Supracondylar fractures of the humerus is the most common elbow fractures in children. The fractures so designated are in the supracondylar area of the humerus just proximal to the elbow, and do not directly involve the joint or the distal humeral epiphysis. Unfortunately, it can also be one of the most difficult fractures to treat. And the catastrophic picture of Volkmann's ischemic contracture and nerve injuries associated with these fractures, as after successful reduction, the late complications of loss of elbow motion, the chage in carrying angle, myositis ossifgicans, and delayed ulnar nerve palsy still lie ahead. For the period of 4 years and 10 months from May 1979 to March 1985, 47 patients who had been treated for supracondylar fractures of the humerus at the Department of Orthopaedic Surgery, college of medicine, Soon Chun Hyang University Hospital, are presented, The results obtained are as follows; 1. Supracondylar fractures of the humerus frequently occured between the ages of 4 and 9 years (70.2%) and the sex ratio was 2.1: 1 in male to female. 2. Of all fratures, 89.4% were the extension type and the left side was predominent in 55.3% than right. 3. According to the Holmberg clasification, Group 1 was 6 cases(12.8%), 10 cases(21.3%) in Group 2, 11 cases(23.4%) in Group 3, and 20 cases(42.5%) in Group 4. 4. Closed reduction with percutaneous pinning showed little changes in carrying angle. 5. Limitation of motion was most frequent complication after closed reduction with plaster cast immobilization. 6. By the modified Mitchell and Adams' criteria for grading results, excellent were obtained in 55.3 %, good in 44.7%, and zero in unsatisfactory. 7. In the neurovascular injuries associated with fractue, there were 4 neural injuries, and 2 vascular injuries. In 4 traumatic neuropathies, median nerve was involved most commonly and the were recovered spontaneously within 5 weeks. 8. Average time from injury to reduction was 1.6 day and delayed reduction or operation made worse the prognosis in most cases.
Casts, Surgical ; Child ; Elbow ; Epiphyses ; Female ; Humans ; Humerus ; Immobilization ; Ischemic Contracture ; Joints ; Male ; Median Neuropathy ; Myositis ; Prognosis ; Sex Ratio ; Ulnar Neuropathies ; Vascular System Injuries

Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.
Atlanto-Occipital Joint ; Dislocations ; Early Ambulation ; Humans ; Nervous System Diseases ; Spine ; Spondylolisthesis ; Transplants

Fractures in the subtrochanteric region of the femur present more formidable problems in treatment than do other trochanteric fractures, because such severe stresses exit at the fracture site. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recommanded for use in subtrochanteric fractures and each of these devices have advantages in certain types of subtrochanteric fractures, and their selection should be based on the individual fracture anatomy. A total of 20 patients with fracture of the subtrochanteric region of the femur, who were treated by internal fixation with Judet plate between January 1982 and December 1988 have been reviewed. Our conclusions were as follows; 1. Average age was 38 years old and most common cause of injury was traffic accident. 2. Cast immobilization was done after Judet plate fixation. Partial weight bearing ambulation was enabled from POD 10 weeks and full weight bearing ambulation was enabled from POD 16 weeks. 3. 18 in 20 cases, primary bony union was happened and the mean duration of radiological bony union was 24 weeks. 4. 3 cases of complications, metal failure with refracture (2 cases) and screw loosening (1 case), were occured due to early weight bearing in the post operative course. 5. Judet plate fixation was gave satisfactory result in uncomminuted subtrochanteric fracture, especially Seinsheimer's type I, II-A,B,C or Fieldings type I, II. 6. From a consideration of these series, Judet plate showed easy to use, perfect adaptation and rigid fixation. We thought Judet plate is one of a good implants for rigid fixation of subtrochanteric fracture without severe medial cortical disruption.
Accidents, Traffic ; Clinical Study ; Femur ; Hip Fractures ; Humans ; Immobilization ; Internal Fixators ; Walking ; Weight-Bearing

No abstract available.
Dupuytren Contracture*

Three hundred and fourty two patients with a fracture of tibial shaft were treated and managed in the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from January 1981 to December 1985. In 147 cases, 62 cases had only tibial shaft fracture and 85 tibial and fibular shaft fracture. All of these were treated conservatively by manipulation and cast immibilization. We analyzed the initial fracture characteristics, the treatment employed, and the subsequent complications in fracture healing in a series of patients who had sustained a tibial shaft fracture with and without a fibular fracture. The results were as follows; 1. Duration of average bone healing was more slowly in the patients more than twenty years old who were treated for a tibial shaft fracture with and without a concomitant fibular fracture than in the patients less than twenty years old. 2. Duration of average bone healing was more slowly by one or two weeks in the the group of tibial shaft fracture without fibular fracture than in than in those with fibular fracture. 3. The frequency of delayed union, nonunion, varus malunion and pain in the ipsilateral ankle joint were more increased in the group of the tibial shaft fractures without fibular fracture in than those with fibular fracture. 4. The frequency of valgus malunion was more increased in the group of the tibial shaft fractures with fibular fracture than in those without fibular fracture.
Ankle Joint ; Fracture Healing ; Humans ; Tibia

