No abstract available.
Thumb*

Although wound healing is a natural biologic process by which the homeostasis is preserved, the resultant hypertrophic scar or scar contracture may produce undesirable morphologic and functional sequelae. To overcome these problems, a number of attempts to produce skin substitute have been made in recent years, but none have proved to be entirely satisfactory. We compared the wound healing of full-thickness dorsal skin defects between ADM(acelluar dermal matrix)-applied wound and ADM non-applied wound group in 20 adult female Sprague-Dawley rats. The wound area was serially evaluated at 1,2,3 weeks and the difference in the mean area ratios between the two groups was then statistically analyzed using Wilcoxon rank sums test. We also performed histological evaluation of the wounds at 1,2,3 weeks. Results were as follows: 1. Experimentally produced ADM was easy to handle. Histologic findings showed no epithelium, no appendages, no cells dermal and subcutaneous layer and pure bundles of collagen. 2. The wound area ratio of ADM applied wound group was statistically larger than that of ADM non-applied(control) wound group. That is, ADM was able to inhibit the wound contraction compared with the ADM non-applied wound group. 3. In the ADM-applied group, we observed low grade exudates, no infection, fine take-up of ADM on full-thickness skin defect, gross and histologic findings of neovascularization, and progressive epithelization on ADM. These findings of biologic attachment implies the function of the ADM as a dermal substitute. These can be basis of the study on the development of artificial skin.
Acellular Dermis* ; Adult ; Animals ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Contracture ; Epithelium ; Exudates and Transudates ; Female ; Homeostasis ; Humans ; Rats* ; Rats, Sprague-Dawley ; Skin* ; Skin, Artificial ; Wound Healing ; Wounds and Injuries*

Since the first experimental nerve graft by Philipeaux and Vulpian in 1870, many successful graft have been reported by Bunnell, Boyes, Millesi, Sunderland and Seddon. Advances in microsurgery techniques prompted Millesi to introduce the concepts of interfascicular nerve grafting whereby groups of fascicles, and not whole nerve, are connected together. Hunt and Taylor described a free vasculized nerve graft with microvascular anastomoses and obtained rapid axonal advance and maturation of grafted nerve in a clinical case. It is true that a nerve graft should be inferior to an end-to-end nerve repair, because in the case of nerve grafting the axon have to cross two suture lines instead of one. On the other hand, nerve grafting is indicated whenever a significant gap is produced in a nerve as a result of injury. In a retrospective study of 46 patients, defect of the nerve with treated by nerve graft were analyzed from March, 1983 to January, 1993 and following results were obtained. 1. Nerve graft was useful method to repair nerve whenever a significant gap is produced in a nerve as a result of injury. 2. The sural nerve was used as a donor nerve and vasculized nerve graft can be useful. 3. Postoperative results of cases caused by electric burns were worse than others. 4. There were little significant value in the treatment results between epineural and perineural nerve graft. 5. Recovery of intrinsic function in median and ulnar nerve lesion above the elbow was poor and recovery of the intrinsic function in median nerve graft at the forearm level was better than level for lesion in the ulnar nerve at the same level.
Axons ; Burns, Electric ; Elbow ; Forearm ; Hand ; Humans ; Male ; Median Nerve ; Methods ; Microsurgery ; Retrospective Studies ; Sural Nerve ; Sutures ; Tissue Donors ; Transplants ; Ulnar Nerve

Preperative radiologic indices, such as cortical index of Engh, morphological cortical index of Sportono and Romagnoli, canal flare index of Noble, and their relationship to the postoperative canal filling, femoral stem fitness, stability and clinical result at last follow up were analyzed in 111 hips of 96 patients treated with bipolar or total hip arthroplasty at the Department of Chthopedic Surgery, Korea University Hospital, between January 1985 and May 1993. The results obtained were as follows: 1. The cortical index had no correlations with age, metaphyseal filling and clinical result but isthmic filling was proportional to the cortical index. In femoral stem fitness and stability, most cases of press fit and optimal stability were obtained in group 3 and 4 that have thick cortex. 2. The morphological cortical index had no correlation with age, canal filling and clinical results. But it was proportional to the postoperative femoral stem fitness and stability. 3. The canal flare index had no correlation with age. The metaphyseal filling was increased in the stove piped canal group(less than 3.0 canal flare index), but isthmic filling was increased in normal canal group(3.0-4.7 canal flare index). The most cases of press fit and optimal stability were obtained in normal canal group. More satisfactory clinical results were obtained in nomal canal group. Above results suggest that straight type of cementless femoral component could get better press fit fixation, postoperative stability and more satisfactory clinical results in the cases of cortical index larger than 2.0, mophological cortical index larger than 2.7 and canal flare index larger than 4.0 but metaphyseal filling is unsatisfactor.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Humans ; Korea

