Individuals with cleft lip and palate often require orthognathic surgery to estabilish facial harmony and optimal occlusal function because cleft induced secondary deformities of maxilla and mandible have been taken for the worse as growing up. During operation many problems as like residual oronasal fistula, bony defects, soft tissue-scarring from previous surgery, and the congenital absence of the maxillary lateral incisor teeth with cleft-dental gap are encountered and interfere the operation. In this retrospective study 16 patients who were performed orthognathic surgery from the January. 1991 to the March 1997, could remind the clinically important problems of the orthognathic surgery and suggest more easy, safety, and accurate methods to solve these problems. The preperative and postoperative cephalometric skeletal and soft tissue data were compared and many problems which could encounter during operation were checked and reviewed many historical experiments and newly suggested articles, so some results can be suggested as like: 1. The sum of maxillary advancement(mean 5.14mm) and mandibular retrusion(mean 6.71mm) is about 11.85mm. Two-jaw surgery is recommended because the scar of upper lip and palate limit the maxillary advancement. 2. Upper lip tightness interfere the soft tissue movement after bone segment mobilization, release of tightness improve the soft tissue profile. 3. Soft tissue profile is most important in orthognathic surgery.4. Soft tissue response to orthognathic surgery is not different in secondary cleft deformities and simple malocclusion patient but amount of soft tissue response is not constant in many experimental study. 5. Camouflage mandibular surgery is benefit in some maxillary deformity patient.
Cicatrix ; Cleft Lip ; Congenital Abnormalities* ; Fistula ; Humans ; Incisor ; Lip ; Malocclusion ; Mandible ; Maxilla ; Orthognathic Surgery* ; Palate ; Retrospective Studies ; Tooth

Previous anatomic concepts in cleft lip nose deformity have following characteristics: 1. Obtuse angle between medial and lateral crus in affected alar cartilage; and 2, Cleft side alar cartilage is hypoplastic. The purpose of this study was to review the anatomy of alar cartilage in cleft lip nose deformity and to find out the effects of removal of intercartilagenous soft tissue on the effects of removal of intercartilagenous soft tissue on relocation of alar cartilage. There were 97 cleft lip nose corrections from Oct. 1996 to March When the affected alar cartilage was dissected, redundant intercartilagenous fibro-fatty tissue was found. After removing this redundant soft tissue, we found that the cleft side alar cartilage was better adjusted to the normal position. In addition, the plicavestibularis was more improved. Alar cartilage suture fixation was subsequently performed. Alar cartilage suture fixation was subsequently performed. After this procedure, we found that subsequently performed. After this procedure, we found that the affected side of alar cartilage was more normally positioned than before. The summary of the author's view on affected alar cartilage is as follows: 1. An acute angle between the medial and lateral crus was noted in affected alar cartilage; 2. Redundant intercartilagenous fibro-fatty tissue was present in cleft lip nose deformity;3.The terminal portion of the lateral crus of alar cartilage makes a plica vestibularis in the cleft side; 4. The position of the medial crus of alar cartilage was lower in the cleft side with the lateral crus was lower and cephalic in the cleft side; 5. The cleft side of alar cartilage is not hypoplastic.
Cartilage* ; Cleft Lip* ; Congenital Abnormalities* ; Nose* ; Sutures

One case of osteoid osteoma in the lamina of the fifth lumbar spine with hamstring muscle tightness was experienced and successfully treated by surgery at the department of orthopedic surgery in Seoul National University Hospital. Literature on the subject was reviewed in detail.
Muscle Tonus ; Orthopedics ; Osteoma, Osteoid ; Seoul ; Spine

Marfan Syndrome is a rare congenital disease characterized by the abnormalities of Sheletal system, eye and cardio-vascular system which was initially desiribed by Marfan in 1896. One case of marfan syndrome was treated at the department of Orthopedic Surgery, College of Medicine, Seoul National University for multiple skeletal deformities. Moderate degree of scoliosis was treated with Milwaukee brace and finger deformities with Z-plasty and full thickness skin graft.
Braces ; Congenital Abnormalities ; Fingers ; Marfan Syndrome ; Orthopedics ; Scoliosis ; Seoul ; Skin ; Transplants

