A clinical observation in 8 cases of multiple laminectomies under the age of 16 years who had been followed for more than 3 years was carried out to analyze deformities and its results of treatment, and the following results were obtained. 1. Spinal deformities were developed in 5 cases-4 kyphosis and 1 lordosis. 2. The kyphosis was developed in 1 case at cervical spine, 1 at thoracic, 1 at thoracolumbar junction and 1 at lumbar, and the lordosis was developed in 1 case at lumbar spine. 3. Anterior interbody fusion was carried out on two cases of kyphosis who had severe pain and neurological symptoms and posterolateral spinal fusion was carried out on one case of lumbar lordosis, with satisfactory results in all cases. 4. Since the incidence of spinal deformities following multiple laminectomies in children is high, laminectomy should be performed only when it is definitely indicated, and when it is done, damage to the posterior complex should be minimized. 5. For the prevention and treatment of the spinal deformities, brace or close observation should be necessary postoperatively, and spinal fusion should be performed in increasing or severe deformities.
Animals ; Braces ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Laminectomy ; Lordosis ; Spinal Fusion ; Spine

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

As trochanteric fractures frequently occur in the elderly patients and complications such as pneumonia, thrombo-embolic disease, decubitus ulcer, and urinary tract infection are common, early mobilization after open reduction and internal fixation with hip nail are the standard treatment. Since 1931 when Smith-Peterson first introduced a tri-flanged nail, further more, since 1941 when Jewett pioneered the one-piece nail by adding a solid plate to a Smith-Peterson nail, numorous implants including threaded pins, screws, nails, and plates have been modified and desiged for fractured hips till now to achieve early ambulation and to maintain stable reduction. In 1955 Pugh and Ken introduced a sliding nail-plate and Schumpelick described the use of sliding screw-plate, which was modified further by Callender and Holt pioneered the concept of heavy nail in 1963. Recently compression sliding screw-plate is popular. Also many surgeons such as Evans, Dimon and Hughston, Sarmiento, and Boyd and Anderson have attempted to provide stable fixation of fracture by altering the position of fracture fragments to improve the mechanical resistances of bone to disruptive forces of weight-bearing. The surgical procedures of open reduction and internal fixation were carried out and followed for more than 6 months on 45 intertrochanteric fractures at Department of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1968 to June. 1975 and the results were observed as follows. 1. Of 45 cases of inter-trochanteric fractures 28 cases occurred in man, 17 cases in woman and each mean age was 54 years in man, 74 years in woman. 2. Of fixation devices, Smith-Peterson nail-plates were used in 19 cases, Jewett nails in 15 cases, compression sliding screw-plates in 9 cases, Smith-Peterson nail in 1 case, and Ken sliding nail-plate in 1 case. 3. Stable fractures occurred in 10 cases were fixed internaly after anatomical reduction. 4. Dimon-Hughston reductions and Jewett Nailing were achieved in 11 cases of 12 unstabIe fractures and had disadvantages such as some limitation of R.O.M. of the affected hip, shortening, and valgus deformity. 5. Of 9 unstable fractures treated by compression sliding screw-plate 7 cases were reduced as anatomicaly as possible and 2 cases were reduced non-anatomicaly because of impossible anatomical reduction but good results were obtained except one failed nailing. 6. Of 7 failures, 6 cases resuIted from failures of nailing during operation and only 1 failure resulted in varus defermity after Dimen-Hughston reduction with Jewett nail.
Aged ; Congenital Abnormalities ; Early Ambulation ; Female ; Hip ; Hip Fractures ; Humans ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Seoul ; Surgeons ; Urinary Tract Infections ; Weight-Bearing

Cubitus varus and cubitus valgus is one of late complications of elbow fracture. Tardy ulnar nerve palsy often accompanies with cubitus valgus. The authors reviewed 40 supracondylar osteotomies (on cubitus varus 31, cubitus valgus 9) performed at the Department of Orthopedic Surgery, Seoul National University Hospital, during the period of 15 years, from 1962 till 1976. During long term follow up, correction of elbow deformity and its maintenance is possible even in growing child. So early operation is recommended for the prevention of neurologic compIication and elbow stiffness.
Child ; Congenital Abnormalities ; Elbow ; Follow-Up Studies ; Humans ; Orthopedics ; Osteotomy ; Seoul ; Ulnar Neuropathies

