are very prevalent in the triple joints, there are many cases of flatfoot that should undergo the triple arth odesis inevitably if his conservative treatment was failed.
Adolescent ; Depression ; Flatfoot ; Foot ; Humans ; Incidence ; Joints ; Neck ; Osteoarthritis ; Prevalence ; Subtalar Joint ; Talus ; Tarsal Bones

Camptodactyly is a non-traumatic flexion deformity of the PIP joint of the digit (except thumb) and one of rare congenital anomalies of the hand. It may be a clinical manifestation of some other syndrome and may not be a disease of its own right. It is very difficult for this particular problem to get satisfactory results. We analysed 36 digits of 19 patients, whom we treated and followed up for an average of 1.7 years from 1982 to 1988 at the Department of Orthopedic Surgery, Seoul National University Hospital. The following results were obtained. 1. Male to Female ratio is 8: 11 and age ranged from 14 months to 32 years old. 2. Unilateral and single digit involvement is twice more commonly found than bilateral and multiple digit involvement respectively. 3. Third digit is the most frequently involved one in our series. 4. Besides soft tissue contractures on the volar aspects of the PIP joints, other pathologic findings are thick reddish glistening palmar skin in 6 patients, tendon problems in 4 patients and bone-joint hypoplasia in 1 patient. 5. We have done 3 types of operation, that is, skin graft, flexor tenotomy with skin Z-plasty, extensor reconstruction with flexor tenotomy and skin Z-plasty. The results of operations ranged from good to poor, however most cases showed above fair results at the final follow-up. 6. Camptodactyly seems to be a disease of various etiologies and pathologies. And it is strongly suggested that the treatment of this syndrome should be individualized according to their pathologies found at surgery.
Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Hand ; Humans ; Joints ; Male ; Orthopedics ; Pathology ; Seoul ; Skin ; Tendons ; Tenotomy ; Transplants

Twenty-seven patients with congenital constriction band syndrome were treated at department of orthopedic surgery, college of medicine, Seoul National University between 1981 and 1989. In order to obtain basic and fundamental information about this syndrome, we have analyzed the clinical records of those patients who were treated at our hospital with above syndrome. Analysis was based on the age at operation, sex distribution, familial history and past-medical history, prevalent sites of constricition bands, associated anomalies and methods of surgical treatments. The results were summarized as follows: l. Average age at operation was 9.3 months and the ratio of sex was 3:2 as male predominant. 2. There was no case with familial history of this syndrome, and serious medical problems of patient's mothers during pregnancy were not experienced except 4 cases who took some medication for URI. 3. The frequency of constriction band was greater distally than proximally, and 91% of these bands were noted distal to knee and elbow joint. 4. About 85% of cases were associated with other anomalies, and among them syndactylism and acral absence were most frequent. 5. For the simple constriction ring, staged excision of the ring and z-plasty of the defects seemed to be a most agreeable recommendation. And other associated anomalies of digits could be treated with combined procedures such as seperation of digits, web construction, transposition of ray, lengthening of digit, skin graft, corrective osteotomy, etc.
Clinical Study ; Constriction ; Elbow Joint ; Humans ; Knee ; Male ; Mothers ; Orthopedics ; Osteotomy ; Pregnancy ; Seoul ; Sex Distribution ; Skin ; Transplants

Acute unstable tibial shaft fractures are common in these days of high energy trauma. There are many options for this common and complicated fracture. Flexible intramedullary nailing using closed technique is prevalent in that this has much technical, functional, and physiological advantages. We reviewed 51 cases of acute tibial shaft fractures treated with flexible intramedullary nailing. There were 3 nonunions (6%), and two refractures. Among 46 united cases, 8 cases (17 %) showed no bridging callus formation within 20 weeks. Followings are the results of average time reaching each of radiological bony progression stage for 46 united cases. l. Average time to earliest discernible callus formation (stage I) was 13.3 weeks (range:8-21 weeks). 2. Average time to definite and bridging callus formation (stage II) was 18.1 weeks (range:8-32 weeks). 3. Average time to some oblitetation of fracture line (stage III) was 32.8 weeks (range:17-50 weeks). 4. Average time to complete obliteration of fracture line (stage IV) was 14.0 months(range:12-18 months).
Bony Callus ; Fracture Fixation, Intramedullary ; Tibia

