The incidence of non-union in the shaft of femur is increasing gradually in spite of considerably improved methods of femoral fracture care. It is necessary that orthopaedic surgeon must draw attention to improve the method of treatment and to prevent the occurance of non-union. This paper presents the follow-up result of 27 cases among 30 established femoral shaft non-union cases, that were treated at the orthopaedic dept. of the National Medical Center from March 1971 to March 1980 by various methods. The study of this series shows the following. l. Amount 27 cases, male was predominant (82%), peak age group was 3rd & 4th decades (52%). 2. The causes of injury were auto-accident (56%), falling down accident (22%), direct blow (11%) & slipping down accident (11%). 3. The most common location was around the mid-shaft of femur (44.4%). 4. The probable causes of non-union were loosening of the implants & metal failure due to improper internal fixation (10 cases), incomplete reduction (7 cases), infection (5 cases) & inadenaute external immobilization (5 cases). 5. Excellent results were obtained by combined method of compression plate, screws & intramedullary nailing with additional autogenous bone graft.
Accidental Falls ; Femoral Fractures ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Incidence ; Male ; Methods ; Transplants

No abstract available in English.
Osteosarcoma

Norfloxacin is a new broad spectrum of antibacterial activity against both Gram-positive and Gram. negative bacteria. After oral administration of Norfloxacin, it produces high concentrations in the urine, so it has the excellent effect for the treatment of urinary tract infection. Norfloxacin was studied with respect to clinical effect in 115 patients with the urinary tract infection and the following results were obtained. 1. Excellent efficacy was 53% and efficacy rate was 90% in upper urinary tract infection(UTI). Efficacy rate for 20 patients with upper UTI without the underlying disease was 100%, and in 29 patients with underlying disease efficacy rate was 83%. 2. In upper UTI resistant for other antibiotics, efficacy rate was 78%. 3. In lower UTI excellent efficacy rate was 36% and efficacy rate was 71%. In gonococcal urethritis excellent efficacy rate was 76% and efficacy rate was 88%. 4. Eliminated rate of bacteria on culture findings were E. coli 93%, pseudononas 89%, proteus 100%, klebsiella 80%, gonococcus 88% and staphylococcus 80%. 5. Mild side effects such as epigastric pain, nausea, dizziness and itching sensation were seen in 5 cases. We consider Neutam-400 is one of the most effective agents in urinary tract infection.
Administration, Oral ; Anti-Bacterial Agents ; Bacteria ; Dizziness ; Humans ; Klebsiella ; Nausea ; Neisseria gonorrhoeae ; Norfloxacin ; Proteus ; Pruritus ; Sensation ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

Incontinentia pigmenti (IP), also known as Bloch-Sulzberger syndrome, is a rare X-linked dominant disorder that is generally lethal to males and almost always leads to death in utero. This disorder is a genodermatosis with characteristic cutaneous lesions and manifestations affecting the eyes, teeth, hair, and central nervous system. Genodermatosis is a hereditary disease caused by mutations in the nuclear factor-kappa B essential modulator gene mapped to chromosome Xq28. This gene encodes a variety of cytokines and chemokine regulators and is indispensable for protecting cells from tumor necrosis factor-induced apoptosis. Here we describe a case of male newborn with vesiculobullous cutaneous lesions over the left thigh and leg. We first considered the cutaneous lesions a skin infection, as they improved with intravenous antibiotics. However, recurrence and the need for repeated hospitali zations made us consider the differential diagnosis of IP, for which we performed a skin biopsy and chromosome analysis. The histology results were compatible with IP, that is, eosinophilic infiltration in the dermis and epidermis, and individual cell dyskeratinization. The chromosome analysis result was a normal 46, XY karyotype.Here we report the case of a male newborn with IP that manifested as multiple vesiculobullous skin lesions and was initially misdiagnosed as a recurrent skin infection.

