Acetabular fractures are usually caused by violent external force such as car clash and commonly accompany injuries of the other parts of the body. And there has been long controversy between conservative and operative treatments. A clinical analysis was performed on the 29 patients with acetabular fractures, who had been treated at seoul National University Hospital from 1973 to 1982, mainly focussed on the result of treatment. Followings are the summary of the result. 1. Conservative treatment was done in 52% and operative treatment in 48%. 2. Mean follow-up period was 1 year and 8 months. 3. The result of treatment was good or fair in 53% of conservative treatment group comparedto 71 in operative treatment group. 4. Primary total hip replacement was done in one case of bursting fracture combined with fracture of femur neck and the result was good. 5. Superior and bursting fractures showed the worst result(poor in 83%). 6. Degenerative arthritis with or without avascular necrosis was the most common complication (45 %) and it was more common in conservative treatment group (60 vs. 29%). 7. From above results it could be said that operative treatment in acetabular fractures, if carefully done with reasonable indications, would improve the result and decrease the rate of degenerative arthritis.
Acetabulum ; Arthroplasty, Replacement, Hip ; Femur Neck ; Follow-Up Studies ; Humans ; Necrosis ; Osteoarthritis ; Seoul

Spinal stenosis is a localized narrowing of spinal canal due to strurctural abnormalities. Its symptoms are obscure, and characterized by chronic, poorly localized, bilateral nerve root compression signs. Computerized tomography(CT) has been accepted as almost an absolute diagnostic method for spinal stenosis after its application in the orthopedic field. During the period of 2 years, from March 1982 to March 1984, 26 cases of spinal stenosis were treated surgically after botlt CT scanning and myelography. We obtained following results about advantage of CT scanning in spinal stenosis. 1. Myelography showed following findings: Hourglass defect 9, Complete block 8, Unilateral focal defect 4, Uniform narrowing 1, Mixed 2, Negative finding 2. Myelographic finding was not specific for spinal stenosis and diagnostic accuracy was inferior to CT. 2. The type of spinal stenosis was identified by CT scan finding. Of 26 cases, 21 cases were degenerative spinal stenosis, of which central stenosis was present in 7 cases, and lateral stenosis was present in all cases. The remaining 5 cases were combined type, and both central and lateral stenosis were present in all cases. 3. The diagnostic accuracy,in localizing the level of stenosis was 61.5% by myelography, and 96.2% by CT scan. CT was especially superior to myelography in the localization of the multi-segmental stenosis. 4. CT gives valuable information about extent and degree of stenosis, especially lateral recess stenosis, thus helping the surgeon to decide on the extent of decompressive lamininectomy preoperatively.
Clothing ; Constriction, Pathologic ; Methods ; Myelography ; Orthopedics ; Radiculopathy ; Spinal Canal ; Spinal Stenosis ; Tomography, X-Ray Computed

No abstract available.
Knee Joint* ; Knee*

From March 1988 to August 1989, 51 knees with clinically suspected meniscus injuries were examined by both MRI and arthroscopy and compared their findings prospectively on the basis of arthroscopic findings to determine the accuracy of MRI in detecting meniscus injury of the knee. We used 2.0 tesla superconducting magnet imager(Spectro-20000, GoldStar, Korea) to obtain MR imaging. Our protocol for imaging was producing Tl sagittal images by spinecho technique and T2 coronal images by gradient echo technique, interleaved at 4mm continuously while the patient's knee was in 8–10 degrees of external rotation and surface coil was placed posteriorly to the knee in supine position. We grouped and correlated the findings of MRI with the arthroscopic findings. With this noninvasive MRI, we could obtain multiplanar, high quality images without compliations. Compared with the arthroscopic findings, MRI resulted in a high diagnostic accuracy of 96 and 86 percent for the medial and lateral meniscus, respectively. And it aided in optimal surgical planning for the clinically suspected meniscus injuries.
Arthroscopy ; Knee ; Magnetic Resonance Imaging ; Menisci, Tibial ; Prospective Studies ; Supine Position

