Kyphosis and scoliosis develops from various causes, Tuberculosis is the main cause of kyphosis and spinal deformity in Korea. Such spinal deformities are frequently accompanied by cardiac and respiratory changes. In 1969, Westgate and Moe reported that, when a kyphoscoliotic patient dies, he dies because of cardio-respiratory failure and not because of skeletal abnormality, and, in 1968, Nilsonne and Lundgren reported that the mortality in patients with severe spinal deformity was twice as high as in normal persons, and that heart or lung disease was the main cause of death. One must consider the cardiopulmonary status when treating patients with severe spinal deformities. While there are numerous reports on pulmonary dysfunction due to scoliosis or kyphoscoliosis, studies on pulmonary function of patients with tuberculous kyphosis are surprisingly few. The authors investigated the correlation of the degrees of curvature and pulmonary function on 17 cases of adults with tuberculous kyphosis and compared the results with those of the children reported in 1972 by Moon and Lee. The results of this study are as follows: 1. The over-all mean degree of kyphosis was 92.6 (Salters angle). Vital capacity was 63.1% and maximum breathing capacity 61.7% of the predicted normal value. 2. Vital capacity showed a negative correlation with the degree of kyphotic curvature; i. e. the greater the spinal curvature, the less the vital capacity and vice versa, R=0.45, P=<0.1, but there was no correlation between maximum breathing capacity and the degree of curvature. 3. Vital capacity showed a relatively significant positive correlation with maximum breathing capacity as kyphosis increased. 4. The over-all mean tidal volume increased 9.3% of the normal predicted value. 5. When comparing with the pulmonary function of the children with same level and same degree of kyphosis, the adults had significant decrease in vital capacity and maximum breathing capacity, but had increased tidal volume. Such disparity was more prominent in the thoracic spine than in the lumbar spine and when the kyphotic curvature was greater than when less. 6. Timed vital capacity was within normal limits in spite of kyphotic changes of the spine.
Adult ; Cause of Death ; Child ; Congenital Abnormalities ; Forced Expiratory Volume ; Heart ; Humans ; Korea ; Kyphosis ; Lung Diseases ; Moon ; Mortality ; Reference Values ; Respiration ; Scoliosis ; Spinal Curvatures ; Spine ; Tidal Volume ; Tuberculosis ; Vital Capacity

No abstract in English.
Congenital Abnormalities ; Tibia

Tibial plateau fractures are a common injury which often produce major disability. The extent of actural damage is always greater than that suggested by X-ray, a situation which, if not appreciated, can easily lead to a complacent surgical attitude. Although recent studies suggest that early knee motion and perhaps better surgical technique have improved clinical end-results, still recent series show unaccepatble results in 20-40 percent of cases. The authors analyzed the 37 cases of the tibial plateau fractures treated at the Department of Orthopaedics, Catholic University Medical College, Kang-Nam St. Mary's Hospital and following results were obtained. 1. The highest incidence was in the 5th decade and the next was 4th, and most frequent cases of trauma was pedestrian car accident(83%). 2. The most common fracture type was type VI by Schatzker classification and next was type II. 3. Among 37 cases, 27 were treated by open reduction and internal fixation and 14 out of those 27 cases meeded bone graft for the elevation of the tibial articular surface. 4. According to Blokker's criteria(1984), 32(86.6%) out of 37 cases had satisfactory result. Among 5 cases of unsatisfactory results 3 cases developed varus tilting of the tibial plateau more than 10 during the early stage (6–12 weeks post operation) of follow-up and those 3 were Schatzker's type VI fracture. 5. It is thought that open anatomical reduction of articular surface bone graft, internal fixation and early joint motion are the best way for the treatment of depressed or displaced fracture. 6. It is found tha Schatzker's type VI fracture has a tendency to develop varus tilting through the proximal tibial fracture before it unites completely.
Classification ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Tibial Fractures ; Transplants