The primary aims of fracture treatment include the restoration of normal anatomy and a return of function to the injuried as early as possible. In pilon fracture, various methods of treatment were developed to accomplish this purpose. Fibular fixstion is a rarely accepted mehtod in the treatment of pilon fractures because it can't provide rigid internal fixation, But it might be indicated when an open wound was : present medially over the distal tibia, the ligamentous attachments of distal fibula and medial malleolus to talus and calcaneus and of the distal tibiofibular syndesmosis are largely intict. Utilizing these attachment, Fibular fixation can stabilize comminuted fractures of distal tibia affecting ankle joint. This procedure is so effective and simple The author has used this technique in three instances for two years with excellent results. This is not an original method, but worthy of being remindful of the literature.
Ankle Joint ; Ankle ; Calcaneus ; Fibula ; Fractures, Comminuted ; Ligaments ; Methods ; Talus ; Tibia ; Tibial Fractures ; Wounds and Injuries

Cysticercosis is due to a larva of Taenia Solium. It is frequently reported in developing countries. It usually affects subcutaneous tissue, muscles and brain. But, spinal cysticercosis is rare and is usually diagnosed at surgery. Authors experienced a case of spinal cysticercosis accompanied with spondylolistheses at the same level. Space occupying lesion and arachnoiditis, confirmed by MMCT and MRI, were noted at the same level of spondylolistheses. So, it was very hard to make dicision whether we should open up the dura or not.
Arachnoid ; Arachnoiditis ; Brain ; Cysticercosis ; Developing Countries ; Larva ; Magnetic Resonance Imaging ; Muscles ; Spondylolisthesis ; Subcutaneous Tissue ; Taenia solium

We Studied 48 patients(62 hips) who were performed hip arthroplasties at the Department of Orthopaedic Surgery, Soonchunhyang University hospital from February 1990 to August 1992. The purpose of the present study was to compare canal filling ratio and clinical results of cases treated by cementless femoral stem with 19 Harris Galante(straight stem), 23 Anatomic(curved stem) and 20 Multilock (straight stem). The follow-up periods ranged from 12 months to 36 months. We assessed canal filling at metaphysis, mid-stem and distal canal, and clinical results according to canal filling. The results were as follows ; 1. The average filling ratio of the medullary canal by each type of stem in the coronal plane were as follows. Harris Galante ; 80. 5%, Anatomic ; 79. 4%, Multilock; 79. 8% in metaphysis. Harris Galante ; 88. 7%, Anatomic ; 88. 3%, Multilock ; 87. 3% in mid-stem. Harris Galante ; 95. 1%, Anatomic 90. 2%, Multilock ; 94. 5% in distal canal. At distal canal, the average canal filling of Harris Galante and Multilock were more excellent than Anatomic in coronal plane. 2. The average filling ratio of the medullary canal by each type of stem in the saggital plane were as follows. Harris Galante ; 64. 0%, Anatomic 69. 6%, Multilock ; 68. 6% in metaphysis. Harris Galante ; 79. 6%, Anatomic; 84. 5%, Multilock; 80. 2 in mid-stem. Harris Galante ; 78. 3%, Anatomic ; 82. 6%, Multilock ; 84. 5% in distal canal. At mid-stem, the average canal filling of Anatomic was more excellent than Multilock and Harris Galante. At metaphysis and distal canal, the average canal filling of Anatomic and Multilock were more excellent than Harris Galante in saggital plane. 3. The average Harris's hip scores of each type of stem at the final follow-up was 89. 9 in Harris Galante, 90. 3 in Anatomic and 91. 9 points in Multilock. There was no significance statistically(p>0.05). 4. The correlation between the average canal filling and thigh pain was not statistically significant (p>0. 05).
Arthroplasty ; Follow-Up Studies ; Hip ; Thigh

The goal of treatment in infected nonunion include the elimination of infection, deformity and defects as same time as obtaining union. It is very difficult to obtain union and to correct deformity, infection and shortening in infected nonunion. The purpose of this study is to review the results of treatment of infected nonunion by the Ilizarov technique. Nineteen patients with infected nonunion were treated using Ilizarov external fixator from july 1991 to September 1993. Seven patients are undergoing treatment until now, so those were excluded from this data. Twelve patients were achieved bony union. Eleven cases were united and one case was failed with Ilizarov external fixator. We analyzed twelve cases. There were eleven males and one female, eight tibias and four femurs. Bony union was achieved by direct compression in six cases. Six cases were treated by bifocal osteosynthesis, but five cases were achieved bony union and one case was failed. So, we achieved bony union with intramedullary nailing and bone graft. The results were summarized as follows; 1. Eleven cases of infected nonunion were united with Ilizarov external fixator. The mean time to union of infected nonunion site was 10. 8 months. 2. The average bone lengthening of six cases was 64mm, ranging from 15mm to 110mm. The healing index averaged l. 64 month/Cm. 3, The bone results were excellent in six cases, good in five cases, poor in one case. The functional results were excellent in four cases, good in seven cases, fair in one case. 4. In all cases, we experienced difficulties. So we concluded that Ilizarov technique for infected nonunion is a valid procedure for control of infection, union, bone defect and deformity.
Bone Lengthening ; Congenital Abnormalities ; External Fixators ; Female ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Ilizarov Technique ; Male ; Tibia ; Transplants

Granular cell tumor is one of the rare tumorous condition. At present there are estimated 600 reported examples of the tumor in the medical literature. Malignant granular cell tumor is a well established but extremely rare entity that is found in appr- oximately 2 % of all granular cell tumor. Diagnosis should be restricted to neoplasms that are similar in their histological appearance to benign granular cell tumors but can be seperated on the basis of cellular pleomorphism, mitotic activity, and, most importantly, their capacity to produce metastases. The authors had experienced that a 55 years old male patient had two large malignant granular cell tumors at the left thigh and left inguinal area with metastatic lesion.
Diagnosis ; Granular Cell Tumor ; Humans ; Male ; Neoplasm Metastasis ; Thigh