Ten cases of unstable spine were treated with various surgical procedures under control of Halo apparatus and following results wen obtained. 1. Six cases of unstable cervical spine were treated with Halo apparatus and were able to obtain solid fusion for permanent stability. 2. Three cases of tuberculous kyphosis were corrected with halo-pelvic hoop on, and were able to obtain mean correction angle of 42 (65%) with little danger. 3. With halo on, staged operations such as anterior and posterior osteotomy, gradual distraction, anterior and posterior fusion of the spine for correcting deformity were carried out securely. 4. Average duration of halo application was eight weeks, no more twelve weeks, and there was no irreversible complication with halo apparatus per se.
Congenital Abnormalities ; Kyphosis ; Osteotomy ; Spine

The authors have reviewed 71 cases (70 patients) of the ankle fractures that were treated through the admission in Orthopedic Department, Paik Foundation Hospital, from June 1972 to April 1978. The average duration of the follow-up waa 15 months. The summary of the results were as follows; 1. Of the 71 cases, male was 54 cases and female 17 cases. The average age of the patients was 32. 2. The main cause of the injuries was traffic accident, and the other causes were sliding down and falling from a height, industrial accident, and sports injury in order. 3. By the classification of Lauge-Hansen, the pronation-external rotation and,supination-adduction types were commoner than the other types. 4. Open reduction was performed in 48 cases, and closed reduction in 23 cases. 5. The average duration of the cast immobilization after the closed reduction was 8 weeks, and that of the open reduction was 6 weeks. 6. The result of the treatment was better in those cases of the open reduction than that of, the closed reduction. 7. The good clinical results could be achieved by obtaining the anatomical position of the talus in the mortise and the reduction was achieved more satisfactorily when the key role of the lateral malleolus in complete reduction was well understood.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Orthopedics ; Talus

PURPOSE: Numerous operative techniques have been developed to correct hypospadias. Tubularized incised plate (TIP) urethroplasty has recently been reported with good results. We analyzed the surgical outcome and complications in children with hypospadias using TIP urethroplasty. MATERIALS AND METHODS: Between July 1998 and July 2001, 28 patients with hypospadias were primarily corrected using TIP urethroplasty by one surgeon. The mean age of the patients was 4.2 years. A position of the meatus was coronal in six boys, at the posterior penile shaft in five, glandular in four, penoscrotal in four, at the anterior penile shaft in three, at the midshaft in three and the perineal in three. An 8 or 10 Fr Foley catheter was used as a urethral stent, which was removed at day 12 (10-15). RESULTS: Of the 28 patients, 23 were corrected with TIP urethroplasty only, and the other 5 combined with an onlay island flap. For the management of penile curvature, skin and ventral releases were used in 14 patients; with tunica albuginea placation used in the other 14. Postoperative complications were noted in 3 patients, of whom 2 developed urethrocutaneous fistula and one developed meatal stricture. The cosmetic results were very good in most patients. CONCLUSIONS: TIP urethroplasty can be used for all type of hypospadias. It has advantages, such as an excellent cosmetic appearance, preservation of the urethral plate and a lower complication rate than other urethroplasty techniques. Our results suggest that this technique is recommendable for the management of primary hypospadias as a first choice.
Catheters ; Child ; Constriction, Pathologic ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Postoperative Complications ; Skin ; Stents ; Urethra

No abstract available.
Mandibular Reconstruction*

We present a case of 15 months old male with Multilocular cystic nephroma (MLCN) which contains fibroblast, smooth muscles, skeletal muscles and well differentiated tubular structure in the septa without evidence of blastemal or embryonal elements. There is no evidence of metastasis and local recurrence after post-op 2 years.
Child* ; Fibroblasts ; Humans ; Infant ; Male ; Muscle, Skeletal ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence

The treatment of urolithiasis in children has been changed dramatically by extracorporeal shock wave lithotripsy (ESWL) and endourological procedure in recent years. Especially, the use of extracorporeal shock wave lithotripsy has changed the place of open surgery in the treatment of urinary stones in children. A total of 24 children with 25 renoureteral units underwent treatment with Therasonic Lithotrirter System for urinary tract stones between Feb. 1992 and March 1996. The patient age ranged from 3 months to 14 years with a mean of 4.7 years. The location of stones were renal in 9, upper ureter in 6, and lower ureter in 10 cases. The average stone length was 14mm with a range of 5mm to 50rnm. Developmental anomalies of the urinary tract were noted in 2 children, and there were the incomplete duplicated ureter and the ureterocele. The excreted stones in 5 children were analysed biochemically and calcium oxalate stones were present in 3 cases, calcium phosphate stone in 1 and cystine stone in 1. A complete stone free rate was achieved in 91.7%. Except for one case, no specific complication occurred during or after treatment, but perioperative antibiotic prophylaxis was done Therefore, the authors conclude that extracorporeal shock wave lithotripsy is a safe and effective method for the treatment of urinary stones in children.
Antibiotic Prophylaxis ; Calcium ; Calcium Oxalate ; Calculi* ; Child* ; Cystine ; Humans ; Lithotripsy ; Shock ; Ureter ; Ureterocele ; Urinary Calculi ; Urinary Tract* ; Urolithiasis

No abstract available.
Arteriovenous Fistula*

From January 1988 to January 1996, 42 infants and children (44 renal units) had undergone surgical management to correct ureteropelvic junction obstruction. Median patient age was 8.5 years (range from 2 months to 17 years) and 11 patients were less than 1 year old at operation. Of 44 renal units surgically managed, 30 were on the left side and 10 were right side. 2 patients had undergone bilateral surgical management. Presenting symptoms were febrile urinary tract infection in 14 cases, abdominal pain in 14 cases, abdominal mass in 5 cases, gross hematuria in 3 cases and 3 cases were detected prenatally. We used imaging antegrade pyelography (AGP) in 15 cases, additional retrograde pyelography (RGP) in 12 cases and both AGP and RGP were performed in 1 case. To correct ureteropelvic junction obstruction, we performed dismembered pyeloplasty in 33 renal units, ureterolysis in 2 renal units, ureterocalycostomy in 1 renal unit, endopyelotomy in 1 renal unit and nephrectomy in 7 renal units. To diverge the urinary flow, we used nephrostomy in 19 renal units, ureteral stenting in 6 renal units and both nephrostomy and ureteral stenting were used in 10 renal units. As postoperative complications, restenosis was developed in 5 renal units, delayed open in 5 renal units, urinary tract infection in 2 renal units and wound infection, prolonged urine leakage, ureteral stone in each 1 renal unit. Postoperative success rate in followed-up patients, who had undergone pyeloplasty, was 91.6%. The success rate in children, who was less than 1 year old, was 100% and in children, who was more than 1 year old, was 88.4%. Finally we suggest that the surgical correction is safe and proper method for ureteropelvic junction obstruction in children. Additionally early operation of ureteropelvic junction obstruction is recommendable.
Abdominal Pain ; Child* ; Hematuria ; Humans ; Infant ; Nephrectomy ; Postoperative Complications ; Stents ; Ureter ; Urinary Tract Infections ; Urography ; Wound Infection

No abstract available.
Caroli Disease*

A case of traumatic myositis ossificans arising from both elbow joints in twenty six year old male is reported. This patient had been confined to his bed in comatous state for three months after head trauma by traffic accident. When he awaked from coma, the patient noticed his both elbows stiff. Roentgenograms of both elbows revealed extensive irregular periarticular ossifications around the joints. At posttrauma tenth month, complete excision of the bony mass was carried out from the left elbow and one month later, from the right one. From postoperative one week, active exercise was started. Duration of follow up was seven months in left side and six months in right side, There are no signs of recurrence and, now patients go through satisfactory range of motion of both eldows.
Accidents, Traffic ; Coma ; Craniocerebral Trauma ; Elbow Joint ; Elbow ; Follow-Up Studies ; Humans ; Joints ; Male ; Myositis Ossificans ; Myositis ; Range of Motion, Articular ; Recurrence