It has been known that osseous stability of the hip is dependent upon the inclination, anteversion and depth of acetabulum and also upon neck-shaft angle and anteversion of femur. Acetabulum enlarges from two different growth centers; one from the concave articular surface cartilage and the other from the triradiate cartilage. The former contributes primarily to the thickness of acetabular wall, where as, the latter to the central enlargement of the acetabular socket. Additionally the shape of acetabulum can be changed by deformity of the femoral head and neck, which can be explained by Wolff's and Hueter-Volkmann's laws. Yet there are still many factors to be clarified by clinical researchers in the future Authors in this experiment tried to clarify the role of triradiate cartilage and greater trochanteric growth plate upon the development of acetabulum. The material used for this study consiated of 30 rabbits of both sexes, aged 8 weeks. Animals were divided into 3 groups, and each group consisted of 10 rabbits In group I. hip was not injured and used as a Control: in group II, right greater trochanter with its growth plate was destructed completely; in group III, triradiate cartilage of right side was destructed. Subsequent to injury of Y cartilage ot greater trochanter with its growth plate, radiographs of the pelvis including hips were obtained weekly on each rabbit over 6 weeks period. and to evaluate the effect of injury upon the hip development acetatular angle, C-E angle, and acetabular depth and width were measured. The following results were obtained; 1. The shape of acetabulum of rabbits have showe remarable developmental changes until the 10 weeks of age after birth, but the changes became less remarkable by age of the 14 weeks. Thereafter it remained unchanged. 2. In group II, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle showed an increase of 1.9 degrees, and the center dege angle and acetabular depth showed a decrease of 3.21 degrees and 0.43mm respectirely. 3. In group III, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle increased by 18.9 degress while the center-edge angle decreased by 22.8 degrees. The acetabular depth showed a decrease of 1.81mm and the acetabular width showed an increase of 0.73mm. These observations suggest that the development of acetabulum depends largely upon the growth of triradiate cartilage, and also is affected secondarily by valgalization of femoral neck which is resulted by destruction of greater trochanteric growth cartilage.
Acetabulum ; Animals ; Cartilage ; Congenital Abnormalities ; Femur Neck ; Femur ; Growth Plate ; Head ; Hip ; Jurisprudence ; Neck ; Parturition ; Pelvis ; Rabbits

No abstract available.
Dislocations ; Spine

No abstract available in English.
Orthopedics ; Suction ; Wounds and Injuries

The intra-articular osteochondroma arising from soft tissue is very rare and has been reported less than a dozen cases in the English literature. This tumor is the result of extrasynovial metaplasia of the fibrous capsule or of the adjacent connective tissue of a joint. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 37 year-old man which arised from the medial meniscus. Histology as well as gross findings were consistent with osteochondroma. Excision of the mass with attached meniscus relieved symptoms. No recurrence, or malignant change was identified up to 1 year after excision.
Connective Tissue ; Joints ; Knee ; Menisci, Tibial ; Metaplasia ; Osteochondroma ; Recurrence

Rickets is a syndrome, characterized pathophysiologically by a failure of normal mineralization of bone and epiphyseal cartilage and clinically by skeletal deformity in growing children. The five principal causes of rickets are vitamin D deficiency, absorptive defects, renal tubular insufficiency, chronic renal insufficiency and hypophosphatasia. In addition to these causes of rickets a defective reabsorption mechanism of the proximal renal tubule is currently believed to be a factor in the development of hypophosphatemic vitamine D resistant rickets. Simple type of hypophosphatemic vitamine D resistant rickets is the most common of all the cases of rickets due to tubular insufficiency. It has a familiar incidence and is a sex-linked dominant disease. There is hypophos-phatemia and an elevated alkaline phosphatase but usually no glomerular disease or uremia. All the clinical manifestations are those of advanced rickets of the ordinary type and usually begin early. We experienced four cases of hypophosphatemic vitamine D resistant rickets which developed in a family.
Alkaline Phosphatase ; Child ; Congenital Abnormalities ; Growth Plate ; Humans ; Hypophosphatasia ; Incidence ; Kidney Tubules, Proximal ; Miners ; Renal Insufficiency, Chronic ; Rickets ; Uremia ; Vitamin D Deficiency ; Vitamins

