Luque introduced new posterior spinal instrumentation by segmental sublaminar wiring for spinal deformity in 1976. This system initially developed for the treatment of paralytic scoliosis, but now its application was extended to treatment of other types of scolisis, spinal fractures and spondylolysthesis. Advantages of this system in scoliosis are better correction force and secure internal fixation enabling early ambulation without external support. Disadvantages include longer operation time, possibilities of epidural bleeding and dural laceration. Luque instrumentation in thoracic and lumbar spine fracture is an effective means of obtaining following goals: provide reduction, maintenance of alignment, restoration of stability, prevention of deformity, low pseudarthrosis rate and early mobilization without external support. Luque instrumentation were carried out in 5 cases at Dept. of O.S. at SNUH from Oct. 1983 to Feb. 1984 with excellent results. The average follow-up period was 7.4 months and there was no complication. Two cases of unstable thoracic and lumbar spine fractures were treated with Luque instrumentation with fusion. The use of double sublaminar wiring with Luque rods, two levels above and two levels below on area of fracture provided early stabilization to allow rehabilitation without external immobilization. Three cases of paralytic scoliosis underwent Luque instrumentation by a modification of the Galveston technique with fusion. Average preoperative curve was 110°(ranged from 101° to 126°). Immediate postoperative correction was 58.7°(46.6%) and average 7 months-following result was 56.3°(48.3%). Operation time averaged 6hr 7min and blood loss was averaged 12 pints. Those patients required instrumentation from the pelvis to middorsal segment, in an effort to control the curve and associated pelvic tilting. In early follow-up the author obtained remarkable correction in paralytic curves, and the pelvic obliquity were well corrected with a pelvis and provid ing with better sitting balance.
Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Hemorrhage ; Humans ; Immobilization ; Lacerations ; Pelvis ; Pseudarthrosis ; Rehabilitation ; Scoliosis ; Spinal Fractures ; Spine

No abstract available.
Hemangioma* ; Ligation*

No abstract available.
Facial Asymmetry*

In 1958, Jackson first reported on the use of proximal tibial osteotomy in the treatment of pain due to osteoarthritis of the knee joint. Subsequently, various osteotomy techniques have been reported. The varus deformity of the knee associated with osteoarthritis can be corrected by realigning the joint and thereby shifting the line of weight bearing to the compartment with preserved articular cartilage. This procedure has been found to relieve pain, improve function and arrest the progress of the condition. Twenty five cases of genu varum associated with osteoarthritis were treated by high tibial osteotomy at Dept. of O.S., Seoul National University Hospital, from July 1976 to June 1983. And the following results were obtained. 1. In a review of 25 high tibial osteotomies, excellent and good results were noted in 80% of the knees after average follow-up 2.9 years. 2. Postoperative valgus angles, ranging from 5° to 20°, were averaged to be 10.8°. 3. Though some authors indicate the obesity as one of risk factors, we obtained satisfactory results in 25 knees of obese patients.
Cartilage, Articular ; Congenital Abnormalities ; Follow-Up Studies ; Genu Varum ; Humans ; Joints ; Knee ; Knee Joint ; Obesity ; Osteoarthritis ; Osteotomy ; Risk Factors ; Seoul ; Weight-Bearing

No abstract available.
Durapatite* ; Forehead*

No abstract available.
Free Tissue Flaps* ; Lower Extremity*

No abstract available.
Zygoma*

In order to describe the demographics, etiologic and clinical factors, and outcomes of orbital fractures in children, we have reviewed a case series of 17 patients under 18 years of age with internal orbital fractures (i.e., without involvement of the orbital rim) presenting to the Ghil hospital between March 2000 and June 2001. For 15 of the patients, we performed orbital wall reconstruction with Medpor (R) barrier sheet implantation (thickness 1mm) through transconjunctival approach under endoscopic guidance, while maintaining mere observation on the other 2 patients. There were 14 male and 3 female patients. The most common cause of fractures was accident (7 cases). Inferior wall involvement was most commonly seen, and the trapdoor type fracture was the most common. Thirteen patients had extraocular muscle restriction, 9 had nausea/vomiting and 5 had bradycardia. Diplopia of 9 patients disappeared after 43+/-23 days. Nausea/vomiting and bradycardia disappeared rapidly after surgical intervention in all cases. These results suggest that trapdoor fractures with soft tissue entrapment are the most common in pediatric orbital wall fractures, and that most of them are associated with nausea/vomiting. We suggest that early diagnosis, and prompt surgical intervention are required for those patients with oculocardiac reflex.
Adolescent ; Adult ; Child ; Child, Preschool ; *Endoscopy ; Female ; Human ; Male ; *Ophthalmologic Surgical Procedures ; Orbit/surgery ; Orbital Fractures/*diagnosis/radiography/*surgery ; Retrospective Studies ; *Surgery, Computer-Assisted ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study is to determine whether partially neovascularized Medpor(R) by preplacement of implant to buttock area for one month before secondary orbital insertion demonstrates earlier refibrovascular ingrowth into implant than that in primary orbital placement. METHODS: Thirty-five rabbits were divided into two groups: Group A (15 rabbits) ; primary orbital implantation of Medpor(R)(nonvascularized) after enucleation, Group B (15 rabbits) ; secondary orbital implantation of implant (vascularized) after enucleation after harvesting implants from buttock area, inserted for one month prior to orbital implantation. Five neovascularized implants by preplacement of implant to buttock area for one month were sectioned and investigated for the fibrovascular ingrowth, expression of bFGF, and CD-31 to evaluate the influence of pretreatment. Implants from group A and B were harvested from the orbit at 1, 2, 4, 6, and 8 weeks postoperatively. The implants were sectioned and studied grossly and histopathologically. Immunohistochemical study on bFGF and CD-31 were conducted to detect the angiogenetic factor and degree of angiogenesis in both group A and B. RESULTS: The fibrovascular ingrowth and expression of bFGF and degree of angiogenesis in group B were higher than those in group A. The degrees of angiogenesis were well correlated with bFGF expression. CONCLUSIONS: This animal model may provide the basis for the future investigation of agents and structural modifications directed towards optimization of fibrovascular ingrowth into porous anophthalmic socket implants and clinically apply to enucleation for the vascular compromised patients such as in the settings of postirradiation, diabetes.
Buttocks ; Humans ; Models, Animal ; Orbit* ; Orbital Implants ; Polyethylene* ; Rabbits*

PURPOSE: To evaluate the efficacy of endoscopic endonasal primary conjunctivodacryocysto-rhinostomy (CDCR) and revision CDCR after primary CDCR. METHODS: Twenty patients who had undergone endoscopic endonasal CDCR with Jones tube and who were followed for over 6 months at our hospital were reviewed retrospectively. Our analysis included success rate, operation time and causes of failure. RESULTS: The indications for revision CDCR were prolapse of Jones tube and inadequate tube length. The initial success rate in the primary and revision groups was 78.6% (11/14) and 100% (6/6), respectively. Two initial failures in the primary group were later successful after revision. The mean operation time in the groups was 23.9 minutes ( +/- 6.3) and 21.7 minutes ( +/- 6.1), respectively. The main causes of failure included inaccurate tube length and abnormal tube position. CONCLUSIONS: Endoscopic endonasal CDCR appears to be a reasonable approach for revision, as well as primary, because of accurate measurement of Jones tube length during surgery and the shortened operation time.
Humans ; Prolapse ; Retrospective Studies