Five cases of osteogenesis imperfecta are reported, and the available literatures concerning to its clinical pictures and treatments are reviewed.
Osteogenesis Imperfecta

Fifty seven consecutive trochanteric hip fracture treated with Smith-Petersen nail and Thornton plate who were treated at the Department of Orthopedic Surgery, St. Marys Hospital Catholic Medical College, during the period of January 1969 to September 1975 were reviewed. This covered a period of six years and nine months. Of the fifty seven cases treated with this method, only thirty four cases were able to be analysed completely. Of these thirty four cases, in two cases the nail penetrated to the hip joint, four cases showed a loosening bolt of the S-P nail, one case involved a delayed union and three cases resulted in malunion, showing a total failure rate of 29.4%. In addition, four cases of intertrochanteric hip fractures of children were reviewed. 1) The sex ratio was 2.1:1 (male to female). Those in their fifth decade showed the highest incidence at 26.3%, next came those in their third decade. 2) The most common cause of the trochanteric hip fractures was traffic accidents (57.9%), other cause were slipping or falling down, direct trauma and pathological fractures. 3) The ratio of left trochanteric hip fractures to right was 7:6. 4) In the group which received external immobilization with Buck's extension skin traction and delayed weight bearing method, the results were better than that group to which external immobilization was not applied and early weight bearing was allowed. 5) The group which received the external immobilization and delayed weight bearing method showed a total failure rate of 21.8% 6) The group to which external immobilization was not applied and early weight bearing was allowed a total failure rate of 64%.
Accidental Falls ; Accidents, Traffic ; Child ; Clinical Study ; Femur ; Fractures, Spontaneous ; Hip ; Hip Fractures ; Hip Joint ; Humans ; Immobilization ; Incidence ; Methods ; Orthopedics ; Sex Ratio ; Skin ; Traction ; Weight-Bearing

In the chronic osteomyelitis of the ilium the infection is often so diffuse that removing all sequestra and small cavities are practically impossible. Either the partial or total resection of the ilium has been thought as a standard method of treatment in these situations. According to authors experience, the partial resection is not sufficient for removing such diffuse lesions, and all the patients that underwent the total resection of the ilium have been suffering from the instability with severe Trendelenburg gait because of the loss of the abductor origin. These results are far from a satisfactory one in modern orthopedic field in which many reconstructive surgeries have been done for the disabled patients. Removal of only one cortex followed with the closed suction irrigation technique are applied in three cases. The result of this operation is as good as that removing the total ilium in controlling the infection, and there are no patients who are suffering from the gait disturbance. The inner or outer cortex could be safely and widely removed without affecting the hip joint of the affected side.
Gait ; Hip Joint ; Humans ; Ilium ; Methods ; Orthopedics ; Osteomyelitis ; Suction

In order to determine the beneficial or detrimental effects of motion on fracture healing, rabbits femora were fractured surgically and each fracture was immobilized with a apecially designed external skeletal flxation device, which permitted a controlled spontaneous angulatory motion. in the first control group no motion was permitted; in the second group 5 degrees, and in the third group 10 degrees of angulatory motion was permitted. At 7th post-operative week, the bony union rates were 79%, 93%, and 54% In the first, second and third groups, respectively. Radiographically, the fractures were united most sufficiently in the second group. The ultimate bending load was signlficantly greater In the second group than the control but no significant differences were observed between the other groups. The ultimate bending stress and the modulus of elasticity were significantly greater ln the second group than the control and the third group, but no signlficant dlfferences were observed between the control and the third group. Fracture healing was significantly enhanced in the second group as compared to the control and the third group. It is suggested that a certain amount of motion at the fracture site enhances fracture healing, while excessive motion hinders it. Such enhancement seems to be related with the motion itself, and not wlth the muscle or jolnt function, since the rabbits Included in this study permitted the spontaneous full weight bearing which also permitted near normal muscle and joint function.
Elastic Modulus ; Fracture Healing ; Joints ; Rabbits ; Weight-Bearing