The Halo-pelvic traction has been considered as a powerful and strong method for correction of the severely deformed rigid spine whether it is kyphotic or scoliotic. It also affords firm stabilization during the operation and postoperative management with immobilization for a long time. Ambulation with this instrument enhances the usefulness. We have succeeded in treating and correcting 6 cases of Tuberculous Kyphosis, and 3 of which accompanied paraplegia. Especially one case of severe kyphosis, 78 was corrected to 20 and anterior strut graft was accomplished with vascuiarized free fibular graft with aid of microvascular technique. The correction rate was 38% in average. No significant complications have developed except osteoporosis of the spine.
Congenital Abnormalities ; Immobilization ; Kyphosis ; Methods ; Osteoporosis ; Paraplegia ; Spine ; Spondylitis ; Traction ; Transplants ; Walking

Over twenty per cent of adult knees have a synovial plica which always has possibility of changes into pathologic synovial plica symptomes and signs resembling those of other common internal derangement of the knee joint. Especially the young active patient who has a history of trauma to the knee should once be suspected incarcerated synovial plica not only the possibility of internal derangement. Four cases of symptomatic synovial plica experienced by authors are reported with available references.
Adult ; Humans ; Knee ; Knee Joint ; Patella

The non-surgical treatment for the fresh humeral shaft fracture would appeared to be not sufficient in respect of immobilization and maintenance of the contact surface of the fracture ends, which have had stimulated surgeons to perform internal fixation. This might be one of the reasons to produce non-union of humeral shaft fracture, supplemented by increasing incidence of fractures due to car and machinary accident. Authors have experienced 18 cases of non-union of humeral shaft fracture and accomplished solid union in all cases by osteosynthesis accompanied by autogenous bone graft. In detail: 1. Non-union was prevalent in the agr group of 20 to 40 and mostly in male. Site of non-union was found mostly at the lower 2/3. 2. The cause of the fracture was mainly due to the car and machinary accident. Initial treatments were surgical in 14 out of 18 cases, and 12 cases of this surgically treated group were treated within 2 days after the injury. 3. On retrospective analysis of medical records and X-ray films, probable cause of the non-union were supposed to be too early performed inadequate internal fixation and post-operative infection in the operated cases, whereas distraction of fracture ends due to poor external fixation and infection in the cases treated conservatively. 4. 16 cases of established non-union were treated by authors with rigid internal fixation and additional bone graft, and 1 case with bone graft only. 5. Authors have utilized shoulder spica or long arm cast post-operatively for 1 to 4 months. 6. Union was obtained in all cases. Developed transient radial nerve palsy in 4 cases; and neighbouring joints contracture in 2 cases, which required considerable time of physical therapy.
Arm ; Contracture ; Humans ; Immobilization ; Incidence ; Joints ; Male ; Medical Records ; Paralysis ; Radial Nerve ; Retrospective Studies ; Shoulder ; Surgeons ; Transplants ; X-Ray Film

Spondylolisthesis and spondylolysis is one of the major causes of the low back pain and orthopaedic surgeons frequently encounter this problems with increasing tendency. In 19th century, spondylolisthesis had been studied by the European obstetrician as the main cause of dystocia. Advancement of the radiological techniques enabled us to know more precise degree of slipping. Therefore, many surgical techniques have been used. Spondylolysis has been also studied as the precursor of the spondylolisthesis. This report is based upon the analysis of the records of 26 patients who had operated at the Department of Orthopaedic Surgery of National Medical Center from 1972 to 1981. The results were as follows. 1. Most common age group was 30–50 age group and theres no sexual difference. 2. Most common symptoms were lumbago and radiating pain and the most common sign was Lasegue sign. 3. Most common type was isthmic type and location was 5th lumbar vertebra, and degree of slipping was grade I by Meyerding's method. 4. The fusion of the grafted bone were observed in 24 cases among 26 cases: of which the duration were 3 months in 16 cases and remaining 8 cases had duration between 3 and 6 months. 5. Postoperative analysis under the basis of the functional recovery was satisfactory in 93% of cases by Gill's criteria.
Dystocia ; Female ; Humans ; Low Back Pain ; Methods ; Pregnancy ; Spine ; Spondylolisthesis ; Spondylolysis ; Surgeons ; Transplants

Of 62 supracondylar fractures of the humerus in children treated for 10 years, 27 cases are described with follow-up study of 2 years and 6 months on average. These patients were treated percutaneous K-wires fixation after closed reduction. This method takes advantage in stability of fixation, vascular safety with any permissible any position of the elbow, early ambulation and short hospital stay, and low incidence of varus deformity in follow-up. Complication included transient ulnar sensory change, pin-tract infection and inaccurate position of K-wires. We observed 1 case of clinical cubitus varus among 17 cases during more than one-year follow-up and concluded this unhappy result was associated with imperfect initial reduction rather than growth disturbance or initial displacement.
Child ; Congenital Abnormalities ; Early Ambulation ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Length of Stay ; Methods

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons