Ankle arthrodesis has been regarded as a good operative treatment for post traumatic and rheumatoid arthritis of ankle, and ankle arthroplasty has been also developed with several types, from 1970, by Lord & Marotte. Ankle arthroplasty is more functional & less cosmetic troublesome than arthrodesis, and with more developed prosthesis design, more good result will come. The authors operated 6 cases of total ankle arthroplasty for posttraumatic and rheumatoid arthritis of ankle, which were also indications of arthrodesis, and introduce the results and operative problems of ankle arthroplasty.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Prosthesis Design

Chronic osteomyelitis continue to be a therapeutic challenge. The osteomyelitis also implies chronic ischemia of the diseased bone ; thus systemic antibiotic treatment may not be as effective as we want. In 1972, Klemm developed a new procedure to supplement saucerization in the treatment of chronic osteomyelitis, alternative to irrigation and suction-drainage, i.e., Gentamicin-PMMA Beads. The authors analysed 35cases of the chronic osteomyelitis which were admitted and treated by sauceriztion and Gentamicin-PMMA Beads in Department of Orthopaedic Surgery, Korea Veterans Hospital from Aug. 1984 to Jan. 1988.
Gentamicins ; Hospitals, Veterans ; Ischemia ; Korea ; Osteomyelitis ; Polymethyl Methacrylate

A Case of double pylorus, in 56 year old man, was diagnosed by fiberoptic gastroscopy and upper gastrointestinal series. Two ovoid large openings of pyloric canal divided by smooth thickened septum were observed endoscopically And the relevant literatures on tihe subject were reviewed.
Gastroscopy ; Humans ; Middle Aged ; Pylorus*

The impingement syndrome has an anatomical character that occur against the anterior edge and the undersurface of anterior third of the acromion, coracoacromial ligament and acromioclavicular joint. The treatment consists of conservative and surgical things. We consider the surgical intervention only in cases fail to control pain by conservative treatment over 3 months(from Feb. 1990 to Jan. 1994). The author experienced 15 cases (14 pts) in positive impingement sign & test and evaluated by shoulder arthrography in all cases. 1. The mean age was 60 years ranged from 48 to 68 years and the average symptom duration was 23 months. 2. There were all positive impingement sign & test clinically. 3. There were partial tear of rotator cuff in 3 cases and complete tear in 12 cases radiologically. 4. The anterior acromioplasty with division of coracoacromial ligament was performed in all cases, additional rotator cuff repair in 3 cases and bicipital tenodesis in 2 cases. 5. At the follow up based on UCLA shoulder rating scale, results were excellent & good in 13(86%) and unsatisfactory in 2(14%) cases.
Acromioclavicular Joint ; Acromion ; Arthrography ; Decompression, Surgical ; Follow-Up Studies ; Ligaments ; Rotator Cuff ; Shoulder ; Tears ; Tenodesis

Among the 85 cases of prosthetic replacement of femoral neck fracture which had been operated at Department of Orthopaedic Surgery, Korea Veterans Hospital from January, 1982 to May, 1990, 32 cases (15 unipolar hemiarthroplasty and 17 bipolar hemiarthroplasty) were examined clinically and radiologically at an average 7.7 years postoperatively. And the results were as follows; 1. The group I (Unipolar hip hemiarthroplasty without cement) had Harris hip score - average 79.4. The group II (Unipolar hip hemiarthroplasty with cement) had Harris hip score average 87.3. The group III (Bipolar hip hemiarthroplasty without cement) had Harris hip score average 80.5. The group IV (Bipolar hip hemiarthroplasty with cement) had Harris hip score average 86. 2. There were 2 cases of stem loosening (13%) among 15 cases in unipolar hip hemiarthroplasty and 1 case (6%) among 17 cases in bipolar hip hemiarthroplasty. 3. The movement of two components in bipolar hip hemiarthroplasty was noted in all cases and the movement of the outer bearing joint was more active than that of the inner. And the movement of the two components was not correlated with the use of cement. But Harris hip score was superior cement stem group to noncement stem group. 4. Unipolar hip hemiarthroplasty showed the similar clinical and radiological results with bipolar hip hemiarthroplasty of femoral neck fracture in the elderly. As a result, unipolar and bipolar hip hemiarthroplasty were considered the proper treatment method of the femoral neck fracture in the elderly.
Aged ; Femoral Neck Fractures ; Femur Neck* ; Hemiarthroplasty* ; Hip* ; Hospitals, Veterans ; Humans ; Joints ; Korea

Eosinophilic granuloma of bone is a self-limited condition, characteristically a disease of children and young adults. It is the most benign variant of histiocytosis X. It is most common in skull, but any bone may be affected. Vertebral involvement occurs in about 10 to 15%. This benign bone destructive lesion is characterized by the presence of Langerhans cells contain Birbeck granules, infilitration of histiocytes and eosinophilic leukocytes unknown origin. We report a eosinophilic granuloma in lumbar spine of old patient.
Child ; Eosinophilic Granuloma* ; Eosinophils* ; Histiocytes ; Histiocytosis, Langerhans-Cell ; Humans ; Langerhans Cells ; Leukocytes ; Skull ; Spine* ; Young Adult

In the paget's disease involving the vertebra, the symptom and sign of compression come from encroachment on the spinal cord due to the enlarging vertebral bodies, pedicles and laminae. The cord compression appears to be preceded by a long insidious period of noncharacteristic clinical symptoms with minor neurologic dysfunction. The lumbar syndrome of Paget's disease is classified according to its severity, clinical findings, biochemical factors and radiologic patterns. The severity of neurologic complication in Paget's disease involving the vertebra varies according to the level involved. The outcome depends on the suddeness of symptom onset and the effectiveness of decompression. We have experienced a case of Paget's disease involving long bones and lumbar spine in 56 year old male patient, in which surgical decompression produced improvement. We report a case of spinal stenosis in paget's disease with brief review of literature.
Decompression ; Decompression, Surgical ; Humans ; Male ; Neurologic Manifestations ; Spinal Cord ; Spinal Stenosis ; Spine

The Marcus ankle arthrodesis was carried out in 16 patients at department of orthopaedic surgery of Korea Veterans Hospital from January 1989 to December 1993. All of patients were reviewed and evaluated with subjective and functional rating scales according to the Mazur scoring system. The average follow up was 23 months, ranging from 12 months to 60 months. The Marcus ankle arthrodesis involves a chevron osteotomy, tibial onlay graft medially, internal fixation with staples and screws. According to the Mazur score, the results were 6 cases of Excellent, 7 cases of Good. The average Mazur score was 75.1. There were 4 cases of complication, a non-union, a superficial wound infection, a bursitis, and a tendon injury. In summary the Marcus ankle arthrodesis by chevron osteotomy seems to be a good procedure, which gives solid bony union with short duration, relief of pain, normal looking ankle configuration without leg length discrepancy and good function with few complications.
Ankle ; Arthrodesis ; Bursitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Inlays ; Korea ; Leg ; Osteotomy ; Tendon Injuries ; Transplants ; Weights and Measures ; Wound Infection

BACKGROUND: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. MATERIAL AND METHOD: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax underwent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a bleb larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant bleb via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. RESULT: Multiple or single bleb lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and bleb was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of 30+/-3 months, no recurrence occurred in both the operative group and the non-operative group. CONCLUSION: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.
Anesthesia, Local ; Blister ; Drainage ; Follow-Up Studies ; Hemorrhage ; Humans ; Pneumothorax ; Recurrence ; Thoracoscopes ; Thoracoscopy

BACKGROUND: In Korea, cerebrovascular accident (CVA) is the most significant cause of death among older people, and the incidence of cerebral hemorrhage is much higher than that of developed countries. There have been many investigations about the risk factors for CVA in both Korea as well as developed countries. A few papers reported various risk factors for cerebral hemorrhage in developed countries:however, well-designed studies of risk factors for the various causes of CVA were rare in Korea. Therefore, the purpose of this study was to compare the risk factors for the various causes of CVA and to evaluate the risk factors compared with age- and sex-matched control groups. In addition, duplex sonographic findings of the carotid artery were evaluated in patients with cerebral infarction. METHODS: One hundred and sixty-four patients admitted to the hospital in 1996 were enrolled. The four groups were divided based on the following states: cerebral infarction (n-63), cerebral hemorrhage (n-64), cerebral infarction with atrial fibrillation (n-19), and lacunar infarction (n-18). Major risk factors were compared with age- and sex-matched control groups and among CVA groups. Duplex sonography of the carotid artery was done in 14 patients with cerebral infarction. RESULTS: In multiple logistic regression analysis, patients with cerebral infarction had higher prevalence of diabetes mellitus and lower high density lipoprotein-cholesterol level than the control group, and hypertension showed borderline significance. Patients with cerebral hemorrhage had higher prevalence of hypertension, higher high density lipoprotein-cholesterol level, and more frequent prevalence of smoking compared with the control group. Patients with cerebral infarction showed lower high density lipoprotein-cholesterol, higher low density lipoprotein-cholesterol levels, more frequent diabetes mellitus, lower prevalence of hypertension and older age than patients with cerebral hemorrhage. Patients with cerebral infarction and atrial fibrillation showed only older age than patients with cerebral infarction only. There were no differences in risk factors between patients with cerebral infarction and lacuna infarction. Atheromatous plaque was found in 71% of patients with cerebral infarction. CONCLUSION: Metabolic abnormalities played more important role in the development of cerebral infarction and hemodynamic abnormalities in cerebral infarction. Sonographic examination of the carotid artery may be useful for predicting the occurrence of cerebrovascular accident in high risk patients.
Atrial Fibrillation ; Carotid Arteries* ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction* ; Developed Countries ; Diabetes Mellitus ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Infarction ; Korea ; Logistic Models ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar ; Ultrasonography*