The growth plate is responsible for longitudinal bone growth and is involved in 6–15% of children's fracture. Of these injuries, 25–35% have been reported to result in some shortening or deformity, but in only 10% are the deformities sufficiently severe to lead to functional problems. The problem of repair of a demaged growth plate in children has never been adequately solved. The purpose of this study is to clarify that allograft of cultured chondrocytes can survive in the growth plate defect and can prevent the angular deformity by avoiding the formation of bone bridge. The chondrocytes were obtained from the rib cartilage of rabbit weighing 500g. The chondrocytes were cultured by socalled micromass culture method. The rabbits were divided two groups; the group I in which medial proximal tibial growth plate was destroyed, and the group II in which the cultured chondrocytes were transplanted into the right medial proximal tibial physeal defect. Each group has 10 rabbits. The tibial growth was observed grossly, radiologically and histologically until 16 weeks after graft. The angular deformity was observed from 3 weeks after operation and histologically the fusion of growth plate was observed in all of group I. In group II, there were no angular deformity and no fusion of growth plate in 7 out of 10 rabbits. Allografted cultured chondrocytes survived and produced matrix in the physeal defects. Through this study it was inferred that allograft transplantation of cultued chondrocytes in the iatrogenical physeal defect is a useful method to keep the physeal growth without cessation. However, further studies will be necessary to prove that the longitudinal growth potential resides in the transplanted chondrocytes as growth plate cartilage.
Allografts ; Bone Development ; Cartilage ; Child ; Chondrocytes ; Congenital Abnormalities ; Growth Plate ; Humans ; Methods ; Rabbits ; Ribs ; Transplants

No abstract available in English.
Animals ; Dogs ; Spine

Authors had reviewed the results of 20 anterior cervical fusions performed between 1975 and 1980 to determine which factors were important to a successful result. There had been 18 single level fusions and 2 fusions at two levels, the majority at C and C. The indications for fusion operation were: firstly in acutely traumatized patient was the spine representing radiologically the signs of segmental instability, secondly was the chronic segmental instability in old traumatized spine representing the nuchal rigidity and severe cervicobrachial pain which. was not ceased by conservative treatments. The index of successful fusion was complete relief of pain, loss of cervical rigidity and radiologlcal stability of fused segment indicated by no-movement in flexion-extension lateral radiograms, and the bony bridges between the fused segments. The postoperative stability of spine was assessed by measuring the changes of disc space and kyphotic angle. The result obtained were as follows: 1. Pre-and post-operative immobilization with cervical traction played an immportant role for successful results after fusion: 4–6 weeks of pre-operative traction in acutely injured spine provided the torn soft tissue structures with sufficient time needed for its healing, and 6 weeks of postoperative traction also provided the bone graft with sufficient time needed for its cooperation with graft bed. 2. ln all cases succeasful fusion was obtained. In a case a adjacent level was incorrectly fused, but it was fused soundly in time, while the unstable unfused segment was not fused spontaneously. 3. The fused segment or segments of spine stabilized clinically in 6-8 weeks after fusion operation which was proven by serial radiograms, and solid bony fusion was obtained radiologically averaging in 12 weeks after fusion operation. 4. The average increase of kyphosis after interbody fusion till solid fusion was negligible, averaging 3.0 degrees. 5. The solid fusion occurred in one to 2 weeks earlier in the spines with wedge and axial conpression fractures than the spines with flexion-rotation and shear types of fractures. 6. No further neurogical damage developed after successful fusion.
Dislocations ; Humans ; Immobilization ; Kyphosis ; Muscle Rigidity ; Spine ; Traction ; Transplants

