Dislocation of the elbow joint is so frequent an injury, and its treatment so standardized, that most of the recent orthopaedic study devoted to the subject has focused on neurovascular complication or recurrent dislocation. Some authors reported minimal period of disability and better range of extension after three to five days short-term immobilization in simple acute dislocation. We, authors, had analyzed clinically 17 cases of acute dislocation of elbow joint who were treated at orthopaedic department of Catholic Medical College from Jan., 1978 to Dec., 1981. The results obtained were as follows: 1. The most prevalent age were second and third decades (76.5%). Males predominated by a ratio of 13:4. 2. The major mode of injury was slip down accident (58.8%). All cases were acute simple dislocation without open wound. 3. Posterolateral, dislocations were 13 cases (76.5%) and posterior dislocations were 3 cases (17.6%). These two type of dislocation were 94.1% of all cases. No anterior dislocation was noted. 4. Four fractures of radial head and one fracture of lateral epicondyle of humerus were seen. Associated fractures were noted in 29.4% of all cases. 5. Severe complication was none except one recurrent habituai dislocation and limitation of elbow extension, averaging 10.5 degrees, 6. In 9 cases which were immobilized for 3 to 5 days had an average loss of extension of 6 degrees and an average of 7 weeks of disability. In 7 cases which were immobilized for 3 weeks had an average loss of extension of 18 degrees and an average of 18.3 weeks of disability. Therefore, immediate reduction and 3 to 5 dhys of immobililization is excellent treatment for uncomplicated dislocations.
Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Head ; Humans ; Humerus ; Immobilization ; Male ; Wounds and Injuries

No abstract available.
Fracture Fixation* ; Mandibular Fractures*

A large mass as a sign of an infection is rare, and it might convince a physician that it had the appearance of a malignancy. The patient in this case visited our clinics after attending several hospitals, with a mass that had the appearance of a malignancy, based on the severe destructive findings observed on plain radiographs. We report the first documented case of a patient with a large mass (12×7×20 cm) and a low-grade infection, which developed at the proximal thigh after a hip arthroplasty. It is important to realize that an infection accompanied by a large mass, can mimic a highly destructive malignant lesion on plain radiographs.
Arthroplasty* ; Hip* ; Humans ; Thigh*

Tuberculous spine has high incidence in children. Many cases of the tuberculous spine are complicated by deformities of the spine and disability such as paraplegia, cardio-plumonary dysfunction, and also early death. There are now several reports on the pulmonary dysfunction due to spinal deformities such as scoliosis and kyphoscoliosis, but there are few papers on the pulmonary function of patients with the tuberculous spine and kyphosis in children. This article is a report on the study of chest excursion in 70 kyphotic children and of the pulmonary function in 10 cases of severe kyphotic patients with collapsing tuberculous spine. The following results are obtained through the study: 1) Chest excursion was evidently diminished in the cases of moderate and severe thoracic, and severe lumbar involvement. The remainders were nearly within normal limits. 2) The study revealed that the chest excursion and the radiological kyphosis has a very gradually sloped negative correlation in thoracic involvement. 3) Pulmonary function in the severe kyphotics who had the curve over 50 degree were revealed as follows; a) Over 50 percent of the cases had diminished vital capacity. That is, over-all average was 67.7 percent of normal capacity. Especially inspiratory reserve volume was diminished, it was 63.7 percent of normal. Maximum breathing capacity was 68.8 percent of normal. b) Tidal volume, timed vital capacity, minute ventilation rate and O2 consumption were within normal limits or nearly normal.
Child ; Congenital Abnormalities ; Forced Expiratory Volume ; Humans ; Incidence ; Inspiratory Reserve Volume ; Kyphosis ; Paraplegia ; Respiration ; Scoliosis ; Spine ; Thorax ; Tidal Volume ; Ventilation ; Vital Capacity

