Forearm bone fractures are difficult to manage, because of their special functions (pronation and supination) and peculiar anatomy. Authors have experienced 68 cases of various types of forearm bone fractures from January, 1968 to December, 1971. They were analized as following. 1. Out of 68 patients, males were 54 cases (79.4%) and females were 14 cases (30.6%). Among them, 91.2% of the cases were occured in people over 15 years old. About 47% of the cases were caused by automobile accidents. 2. Both forearm bone fractures were 51 cases (75%), and most common site of the fractures were mid 1/3(66.2%). Stable (transverse or incomplete) fractures were 24%, and unstable(comminuted, segmental, oblique or spiral) fractures were 76%. Open fractures were 26.5% 3. Conservative treatment was given to 41 cases (60.3%), and open reduction & internal fixation was given to 27 cases (39%). 4. A comparison has been made between the groups treated by conservative method and open reduction & internal fixation. 1) Average healing time of open reduction group was 19.5 weeks and conservative group was 16.4 weeks. 2) Non-union was occured in 7.4% of conservative treatment group, and 22.7% of open reduction group. 3) Satisfactory functional results were shown in 23.5% of conservative group and 54.5% of open reduction & internal fixation group. 4) Rotational deformities were noticed in 53.3% of the conservative treatment group and 54.5% of the open reduction group (No difference was noticed). 5) Angulatory deformities were shown in 70.4% of the conservative treatment group and 44.4% of the open reduction group. 5. Three cases were complicated by cross unoin, and no postoperative wound infection was noted. But two cases of open fracture developed to chronic osteomyelitis.
Automobiles ; Congenital Abnormalities ; Female ; Forearm ; Fractures, Bone ; Fractures, Open ; Humans ; Male ; Methods ; Osteomyelitis ; Surgical Wound Infection

No abstract available.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis

It is socially fortunate that there is little chance in the civil hospital to experience the victims of high velocity missiles. However it is reasonable thought to educate doctors about the gunshot and explosive injuries who might be mobilized in emergency condition. Authors have experiences to treat the high velocity missile wounds. In order to provide valid data to be an educational material, we clinically analyzed 41cases of those injuries who were treated at the Capital Armed Forces General Hospital from 19xx to 19xx. The results obtained were as follows: 1. In 15 cases there were only soft tissue injuries, The remaining 26 cases had the bone injuries and six of them had two injury sites. 2. In 28 cases the lower extremities were injuried, and they out-numbered the injury of upper extremities. The most frequent site of injuries was the thigh (31.7%). 3. Most common associated injuries were the periphenal nerve injuries, which numbered 10 cases. 4. The early operative treatments were given in 5 out of 32 cases having bone injuries. And the secondary operations, including bone graft and intemal fixation, had to be done in 10 out of the remaining 27 cases due to delayed union or nonunion. 5. There was no infection in cases having only the soft tissue injuries. But the localized osteomyelitis occurred in 4 cases among the cases having bony injuries. 6. Factors affecting the result of high velocity missile wounds were presence of bony involvement, site and extent of injuries, associated thoracoabdominal injuries and presence of peripheral nerve injuries and infection. 7. The evacuation time, chance of early adequate wound management, site of injury and extent of injury were the important factors in deciding the method of treatment. We suggest that the more selective and aggressive measures should be taken in the management of bony injuries.
Arm ; Emergencies ; Extremities ; Hospitals, General ; Lower Extremity ; Methods ; Osteomyelitis ; Peripheral Nerve Injuries ; Soft Tissue Injuries ; Thigh ; Transplants ; Upper Extremity ; Wounds and Injuries

No abstract available.
Accidents, Traffic* ; Aggression*

No abstract available.
Hepatic Veins*

No abstract available.
Breast Neoplasms* ; Breast*

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane

Biopsy has proved to be of value in the diagnosis of many inflammatory and malignant diseases, and needle biopsy of the synovial membrane in arthritis is well established and often employed as the final diagnostic aid in patient with joint disease. Authors have carried out synovial needle biopsy in 76 joints with Franklin-Silverman needle used commonly in liver biopsy. The results obtained were as followa; 1) Of seventy five biopsies attempted, adequate amount of tiasue was obtained in 51 of 53 knee cases (96.2%), 11 of 14 wrists (78.6%). 3 of 5 elbows (60%), 1 of 3 ankles (33.3%). Adequate amount of tissue was obtained in 66 cases and the overall succese rate was 88%. 2) Histopathological diagnosis was made in 53 of 75 cases (70.7%). In 12 cases, correct specimens were obtained but proved to be incompatible with the diagnosis done by either clinical data or open biopsy. 3) Histopathological diagnoses were made in 25 of 35 cases of rheumatoid arthritis (71.4%) 14 of 18 cases of tuberculous arthritis (77.8%), 7 of 13 cases of degenerative arthritis (53,8%), 4 of 6 cases of suppurative arthritis (66.7%), 2 cases of traumatic arthritis (100%), and one case of villonodular synovitis (100%). 4) The complications resulting from this proedure were pare; mild transient hemarthrosis was found in only 5 cases We also discovered that for an accurate diagnosis multiple specimens should be obtained because otherwise the specimens were too small to interprete histopathologically. In addition we concluded that the success rate depended not upon the sorts of needle used but rather more upon the biopsy technique. Franklin-Silverman needle biopsy proved to be a simple, safe and reliable procedure for diagnosis of the synovial diseases in which conventional arthrotomy is inadvisable and other diagnostic procedures are inadequate.
Ankle ; Arthritis ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Diagnosis ; Elbow ; Hemarthrosis ; Humans ; Joint Diseases ; Joints ; Knee ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane ; Synovitis ; Wrist

The tibial fracture apt to be encountered many complicationa including delayed or non-union. Many authors reported aeveral methods of early detection of the complication. Among them, it has been known that interoeseous phlebography is one of the simplest and valuable method to predict the delayed or non-union. Puranen and Kaski(1974) reported that the osteomedullography was valuable in early detection of delayed union and in deciding whether a bone graft is indicated. We performed ostemedullogram in the cases of tibial fracture since July, 1974. In this paper, we presented the caaes which showed unusual findings, and dicussed the method of evaluation of these findings. The results obtained as follows; 1. The positive Kaski signs did not always mean the completness of union of fracture. It only indicated that the union was going on. 2. Even in cases in which Kaski signs are positive, the final decision for bone graft have to depend upon the clinical and physical findings and simple roentgenogram. 3. The negative Kaski signs did not always mean the possible development of delayed or non-union. Usually it indicated only delaying of union, and the treatment should not solely depend on only the osteomedullographic findings. 4. Even in cases in which bridging callus is well formed around both fracture ends, also in cases of solidly united fracture Kaski signs were sometimes completely negative. This osteomedullography is clinically easily to apply in all cases of tibial fracture, and give us a lot of information concerning with fracture healing. We have to pay attention to the false nagative cases. In those cases we have to depend more on clinical test and simple roentgenogrm.
Bony Callus ; Fracture Healing ; Methods ; Phlebography ; Tibial Fractures ; Transplants

Two cases of acquired absence of forearm bone secondary to compound comminuted fractures were treated by reconstructive surgery, which consist of surgical construction of one-bone forearm. The results of treatment were referred and the review of the literature was done concerning about surgical reconstruction of one-bone forearm.
Forearm ; Fractures, Comminuted