Eosinophilic granuloma of bone is the most common variant of histiocytosis X. Most of the lesions occur in the skull, ribs, spine or long bone and may be single or multiple. The occurrence in a growing epiphysis is extremely rare and only seven cases have been reported in the literature. A 13 year old boy with eosinophilic granuloma occurring in proximal humeral epiphysis was seen at Seoul National University Hospital in Nov. 1984 and was treated with curettage and autogenous bone graft followed by radiotherapy. The patient was followed for 13 months and complete healing was obtained.
Curettage ; Eosinophilic Granuloma ; Eosinophils ; Epiphyses ; Histiocytosis, Langerhans-Cell ; Humans ; Male ; Radiotherapy ; Ribs ; Seoul ; Skull ; Spine ; Transplants

Benign odontogenic neoplasms are rare, but malignant odontogenic neoplasms are extremely rare. The majority of malignant epithelial neoplasms occurring in the jaws are the result of metastasis from distant primary neoplasms of direct invasion from contiguous carcinoma of the oral mucosa, sinus mucosa, salivary gland or skin. A few remaining primary intraosseous carcinoma of the jaw are presumed to be of mostly odontogenic origin since epithelial remnants of odontogenesis are numerous in the maxilla arts mandible. Although calcifying odontogenic cyst(COC) is a well-established pathologic entity, it has been recognized that there is an odontogenic neoplasm with histologic features similar to the COC(malignant epithelial odontogenic host cell tumor; EOGCT) that has been diagnosed as COC. Some authors have reported previously in the literature describing malignant EOGCT. We experienced one case of malignant EOGCT with aggressive growth pattern and histologic features strongly implying its malignant potential. The lesion was excised by anterior mandibular resection, total 1 resection of the tongue and bilateral functional neck dissection. The tongue was reconstructed by using the infrahyoid muscle neurovascular island flap and neurovascular radial forearm free flap. The mandible was reconstructed by using the osteocutaneous fibular free flap.
Carcinoma ; Forearm ; Free Tissue Flaps ; Jaw ; Mandible* ; Maxilla ; Mouth Mucosa ; Mucous Membrane ; Neck Dissection ; Neoplasm Metastasis ; Odontogenesis ; Salivary Glands ; Skin ; Tongue*

22 cases of giant cell tumor of bone treated between 1973 and 1979 have been reviewed after a miaimum follow-up of two years and following results were obtaind. 1. Fourteen cases (63%) were in the third and fourth decade. 2. Fourteen cases (63%) were located around the knee joint. 3. Five (42%) of the twelve tumors treated by curettage and bone graft recurred. Five tumors treated by En bloc resection and two tumors treated by amputation had no recurrences. 4. Five of six recurrences occured within two years after mitial treatment.
Amputation ; Curettage ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Knee Joint ; Recurrence ; Transplants

Forty-five patients with primary neoplasm of the spine, disgnosed and operated at Dept. of Orthopedic Surgery, Seoul National University Hospital, from 1970 to 1988, were reviewed in an attempt to analyze the incidence of the primary spine tumors and effectiveness of surgical treatment. Mean follow-up was 2.5 years. Among 29 benign tumors, 7 cases of osteoid osteoma, 6 cases of giant cell tumor, 4 cases of osteoblastoma and aneurysmal bone cyst, and 2 cases of fibrous dysplasia and osteochondroma, and others were identified. Of 16 malignant tumors, 6 cases of eosinophilic granuloms, 4 cases of chordoma, 3 cases of solitary plasmacytoms, and others were noted. 17 cases occurred in the anterior compartment, 18 cases in the posterior compartment, and 10 cases involved both compartments. Surgical treatment consisted of complete or near complete excision, decompression, and additional stabilization procedure when the stability of the vertebral column was compromised. Stablization was achieved either by fusion, strut bone graft, or by additional Zielke, Cotrel-Dubousset, or Luque-Harringtion instrumentation. The results were astisfactory in most of the cases with benign tumors except cases of giant cell tumor. The results in malignant tumor were satisfactory especially in eosinophilic granuloma and solitary plasmacytoma with respects to symptoms and survival, and this fact was attaibuted to good response to adjuvant chemotherapy and radiation therapy. Recent application of Cotrol-Dubousset or Zielke instrumentation after agressive resection made early ambulation a clinical reality.
Aneurysm ; Bone Cysts ; Chemotherapy, Adjuvant ; Chordoma ; Decompression ; Early Ambulation ; Eosinophilic Granuloma ; Eosinophils ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Incidence ; Orthopedics ; Osteoblastoma ; Osteochondroma ; Osteoma, Osteoid ; Plasmacytoma ; Seoul ; Spine ; Transplants