Tuberculosis of the spine still remains as an important problem and also have high incidence in children in Korea. Many cases of the tuberculous spine are complicated by deformities of the spine and disability such as paraplegia, incordination of the cardio-pulmonary function and also result in early death. For the treatment of the tuberculous spondylitis following measure should be considered. First, eradication of the tuberculous lesion by conservative treatment or combined surgery, secondly, prevention of the deformity of the spine. Lastly, care for physical and psycological or emotional changes, and care for cardio-pulmonary dysfunction which develops after establishment of spinal deformity. Authors also attempted to analyse the kyphotic changes of the tuberculous spine of 70 children who were ambulating treatment at Pusan University Hospital and Pusan Charity Hospital, and obtained the result as follows; 1. Lower thoracic and upper lumbar were mostly involved. Nearly all cases of the new involvement of adjacent vertebra within 18 months. Only 4 cases now involvement occured after 18 months. 3. Kyphosis aggrevated grossly in 61.3% of cases. Most of them were apparent within 18 months but the changes developed after 18 months in 4.23% of cases. 4. In measuring the radiological kyphosis, Salters angle usually more simpler one than the internal gibbus angle. 5. Salters angle was larger involved than the internal gibbus angle except in mild and severe cases of the lumbar and lumbosacral involvement. Increase of kyphosis was 13.6 degree by internal gibbus angle and 16.3% by Salters angle. Kyphosis increased after 18 months were 3.1 degree by internal gibbus angle and 5.0 degree by Salters angle. 6. Radiological kyphosis changed in all stages and at least we should consider the changes of the kyphosis could be measured. 7. By the Kawakamis spinometer, the compensatory curvature, the posture of the patient and state of the kyphosis could be measured. 8. The compensatory curvature measured by Kawakamis spinometer were as follows: a) compensatory curvature in decrement in mild or morderate degree of cases, changed lumbar only or both cervical and lumbar curvature. b) compensatory curvature in increment in severe thoracic involvement changed both cervical and lumbar curvature, or cervical one only, the value in the cervical one was larger than that in the lumbar curvature.
Busan ; Charities ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Korea ; Kyphosis ; Paraplegia ; Posture ; Spine ; Spondylitis ; Tuberculosis

It has been well known that the incidence of delayed or nonunion of tibial shaft fracture is high and in order to improve methods of treatment and to get satisfactory final results in these fractures, it is important to find out as early as possible whether the fracture is healing normally or not. The fracture healing is closely related to the circulatory conditions at the fracture site, however, in contrast to animal experiments it is impossible to visualize directly the circulatory conditions at the fracture site. There have been many efforts to visualize indirectly these vascular re-establishments through angiography. Kaski(1974) reported a paper concerning osteomedullography of tibial fracture with phlebocompression and noticed 5 types of veins related to the process of healing. We performed 54 cases of osteomedullography in 41 tibial fracture at 3 months after treatment and the following results were obtained: 1. The sinusoidal vein in the proximal fragment was observed most frequently and the next were intra-osseous crossing vein, periosteal callus vein, ascending branch of main efferent vein, and periosteal veins of proximal fragment in decreasig frequency. 2. The rate of positive finding in osteomedullography at 3 months after treatment was lower, and periosteal callus veins were observed more frequently in the group treated with only cast immobilization than in the group treated with plate and screws. 3. In the group treated with compression plate and screws, osteomedullographs were positive in all 3 cases within 3 months after operation and sinusoidal veins in the proximal fragment were visualized in all cases, however periosteal callus vein was not visualized at all. 4. After bone graft, the differentiation of periosteal callus from grafted bone was not easy in plain X-ray film, but osteomedullography was very useful in these cases. Positive findings were noticed in 2~3 months in all cases following bone graft. 5. The authors found that the ideal time of performing osteomedullography was 3 months following treatment. If found to be negative after 4 months following treatment, bone graft was necessary.
Angiography ; Animal Experimentation ; Bony Callus ; Fracture Healing ; Immobilization ; Incidence ; Tibial Fractures ; Transplants ; Veins ; X-Ray Film

The authors reviewed 17 patients with radial nerve palsy complicating fracture of humerus who were treated at the Department of Orthopedlc Surgery, St. Mary's Hospital Catholic Medical College, for past 3 years from Jan. 1974 to Dec. 1976, and the following results were obtalned. 1. The ratio of male to female in 17 cases with radial nerve palsy was 4 to 1, and In patients within the first decade the ratio was same (1:1). But those in the 3rd and 4th decade showed high incidence of palsy. 2. Among 113 humerus shaft fractures, 17 cases (15.0%) complicated the radial nerve palsy; among 17 cases the middle shaft fractures were 15, lower 2, none in the upper third. 3. The radial nerve was the most vulnerable to injury at the middle third of the humerus, especially when there was comminution of fracture. 4. The incidence of radial nerve palsy in closed fracture (102 cases) was 13.7% (14 cases), and 27.2% (3cases) in open fracture (11 cases). 5. By early surgical exploration the practlcal cause of radial nerve palsy in 9 cases were found; 2 cases by bruise, 2 by interposition, 2 severance of nerve, one stretching, one impaled, and one unknown. 6. There were no signiflcant correlation between the type of nerve damage and the degree of its recovery, and between duration of paralysis since onset and its prognosis. 7. Of the 17 cases with palsy, complete recoveries were obtained 11 cases, 5 incomplete, and no recovery in one.
Contusions ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Humerus ; Incidence ; Male ; Paralysis ; Prognosis ; Radial Nerve