Trochanteric fractures are seen in elderly patients and have high mortality and morbidity. Strong internal fixation and early ambulation is the best way to treat fractures. For this purpose, recently, compression sliding screw plate became popular. The surgical procedure of open reduction and internal fixation were carried on 36 intertrochanteric fractures at Depertment of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1972 to Dec. 1977 and the following results were obtained. 1. Of 36 cases of intertrochanteric fracture, 20 cases were in man, with the peak age at the 5th decade, and 16 cases in woman mostly over the 7th decade. 2. Most common causes were fall or traffic accidents in man and fall in woman. 3. Interval from injury to operation was less than 1 week usually. 4. Unstable fractures were 86% and of these, Tronzo Type III was the most common. 5. The trend of use of internal fixation device was from S-P plate and screw, and Jewett nail to sliding compression plate and screw. 6. Reduction of medial displacement with Dimon-Hughston method was used commonly in Jewett nailing and anatomical reduction in sliding compression plate and screw. 7. Post operative cast immobilization were applied in a few cases of under 50 years old, Other-wise early ambulation were carried out. 8. Post operative complications were encountered in 8 cases (22%), but none were fatal.
Accidents, Traffic ; Aged ; Early Ambulation ; Female ; Hip Fractures ; Humans ; Immobilization ; Internal Fixators ; Methods ; Mortality ; Orthopedics ; Seoul

The use of antituberculous drug made it possible to develop the radical operative procedure in the treatment of the spine tuberculosis. The anterior fusion is the most frequently used surgical measure in the treatment of the spine tuberculosis but several problems were observed not infrequently. One hundred and twenty-nine cases of childhood spine tuberculosis were treated by the anterior spinal fusion for the period of ten years from 1968 to 1977 at Seoul National University Hospital, and following results were obtained. Problems of the anterior spinal fusion could be divided into two categories; one is the complications and the others are difficulties in the surgical procedure. Complications of the anterior spinal fusion were divided into early and late. Early complications include graft failure, pulmonary problems, cord compression and spinal fluid leakage. Late complications include increasing kyphosis, draining sinus and graft failure. Degrees of increasing kyphosis were the greatest in the age group between the and five years, and greater degrees of increasing kyphosis were observed in more joint involvement. Increasing kyphosis were observed more frequently in longer follow up. The causes of increasing kyphosis could be considered as the relative discrepancies between the growth of the anterior and posterior comparment, and graft failure.
Child ; Follow-Up Studies ; Humans ; Joints ; Kyphosis ; Seoul ; Spinal Fusion ; Spine ; Surgical Procedures, Operative ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Great strides has been made in the past 20 years in the treatment of scoliosis. Treatment before scoliosis becomes severe eliminates the need for extensive surgery. Early detection of scoliosis by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 5,256 middle and high school students in Seoul, who were chosen arbitrarily, to determine the incidence rates of scoliosis, and following results were obtained. 1. Scoliosis was diagnosed on a combination of at least one positive physical sign and a lateral curvature more than 5 degrees on an antero-posterior standing X-ray. 2. The overall incidence of scoliosis was 4.68% (Male 0.74%, Female 6.43%). 3. Idiopathic scoliosis was found in 238 students, congenital scoliosis in 5, and paralytic scoliosis in 3. 4. The most common pattern of curvature was thoracic curve. 5. In the single curve right to left ratio was 2.1, but 8.4 in the upper curve of double curve. 6. Close observations were required for all the 246 students and treatment was required in 14 students who had more than 20 degrees, 9 students for Milwaukee brace, and 5 students for surgical correction.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Scoliosis ; Seoul

No abstract available in English.
Spondylolisthesis

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