This is to present 44 cases of hip fractures, of these 28 being fractures of femoral neck and the remainder, intertrochanteric, which were treated at the Department of Orthopedic Surgery, Seoul National University Hospital for four years and 8 months from Jan. 1965 to Aug. 1969. 1. There were 33 males. and 11 females in the series. 26 cases(59.1) were over 51 years of age. 2. The femoral neck fractures were treated by means of Smith Petersen nailing in 16 cases, modified Girdlestone hip arthroplasty in 3 cases, Austin-Moore hip prosthesis in 6 cases and other methods in 3 cases. 3. Modified Girdlestone hip arthroplasty could be a treatment of choice for femoral neck fracture requiring hip arthroplasty for those unsuitable for extensive surgery. 4. The intertrochanteric fractures of femur except for 3 unstable fractures were treated successfully with the Smith-Petersen nail and plate, following anatomical reduction of fracture. In 3 unstable fractures, satisfactory stabilization and internal fixation was obtained by the method of medial displacement of proximal part of distal fragment of fracture.
Arthroplasty ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip Prosthesis ; Hip ; Humans ; Male ; Methods ; Orthopedics ; Seoul

Metaphyseal Chondrodysplasia is a disease characterized by metaphyseal ossification leading to shortening of stature. The extremities, especially lower, and mainly affected, resulting in a disproportionate drarfing which spares the trunk. The first case was reported in a patient with irregular metaphysis of lower extremities and hands, and severe shorteness of stature by Murk Jansen in 1934. A milder form of Metaphyseal Chondrodysplasia was noted in 1949 by Schmid, which is more common and transmitted in autosomal dominant. Mckusick recently reported another form of Metaphseal Chondrodysplasia, and other types were reported, but they are extremly rare, and of little clinical significance. In the Schmid type, patient is normal at birth, but characteristically shortness of stature, bowed leg, and waddling gait developed at biginning of walking. Ali labratory findings including serum calcium level, phosphorous, alkaline phosphatase, renal function test is normal in Metaphyseal Chondrodysplasia. The most difficult differential diagnosis is Vitamin D-resistant rickets in clinical and x-ray findings. The only treatment is careful observation and properly timed corrective surgery. Authors experienced on case of Schmid type of Metaphyseal Chondrodysplasia which had been treated with Vitamin D under impression of rickets for 1 year before the case was consulted to Orthopedic Department. Proximal tibial osteotomy and subtrochanteric valgus osteotomy were performed for the correction of genu varum and coxa vara deformity with satisfactory results for one year follow up.
Alkaline Phosphatase ; Calcium ; Congenital Abnormalities ; Coxa Vara ; Diagnosis, Differential ; Extremities ; Follow-Up Studies ; Gait ; Genu Varum ; Hand ; Humans ; Leg ; Lower Extremity ; Orthopedics ; Osteotomy ; Parturition ; Rickets ; Rickets, Hypophosphatemic ; Vitamin D ; Walking

No abstract available in English.
Congenital Abnormalities ; Paraplegia

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

CT and myelography, separately or combined together, have been used for the study of spine lesion. Metrizamide enhanced CT is a new diagnostic modality for the study of spine lesion. The purpose of this study was to compare the efficacy of metrizamide enhanced CT with those of CT and metrizamide myelography. Among 163 surgically proven cases, metrizamide CT was carried out on 49 cases, CT on 50 cases and myelography on 64 cases, at Department of Orthopedic Surgery, Seoul University Hospital for 3 years period from August 1981 to July 1984. 1. Overall diagnostic accuracy of CT was 90%, that of metrizamide myelography was 82.8%and that of metrizamide CT was 93. 9%. 2. Diagnostic accuracy of metrizamide CT in HIVD was 95%, in spinal stenosis 94.4% and in spondylolisthesis 80%. 3. Most of complications were observed in myelography, even they were minor. 4. It was concluded that plain CT was advisable on a clinically typical HIVD, considering complications and expenses of myelography and metrizamide CT. 5. Metrizamide CT was indicated on previously operated cases or atypical HIVD, spinal stenosis and spondylolisthesis.
Metrizamide ; Myelography ; Orthopedics ; Seoul ; Spinal Stenosis ; Spine ; Spondylolisthesis

This study was performed by the necessity of objective information upon change of pulmonary function after surgical correction of spinal deformity in scoliotic patients. It is relatively well known that deformity of spinal curvature affects the pulmonary functions, especially lung volume or vital capacity, due to restriction of the thoracic cage. It is carried out the comparative study between preoperative and postoperative pulmonary functions in thirty two cases of thoracic scoliosis, all who were treated with Harrington instrumentation and posterior fusion at Department of Orthopedic Surgery, Seoul, National University Hospital from 1969 to 1983. The age distribution of patients was from 6 years to 21 years and female was more involved two times than male. Following observations were obtained: Following observations were obtained: 1. Pre-and postoperative angle of scoliosis were 77.5° and 39.2° with correction rate of 48.2%. 2. Preoperative vital capacity was 64.2% and postoperative value was 74.8%, 2 years and 2 months after operation in average. 3. Postoperative vital capacity was significantly increased compared to preoperative value in patients with scoliosis (p<0.05). 4. Ther was no definite pattern of obstructive pulmonary disease in patients with scoliotic deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Humans ; Lung ; Lung Diseases, Obstructive ; Male ; Orthopedics ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spinal Curvatures ; Vital Capacity