Patients with rickets frequently are seen by orthopaedic surgeon with complaints of growth disturbance, limb deformity, weakness, and multiple fracture. Among them, bow leg deformity is the most common and difficult orthopaedic problem. In growing child, however, if effective tretment is given sufficiently in early age and early disease process, the deformities usually correct spontaneously and there is little need for orthopaedic treatment other than careful observation. The orthopaedic treatment may be required to correct deformities that cannot be expected to improve with growth. A clinical study was done for 11 cses of rachitic bow leg deformity who were treated at the department of orthopaedic surgery, Catholic medical College and Center from Jan. 1978 to Dec. 1981. Results obtained were as follows: 1. The most common patients age group was in 1 to 2 years of age and there was no sexual difference. 2. Associated deformities with rachitic bow leg were rachitic rosary (5 cases), double wrist (3 cases), coxa vara (1 case), and Harrison's groove (1 case). 3. Low Ca * P solubility product, below the level of 30 (mg/dl)2 suggested active form of rickets in all cases. 4. Laboratory values such as Ca * P solubility product and alkaline phosphatase improved at 3 weeks after administration of vitamin D in 7 cases, 3 at 6 weeks, and no improvement in one case even at 6 months after treatment. 5. Six months after treatment, the average amount correction of tibiofemoral angle was 9° (43.7% of initial angle) in group 1, 13.3° (47.0%) in group II, 4.9° (29.6%) in group III, and 3.3°(25.6%) in group IV. 6. Through this study it is suggested that the more growth correction of the rachitic bow leg deformity in a younger child below the age of 2 is obtained with growth by treatment, whereas a little or no growth correction can be expected after the age of 3 or 4 years.
Alkaline Phosphatase ; Child ; Clinical Study ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Fractures, Multiple ; Genu Varum ; Humans ; Rickets ; Solubility ; Vitamin D ; Wrist

There have been many methods of manual reduction of shoulder dislocation. But each method has its unique complications such as fracture of'humeral neck or shaft as well as vascular and nerve injuries around the shoulder due to excessive pulling and rotation during the maneuver. The present authors devised a method in which the backrest of a chair is used as a fulcrum during manupulative reduction. The dislocated shoulder can be abducted by the backrest rim, when the armpit is placed over the top of the backrest. In this abducted position of the shoulder, minimal adduction force on distal humerus and gentle backward pressure on humeral head are very effective in reducing the anterioly disocated shoulder.
Axilla ; Humeral Head ; Humerus ; Methods ; Neck ; Shoulder Dislocation ; Shoulder

Twenty nine patients who had fracture of tibial shaft were treated with closed Rush nailing and early weight bearing. 1. The average age was 37.8 years (range from 20 to 65), and 21 were men and 8 women. Eighteen cases were open fractures and 11 closed. 2. The time for clinical union was averaging 15.4 weeks. In some cases callus appeared as early as 3 weeks after nailing and in most cases appeared at 8 weeks. 3. Mild angular and rotational deformity of the fractured shaft were developed as complication but did not present any clinical problems. No deep wound infection and pulmonary embolism were encountered. 4. The nails allowed a certain dynamic controlled motion at the fracture site which was probably beneficial to early callus formation. 5. This type of closed nailing method required no medullary reaming, further periosteal stripping and muscle detachment. The allowance of early knee and ankle movements and early weight bearing after surgery could be listed as the advantage.
Ankle ; Bony Callus ; Congenital Abnormalities ; Female ; Fractures, Open ; Humans ; Knee ; Male ; Methods ; Pulmonary Embolism ; Tibia ; Weight-Bearing ; Wound Infection