Authors clinically analysed the end results of the 56 elderly patients having fresh femoral neck fracture who were treated with osteosynthesis procedures and 23 endoprosthesis replacement surgery. All these 79 patients were treated between 1970 and 1979 at the St. Marys Hospital, Seoul. The indications of primary endoprosthesis replacement surgery in femoral neck fractured patients were in elderly patients over 65 years, displaced, comminuted sub capital or transcervical fractures, irreducible fractures, pathological fractures and patients having generalized diseases or senile psychosis. The results for the operated hip joints were assessed by duration of hospitalization, early and late post-operative complication. and the Jessels hip grading method at least post-operative one and half year later. The results obtained were as follows: 1. The average age of the patients were 65 years in 56 cases with initial osteosynthetic group, and 73 years in 23 cases of initial endoprosthesis group. 2. The slip down was the most common cause of injuries. The transcervical type of fracture was 54% of all cases. 3. The eligibility of ambulation was average 34 days after surgery in cases having initial osteosynthesis and 18 days in cases having endoprosthesis. 4. Early post-operative complications such as pneumonia and urethritis etc. were more common in cases of endoprosthesis than in osteosynthesis. But we think these complications were not related with surgery itself and transient. 5. Late post-operative complications in cases of osteosynthesis were avascular necrosis of head (16%), nonunion (9%), osteoarthritis (4%), and deep wound infection (2%), but in cases with endoprosthesis, leg length discrepancy (12%), acetabular erosion (4%) and loosening (4%) in order. 6. We performed the second operation in 12 cases among the 56 patients of osteosynthesis because of post-operative complications. 7. Good end results were obtained 90% in 56 osteosynthesis and 91% in 23 endoprosthesis. Conclusively, author's observation time was relatively short (11/2–3 years) and it is impressed that long term study for the prosthetic group is necessary for the more accurate evaluation of their hip function.
Acetabulum ; Aged ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Hip Joint ; Hospitalization ; Humans ; Leg ; Methods ; Necrosis ; Osteoarthritis ; Pneumonia ; Psychotic Disorders ; Seoul ; Urethritis ; Walking ; Wound Infection

The results in thrity-six adolescent idiopathic scoliosis patients(thirty-nine curves) who have been treated with the Boston brace are reported. The average follow-up was two years and three months(range, one year to four years ten months). Before treatment, all the patients had a curve that measured 20 to 35 degrees; 26 patients were in Risser sign of zero or 1, 10 patients in Risser sign 2 to 4. Although the magnitude of the curve was generally reduced about 40 percent by the initial application of the brace, a gradual loss of this initial correction was observed both during active treatment and after the wearing of the brace. Although eleven(28.2 percent) of the curves had progressed more than 5 degrees at follow up. Sixty-seven percent of the thoracic curve, 33.3 percent of the thoracolumbar, 27.8 percent of the lumbar curve had progression of more than 5 degrees. Twelve patients wore the brace for sixteen hours a day, 19 patients wore for 16 to 20 hours a day and 5 patients wore more than 20 hours a day. 41.7 percent of sixteen hours bracing, 15,8 percent of 16 to 20 hours bracing and 60 percent of 20 hours bracing had progression of more than 5 degrees. Our finding indicates that the Boston brace prevents deterioration in certain cases but does not convert major deformity into minor ones, and part time bracing can prevent progression of the curve and can even afford some correction.
Adolescent ; Braces ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Scoliosis

In general, soft tissue and bone tumors are diagnosed clinically by physical findings, laboratory data, and X-ray findings with only limited reliability, and a definite diagnosis must be supported by histopathological evidence. For this purpose, open biopsy routinely has been carried out, but there have been many disadvantages and sometimes followed by surgical complications. The present study was undertaken to compare the cytologic findings of soft tissue and bone lesions with the histological findings. The specimen were obtained by fine needle aspiration and Franklin-Silverman needle. For cytodiagnosis Stormby's cell block of aspirates were utilized. For histological diagnosis small tissue fragments obtained by the Franklin-Silvermans cutting needle were used. Then, the diagnostic accuracy of 3 different methods were compared, and the clinical applicability of those methods as adjunctive diagnostic procedures in the diagnosis of the soft tissue and bone tumors were assessed. The results obtained were as follows: l. In 15 out of the 20 cases (75%) in which clinically and roentgenologically the soft tissue and bone tumors were suspected, sufficient material was aspirated to enable detailed cytological diagnosis possible by fine needle aspiration. ln 13 out of the 15 cases, diagnosis could be made by cytologic findings, which was similar to histologic findings of tissue obtained by Franklin-Silverman needle. 2. In 6 out of the 20 cases, sufficient tissue fluid for cell block preparation were obtained from the tumor tissues. In 5 cases, cytologic findings of cell blocks were consistent with that ot the tissue obtained by Silverman needle. But in one case malignancy was susupected by cytodiagnostic method, and definite diagnosis could not be made. Finally the lesion was found to be malignant schwannoma through the histological study of tissue specimen obtained by Franklin-Silverman needle biopsy. 3. In 19 out of the 20 cases, diagnosis could be made by Franklin-Silverman needle biopsy. 4. Diagnostic accuracy of the lesions by clinical and roentgenological method was 75%, which overall diagnostic accuracy of 3 methods were 86.7% in aspiration cytology, 83.3% in cytodiagosis of cell block and 95% of histodiagnosis of tissue specimen obtained by Franklin-Silverman needle. Through this study it is found that cytodiagnostic method of aspirates and histodiagnosis of the small tissue specimen by Franklin-Silverman needle are very useful adjunctive methods in enhancing the diagnostic accuracy of the soft tissue and bone lesion prior to open biopsy trial.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Cytodiagnosis ; Diagnosis ; Methods ; Needles ; Neurilemmoma