Sjogren-Larsson syndrome is a rare autosomal recessive neurocutaneous disorder due to a deficiency of the fatty aldehyde dehydrogenase. It consists of ichthyosis, spastic di- or quardriplegia and mental retardation. We report a case of a 9-year-old boy who was suspected to have Sjogren-Larsson syndrome. He had congenital ichthyosis, spastic diplegia and mental retardation. In addition, there was macular degeneration on the fundus. His neurological symptoms were improved after selective posterior rhizotomy and rehabilitation therapy. However, the dermatological problem did not subside with conservative treatment.
Aldehyde Dehydrogenase ; Cerebral Palsy ; Child ; Humans ; Ichthyosis ; Intellectual Disability ; Macular Degeneration ; Male ; Muscle Spasticity ; Neurocutaneous Syndromes ; Rehabilitation ; Rhizotomy ; Sjogren-Larsson Syndrome*

Infantile hypertrophic pyloric stenosis (IHPS) is known to be prevalent in full-term babies, and relatively rare in prematures. The diagnosis of IHPS in premature infants may be obscured because of the lack of classical symptoms and signs and the absence of the standard criteria for ultrasonic diagnosis. The purpose of this study is to discover the clinical differences of IHPS between premature and full-term infants with pyloric stenosis, and to determine the appropriate diagnostic methods for early diagnosis in prematures. The clinical records of 52 IHPS patients who had been operated from October, 1994 to April, 1997 were reviewed. IHPS in premature infants was 25%. The onset of symptom was 4.7 weeks of age in premature, and 2.9 weeks in full-term babies. Diagnosis was established by typical symptoms, signs, and diagnostic imaging studies. In two premature infants, diagnosis was confirmed by upper gastrointestinal (GI) series, because ultrasonography did not meet the diagnostic criteria. Two premature infants diagnosed as gastroesophageal reflux by esophagography initially, were confirmed to have IHPS by upper GI series. For the diagnosis of IHPS, a new set of criteria for premature babies has to be developed.
Diagnosis ; Diagnostic Imaging ; Early Diagnosis ; Gastroesophageal Reflux ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Pyloric Stenosis ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography

No abstract available.
Dislocations* ; Knee Joint* ; Knee*

In carpal injury, a good functional end result seems to correlate with final anatomic alignment of carpus after treatment. Some cases are often misdiagnosed and result in inadequate treatment. Forty six cases of carpal injuries were analysed which were treated for 9 years from 1975 to 1984 at the Department of Orthopedic Surgery, Seoul National University Hospital. The observations can be summarized as follows. 1. The male to female ratio was 3.5: 1 and 82% of total cases were in the third and fourth decades. 2. The most frequent cause of injury was fall from height with outstretched hand. 3. Trans-scaphoid perilunar dislocation and its variant were the most common diagnosis in this analysis. 4. All of the scapho-lunate dissociation showed volar flexion intercalated segmental instability with scapho-lunate gap more than 2 mm in our series. 5. In 11 cases of trans-scaphoid perilunar dislocation and its variant, carpal collapse was found in 10 cases. In 5 cases dorsiflexion intercalated segmental instability pattern and in one case volar flexion intercalated segmental instability pattern were found to be present. 6, There was an increase in scapho-lunate angle in all cases of dorsiflexion intercalated segmental instability, but a decrease in scapho-lunate angle is not a consistent finding in volar flexion intercalated segmental instability. 7. In 24 cases more than 6 months follow-up, excellent and good results were obtained in 20 cases. 8. As a result of above findings, authors conclude that scapho-lunate gap more than 2mm has diagnostic value in scapho-lunate dissociation but that dorsiflexion intercalated segmental instability or volar flexion intercalated segmental instability only means the changes in the relationship between carpal bones and does not have definite or specific diagnostic value for a specific carpal injury.
Carpal Bones ; Diagnosis ; Dislocations ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Orthopedics ; Seoul ; Wrist

We applied arthroscopy in the diagnosis of thirty four patients with internal derangement of the knee from March to August, 1982. Its results were compared with clinical diagnosis and arthrographic findings. We also performed arthrofomy in twenty nine patients and the final diagnosis enabled us to evaluate the diagnostic accuracy of each method. The accuracy of clinical diagnosis was 63.4%. Arthrographic findings were correct in 77.8%. The diagnostic accuracy of arthroscopy was 92.3% with one false negative case. Unnecessary operations were avoided in five patients with the assistance of negative findings of arthroscopy. Arthrography and arthroscopy were complementary in the diagnosis of internal derangement of the knee.
Arthrography ; Arthroscopy ; Diagnosis ; Humans ; Knee ; Methods

No abstract available in English.
Arthroscopy ; Knee Joint ; Knee