It appears that frequency of fractures of the aceta ulum is increasing with the number of automobiles on our roads and when they occur they seem to pose difficulties of management. Because, the anatomy of this region is complicated, making surgical approaches difficult. Second, the patients often have major associated injuries, making early operative treatment hazardous. Third, the fractures are often severly comminuted, leading many surgeons to beleave that operative reduction is impossible. Finally, and unfortunately, the fractures are often missed. The aim of treatment must be to restore the fractured acetabulum to its normal anatomy followed by early motion to promote healing and restore function. Undisplaced acetabular fractures have a good prosis with conservative treatment but patients with displaced fractures of the acetabulum not reduced by manipulation and traction should be considered candidates for open reduction. The author experienced 72 cases of acetabular fracture patients who were admitted to the department of Orthopaedic Surgery of Catholic Medical College and Center from January 1979 to August 1983. The results of 48 patients who were followed up over 6 months period were as follows; l. Among 72 cases(44 were male and 28 were female), the most common causes of acetabular fracture was pedestrian struck by car. 2. 56 were treated conservatively and 16 were treated surgically. The result were as follows; Excellent-15(31%), Good-23(48%), Fair-8(17%), Poor-2(4%). 3. 72 cases were classified by Letournel classification. The most common type was posterior wall fracture(14 cases), and second most was T-shaped fracture(13 cases). 4. If the grossly displaced fragments are present they should be reduced and fixed surgically if surgical approach can be done. 5. It is essential to understand the pathologic anatomy of the acetabulum in order to approach the acetabular fracture sefely and with maximum ease.
Acetabulum ; Automobiles ; Classification ; Clinical Study ; Humans ; Male ; Surgeons ; Traction

Evaluation and management of the anterior cruciate ligament (ACL) deficient knee pose several problems. For acute injuries, the essential factors are diagnosis of the ACL rupture and associated injuries, and selection of the appropriate method of the management. Until recently, the frequency of complete disruption of the ACL was though to be less than that of the medial collateral ligament. However, there is little doubt that the ACL is the most frequently torn ligament in the knee. Diagnosis may be made with a combination of tests: Anterior drawer, valgus or varus stress test, Lachman, and pivot shift. If the patients is unable to relax because of pain or fear, examination under the anesthesia should be performed. Treatment can be surgical or nonsurgical. Since the ACL is vital to normal knee function, surgical intervention is advisable in the majority of cases of acute disruption. Authors analyzed the records of 58 cases of acute knee ligament injuried patients treated at the department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, Catholic Medical College and Center, from November 1982 to January 1984, with follow-up range from 6 to 20 months. 1. Among 58 cases, 41(71%) had anterior cruciate ligament injury and 39(67%) had medial collateral ligament injury. 2. The causes of injury were mostly traffic accident (77%) and majority of the patients was in their twenties and thirties of age. 3. Among 41 cases of ACL Injury, 5 had isolated anterior cruciate injury, 27 cases (66%) had associated medial collateral injury, 9 (22%) had associated lateral collateral injury, and 7 (17%) had associated posterior cruciate ligament injury. 4. Meniscal injury was found only in 6 cases (15%); 4 medial and 2 lateral menisci. 5. Majority of anterior cruciate injured patients (71%) had more than 5mm joint openning than normal side in valgus or varus stress radiogram with the knee in extension. 6. In all cases of anterior cruciate ligament injured patients, the Lachman test was positive under the general anesthesia, hut anterior drawer test was positive in 80%. 7. In about 90% of the cases, the anterolateral rotatory instability (ALRI) test was positive and this finding was accentuated when the lateral collateral ligament was torn. 8. Among 41 cases, 16 (39%) had failure at the insertion site, 7 (17%) had tibial spine avulsion, and 9 patients each (22%) had tear at the ligament substance level and had grade II sprain. 9. In twenty-three, primary repair was done, in 9, primary intra-articular recopstruction was performed and 9 were treated conservatively. The result was from fair to excellent almost in all cases.
Accidents, Traffic ; Anesthesia ; Anesthesia, General ; Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Menisci, Tibial ; Methods ; Posterior Cruciate Ligament ; Rupture ; Spine ; Sprains and Strains ; Tears