Roller skating is a sort of sports with high risk which is increaseed in trends. It has become a very popular recreational sports in children, and concomitantly injury caused by it is very variable and sometimes servere. Therefore, adequate preventive garments or additional support for roller skating is essentially recommended to be worn. Authors in this study clinically analysed 24 cases of roller skate injury who were treated at the department of orthopaedic surgery, Kang-Nam St. Mary's hospital, Catholic Medical College and Center, during the 6 months period from May to October 1980. 1. Of 24 patients, 18(10 fractures) had injuries in the upper extremity, and 8(4 fractures) in lower extremity. 2. No unique mechanism was found which reasonably explains various types of injuries encountered In roller skating. 3. Through this study it is said that roller skating is not a benign sports, and the Injury caused by it may be largely preventable with adequate practical Instructions, coaching and wearing protective garments.
Child ; Clinical Study ; Clothing ; Humans ; Lower Extremity ; Skating ; Sports ; Upper Extremity

It is well-known that early diagnosis and treatment is still the most important aspect of congenital dislocation of the hip. However, the orthopaedist can not see the cbildren with dislocated hip before they begin to Walk, especially in the developing countries. When the children with dislocated hips are discovered lately,it is impossible to reduce the hip by simple manipulation, and also is very difficult to maintain the reduction successfully. Our method of treatment was based on the concept that the various components of the abnormal joint will develop satisfactorily into a normal hip provided acccurate congrucus and concentric reduction is obtained as early as possible to take advantage of the maximum growth potential, and is maintained throughout growth, In this study 16 children with 18 dislocated hips among the 75 children with congenitally dislocated hips were primarily treated by open reduction,followed by 3 weeks of temporary fixation of reduced hip by Kirschner wire and 6 weeks of cast immobilization from November 1973 to April 1979. They were clinically and roentgenologically analized. The end results of treatment were assessed by 3 roent- genological determinants; the medial joint space, the acetabular angle and the centeredge angle. The results obtained were as follows: 1. The pathologically widened medial joint space of hip or hips decreased rapidly during first 6 months after reduction, irrespective of the age at reduction, and satisfactory results were obtained in 83 per cent indicated by joint space distance less than 10 mm. 2. Postoperative Kirschner wire fixation of reduced hip to maintain the reduced position did not impair the physeal growth or bring the joint stiffness. 3. The acetabular angle improved rapidly during the first year after reduction in all age groups of patients and thereafter the rate of acetabular development decreased, but the acetabular angle continued to improve throughout the period of observation and satisfactorily (less than 25 degrees) developed in 83 per cent of children. 4. The center-edge angle increased rapidly during first three months after reduction and was satisfactory (more than 20 degrees) in 78 per cent. Overall success rate of treatment was 81.3 per cent. 5. Assessment of end results by medial joint space has more advantages in evaluating the result of treatment because of the aimplicity of it's measurement and leas error regardless of the change of patients position on roentgenagrams. 6. There were only few complications (11.1%) after surgical treatment; coxa magna in a case and resubluxation in another case were complicated. 7. Parameters utilized for assessing the results were faund to be the very helpful criteria to evaluate the hip development indicated by cephalocotyloid relation when used together. 8. Simultaneous open reduction followed by temporary internal fixation with K-wire was found to be recommendable method of treatment ae a first choice of treatment even in children under age of 3 if once nonsurgical reduction fails; because by this type of treatment more easily and accurately concentric reductions were obtained, and also reduction was more easily maintained without subsequeat redislocation.
Acetabulum ; Child ; Developing Countries ; Dislocations ; Early Diagnosis ; Hip ; Humans ; Immobilization ; Joints ; Methods