No abstract available.
Fingers* ; Toes*

No abstract available.
Ciprofloxacin* ; Mycobacterium tuberculosis* ; Mycobacterium*

Arthrodesis of the knes has lost its nopularity since the development of modern knee replscement arthroplasties, however it still has its place as a salvage procedure when replacement arthroplasties are contraindicated. Various techniques have been in the use including the time-tested Charnleys compressiori arthrodesis. Instead of using Charnley's and other similar compression devices, the authors applied single or double compression plates in 8 knees with severe destruction and deformities, and the results are summerized ss follows: l. Included in this series are 5 cases of tuberculous arthritis, 1 case of septic arthritis, 1 case of resistant scar contracture, and 1 case of Charcots knee. 2. Successful fusion was obtained within 18th week, aversge 13th week. No case of pseudarthrosis was experienced. 3. 3 cases of postop. wound drainage and 1 case of peroneal nerve palsy were experienced, but these did not compromise the final results. 4. It may be concluded that Arthrodesis of the knee using compression plate is rigid enough to permit early mobilization of patients and get the certainty of union.
Arthritis ; Arthritis, Infectious ; Arthrodesis ; Arthroplasty ; Arthroplasty, Replacement ; Cicatrix ; Congenital Abnormalities ; Contracture ; Drainage ; Early Ambulation ; Humans ; Knee ; Paralysis ; Peroneal Nerve ; Pseudarthrosis ; Wounds and Injuries

No abstract available.
Chondrodysplasia Punctata*

No abstract available.
Congenital Hypothyroidism* ; Thyroid Dysgenesis*

Scaphoid fractures are the most common fracture and early diagnoses are very important because of preventing from serious complications such as nonunion, avascular necrosis, and disability of wrist joint. There are a few reports of clinical survey of scaphoid fractures, but not to be reported the evaluation for the close relation among mechanism, modes of treatment, especially operation and late complications. This paper reports more clear corelationships among them as mentioned as above through clinical study of scaphoid fractures. The authors have surveyed the clinical study of 26 cases of scaphoid fractures from July, 1983 to November, 1989 at Department of Orthopedic Surgery, Haewha hospital of Korea University. The following conclusions were obtained through clinical survey. 1. Among 26 cases, they were 25 males and one female between 20 and 50 years of age, and ocalization was 16 in right and 10 in left. They were 21 fresh fractures and five nonunions. 2. Mechanism of injuries had revealed fall down or slip down in 13 cases, roller injury in five cases, fisting injury in four cases, direct trauma in two cases, and traffic accident in two cases. Fracture loeation was four cases in proximal 1/3, 17 cases in middle 1/3, and five cases in distal 1/3. 3. Operations using volar approachs in 12 cases and dorsal approachs in three cases had been done for ten cases of displaced fresh fractures and five cases of neglected nonunions. 4. Eleven undisplaced fresh fractures were treated with short arm thumb spica cast but one with. long arm cast. Of ten displaced fresh fractures treated by open reduction, seven cases were treated with Herbert screw, two cases with K-wire, and one case with treated by open reduction and bone graft with Herbert screw fixation in three cases, K-wire fixation in one case, and open reduction with bone graft in one case. 5. Unions were obtained at average 11.5 weeks in eight of 11 cases treated with conservative treatment for fresh fractures, 12 weeks in eight of 10 open reduction cases of fresh fractures, and 20 weeks in three of five neglected nonunion cases. 6. Of eleven conservatively treated cases, two cases resulted in nonunion and other one case in avascular necrosis. Of ten treated with open reduction, one complicated in delayed union, other one nonunion. Of five neglected nonunion cases treated by open reduction added with bone graft, one remained in nonunion and other one case complicated with arthritis and nonunion.
Accidents, Traffic ; Arm ; Arthritis ; Clinical Study ; Diagnosis ; Female ; Humans ; Korea ; Male ; Necrosis ; Orthopedics ; Thumb ; Transplants ; Wrist Joint