Two hundreds cases of spine tuberculosis were treated surgically for the period of 7 years between 1970 and 1976 at Seoul National University Hospital and following results were obtained. 1. Many patients failed to be treated with conservative method. Spontaneous fusion was found in 10% of 200 cases with long duration of disease. Anterior fusion was performed in 166 cases and posterior fusion was carried out in 34 cases. In those 34 cases, anterior currettage was combined in 7 cases, anterior fusion combined in 19 cases in which 7 cases were performed anterior and posterior fusion at one stage. Posterior fusion alone was carried out only in 8 cases. 2. Anterior fusion is indicated for: a. decompression in cord involvement b. confirmation of diagnosis c. involvement of one joint space in children d. mild to moderate kyphosis in adult 3. Anterior and posterior fusion is indicated in: a. severe kyphosis for solid funsion b. involvement of more than two joint spaces in children to prevent increasing kyphosis c. one stage operation was technically possible and has many advantages 4. Posterior fusion is indicated in: a. poor general condition b. technically difficult cases.
Adult ; Child ; Decompression ; Diagnosis ; Humans ; Joints ; Kyphosis ; Methods ; Seoul ; Spine ; Tuberculosis

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

There have been numerous hypotheses about the pathogenesis of idiopathic scoliosis, but it is still unclear. There are some reports that abnormalities of contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The purpose of this report is to study the quantitative abnormalities of contractile proteins in muscles and nonactivated and activated platelets, and to determine whether or not the abnormalities in contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The materials were 21 idiopathic scoliosis patients aged from 13 years to 28 years(average 19.2 years) and 20 persons aged from 17 years to 25 years(average 20.1 years) as a control group. The electrophoretic analysis(SDS-PAGE method) was done on platelets both unstimulated and stimulated with thrombin and also on proteins of paraspinal muscles and gluteus maximus of idiopathic scoliosis patient and paraspinal muscles of control group. The results are as follows. 1. The myosin/actin ratios of triton-insoluble fractions to paraspinal muscles in convex sides of main curvatures of scoliosis patients(1.69±0.81) were significantly decreased compared to those of concave sides(2.55±1.28), gluteus maximus muscles(2.56±1.70) and control group(2.61±1.01). 2. There were no significant differences between scoliosis group and control group in the actin/myosin ratios of triton-insoluble fractions of the platelets both nonactivated and activated by thrombin. In conclusion, abnormalities of contractile protein in paraspinal muscles of convex side may play a role in the pathogenesis of idiopathic scoliosis, rather than abnormalities of systemic contractile protein.
Actins ; Blood Platelets ; Contractile Proteins ; Humans ; Muscles ; Myosins ; Paraspinal Muscles ; Scoliosis ; Thrombin

Congenital scoliosis is defined as a lateral curvature of the spine caused by congenital anomalies of the vertebral development. In this study seventeen congenital scoliosis patients seen and treated by either Milwaukee brace or surgical intervention at Department of Orthopedic Surgery, Seoul National University Hospital from December 1972 to April 1978 were evaluated according to frequency of the curve pattern, character of the deformity, method of treatment and its correctability. The following results were obtained in this study. 1. Age distribution was from 2 to 39 years and mean age was 13.4 years. 2. The most common deformity pattern was hemivertebra in 8 cases (47.1%), unilateral unsegmented bar in 4 (23.6%) and mixed type in 3 (17.6%). 3. The most common curve level was thoracic in 6 cases (35.3%), followed by thoracolumbar in 4 (23.5%) and lumbar in 4 (23.5%). 4. The best corrected type by Milwaukee brace was trapezoid vertebra (29.4%) and then mixed type(26.1%), followed by block type (20%) and hemivertebra(2.3%). 5. The operative treatment was performed in the cases of unilateral bar and progressive type with Milwaukee brace. In terms of the correctability of the curvature, the surgical intervention was better than the conservative treatment, with the result of its average correction of 33.5% that is compared with 15.9% of Milwaukee brace. 6. Halofemoral traction was effectively applied in the cases of rigid and severe curve; the initial curve 76.3 degress with 21.3% of flexibility. 7. Loss of correction in operative treatment was 2.3 degrees (6.5%).
Age Distribution ; Braces ; Congenital Abnormalities ; Humans ; Methods ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Spine ; Traction

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spinal Stenosis*

No abstract available.
Scoliosis*