The object of treatment of Legg-Calve-Perthes disease (L.C.P.D.) is to shorten the clinical course and minimize, or prevent residual deformity, This is accomplished by placing the femoral head deeply within the acetabulum, so that its articular surface is completely contained and maintaining a full range of motion, thereby preventing lateral extrusion of head, concentrated vertical loads and collapse. The purpose of this study was to determine the predicting value of prognosis and correlation of three different evaluating methods, when examining an identical series of radiographs to assess the effect of treatments, and to determine whether the result obtained by femoral osteotomy gave better result than those by non-surgical means. During the past ten years prior to writing, 89 patients with L.C.P.D. were treated by authors. Seventy eight (87.6%) patients were boys and 11 (12.4%) girls. Their ages at the time of initial visit ranged from 2 to 13 years. Twelve (13.5%) patients had bilateral and 77 had unilateral involvement for a total of 101 hips. They were analysed according to Catteralls classification, and also comparative study was done for 32 patients who were followed up over 15 months. The longest follow-up was 5 years and 2 months. They were divided into 2 groups: clildren in group A were treated by rest and abduction brace,. followed over 3 years and 3 months in average, and children in group B were treated, by intertro-chanteric osteotomy, followed over 2 years and 6 months in average. End results for 32 cases were evaluated at each follow-up time by Length/Width Index (L/W.I.) of femoral neck (Robichon, 1974), Migration Index (M.I.) and Spherical quotient (S.Q.) of capital femoral epiphysis (Edsberg et al, 1979). L/W.I.,M.I, S.Q. were used not only as the method of evaluation, but also were used as a predicting the prospective clinical course during the treatment by regular measurement whether it takes the good course or not. Results obtained were as follows: 1. 21(20.8%) were classified as group I, 30(29.7%) as group Il. 31(30.7%) as group III and 19 (18.8%) as group IV. 43 children (42.6%) on their initial visit were found to have this diasbling hip condition at stage II (necrosis and early fragmentation stage). 2. Regardless of the type of treatment, good results were obtained in younger children under age of 7 years, and in mild form as in group I, and lI. Also good, results were obtained in the cases who had treatment at early stage of the disease. No difference was found in the end results between girls and boys when they had same degree of head involvement. 3. In 14 surgically-treated patients, the good results were obtained in 9(64.3%) when assessed by L/W I. 10(75.4%) by M.I., and 7(50%) by S.Q., while in 18 conservatively treated patients good results were obtained in 8(44.4%) when assessed by L/W I. in 6(33.3%) by M.I., and 7(38.7%) by S.Q.. This fact means that S.Q. under-estimates the results of well-treated cases, while M.I. seemingly over-estimates them. 4. when X-rays of the hips were taken in different position's, different L/W Indices were unexpectedly obtained; these deviations in assessment may be listed as a drawback. Migration Index can prognosticate the healing process of the disease during treatment, if the index together with medial joint space is measured repeatedly with certain intervals. Also it is difficult to obtain accurately the S. Q. by measurements because of difficulty locating the center of fragmentary head, but it is considered the best method assessing the end-result at the healed stage. S.Q. expresses the head spherocity, while the M. I. expresses the degree of head coverage and the neck L/W.I. expresses the indirectly amount of neck deformity. 5. When the clinical course is assessed by three evaluating methods, occasionally these three results contradict to each other and do not show similar prognostic tendency or trend. The reason is that neck L/W Index and Spherical quotient indicate directly the progress of the disease while Migration Inex receases only the state of femoral head containment and there by indirectly indicates ensuing prospective course when containment is good, and do not indicate the state of severity of the involved head. 6. In this study, the result of surgically treated patients were superior to those of conservatively treated patients.
Acetabulum ; Braces ; Child ; Classification ; Congenital Abnormalities ; Containment of Biohazards ; Epiphyses ; Female ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Legg-Calve-Perthes Disease ; Methods ; Neck ; Osteotomy ; Prognosis ; Prospective Studies ; Range of Motion, Articular ; Writing

The principal cause of avulsion fracture of anterior superior iliac spine is sudden powerful contraction of sartorius muscle in strenuous sporting activities. The condition usually occurs in young people in whom the apophysis has still not firmly united to the ilium. We presented the three cases of avulsion fracture of anterior superior iliac spine which occurred during sprinting in Physical Fitness Test.
Ilium ; Physical Fitness ; Spine ; Sports