20 patients with lumbosacral disorder underwent anterior spinal fusion using wide muscle splitting approach. The approach has considerable advantages over the usual muscle cutting approach or the transperitoneal approach commonly employed for this incision. The advantages of this approach are as follows: 1. The approach to the lesion site is safe and accurate. 2. The operation field is wide. 3. It is less destructive to the abdominal wall. 4, The defect left in iliac crest after removal of bone graft can be covered with external oblique layer. 5. The exposure given to the Ls-S1 intervertebral disc is superior to that given by the Rutherford Morrison approach.
Abdominal Wall ; Humans ; Intervertebral Disc ; Spinal Fusion ; Spine ; Transplants

No abstract available.
Humans ; Infant, Newborn ; Infant, Premature* ; Nephroma, Mesoblastic* ; Ultrasonography, Prenatal*

No abstract available.
Botulism*

OBJECTIVES: We performed anterior spinal fusion and instrumentation in treatment of spinal tuberculosis. The clinical results of this operation and metal-related complications were evaluated to determine the rationale of anterior instrumentation in active tuberculous lesion. METHODS: From July 1989 to February 1993, we treated twenty-one patients with spinal tuberculosis by radical resection of the tuberculous lesion and bone grafting, followed by anterior instrumentation using Zielke rod system. The changes in spinal deformity were measured from lateral spinal radiographs obtained preoperatively and postoperatively at 3 months, 6 months, 1 year, 2 years and final follow-up. The recurrence of infection and possible complications were also observed clinically and radiologically. RESULTS: The mean kyphotic angle was decreased preoperatively from 21 degrees to 16 degrees at final follow-up in patients with thoracolumbar tuberculous lesions. The mean deformity angle was corrected 7 degrees in thoracolumbar tuberculosis and 12 degrees in lumbar tuberculosis compared with the preoperative deformity angle. There was not any persistence or recurrence of infection possibly related to the instrumentation. All patients were allowed early ambulation with the aid of a light brace. CONCLUSION: The clinical and radiological results suggested that the anterior instrumentation seemed to be one of the rational approaches for providing immediate stability in treating severe spinal tuberculosis without any significant risk of persistence or recurrence of infection.
Bone Transplantation ; Braces ; Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Humans ; Recurrence ; Spinal Fusion ; Tuberculosis ; Tuberculosis, Spinal*

Alveolar soft part sarcoma is a clinically and morphologically distinct soft tissue tumor that was first defined and named by Christopherson et al in 1952. Since 1953, alveolar soft part sarcoma invading bone have been reported sporadically. We experienced a case of alveolar soft part sarcoma with metastasis to femoral shaft, which was treated by wide resection & vascularized fibular strut graft.
Neoplasm Metastasis ; Sarcoma, Alveolar Soft Part ; Transplants

Various kinds of spinal instruments have been developed for the treatment of lumbar spinal disordors. Recently, the Graf instrument as soft stabilizer has been introduced in treating lumbar spinal disordors associated with instability. To determine the reliability of Graf instrument providung spinal stability we have analysed 19 cases of unstable lumbar degenerative disease treated with adequate decompression and Graf instrumentation between May 1991 and March 1992. There were 15 females and 4 males. Average age at operation was 50.8 years (Range, 35 to 70). Minimum follow up was 14 months. The main surgical indication was serious limitation of daily activity caused by intractable symptoms and signs with spinal instability. Clinical assesment based on authors modified criteria revealed satisfactory (Exellent/Good) in 16 cases (84.2%). The Graf instrument has many advantages over rigid implant such as enough stability without arthrodesis after extensive surgical decompression, rapid rehabilitation, less operative risk and preservation of spinal motion. These results suggests Graf instrument instead of rigid implant is highly recommendable in managing unstable lumbar disordors.
Arthrodesis ; Decompression ; Decompression, Surgical ; Equidae ; Female ; Follow-Up Studies ; Humans ; Male ; Rehabilitation

The spleen is the most common intraabdominal organ injured in blunt trauma, Although physical signs andsymptoms, coupled with abdominal paracentesis & peritoneal lavage confirm intraabdominal injury, but isolatedsplenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation ofplain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patiens of theautopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Malepatients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode oftrauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struckby fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occured in 2 cases(8.3%). 4. Commonpatterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a lacerationthat involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). Themost common plain abdominal roentgenographic findings was the evidence of intraabdominal fluid in 21 cases(87.5%).The others are included in order of frequency: gastric dilatation, prominent mucosal folds on greater curvature ofthe stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in theregion of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plainroentgenological findings. But the evidence of intraabdominal fluid is most important in the light of earlydiagnosis. 7. Diagnosis of splenic injury may be most helpul that in combination with clinical history, clinicalsymptoms & signs and plain film findings. In delayed rupture, diagnostic value of serial examination and surgicalobservation is emphasized.
Constitution and Bylaws ; Diagnosis ; Early Diagnosis ; Gastric Dilatation ; Incidence ; Lacerations ; Motor Vehicles ; Paracentesis ; Peritoneal Lavage ; Retrospective Studies ; Rupture ; Spleen ; Stomach ; Thorax

The posterior cruciate ligament is an anatomically and biomechanically complex structure. PCL injuries are reported to occur in 1-40% of acute knee injuries, with isolated PCL tear, less common than PCL tears combined with other Iigament injuries. Controversy exists concerning the geatment of the PCL injures. Recently, arthroscopic techniques of PCL reconstruction are becoming nore refined and reproducible. Between July 1993 and May 1995, 25 operations for PCL rupture were performed in our hospital. At the follow-up examinations we noted mild to moderate posterior instablilty which was not noted at the time of operation and during the immediate postoperative period. We reviewed type (if injuries, amplitude of initial posterior tibia1 translation, surgical techniques, which seemcd to be in relation ivith the postoperative instabilities. At final follow-up, the mean Lysholm knee score was 86 points, and the posterior tibial translation 6.5mm on posterior stress radiographs. The ligament augmentation device provided no benefit. The ideal positioning and fixation of the graft and protection of the graft from abrasion seemed to be important to get a good results.
Follow-Up Studies ; Knee ; Knee Injuries ; Ligaments ; Patellar Ligament* ; Posterior Cruciate Ligament ; Postoperative Period ; Rupture ; Transplants*

Authors report the preliminary result of 86 consecutive femoral head replacements with ceramic head performed at Chonnam University Hospital(73 hips) and Kwangju Christian Hospital(13 hips) during the period of 2 years and 6 months between January 1985 and June 1987. The results were as follows ; l. Eighty-three patients were comprised of 41 men(44 hips) and 42 women(42 hips). 2. Their average age at operation was 62.8 years, the oldest being 86 and the youngest being 24 years and 57 patients(68.7%) of them were over 60 years of age. 3. The causative diseases of the femoral head were hip fracture and its related conditions in 74 hips, and idiopathic avascular necrosis in 12 hips. 4. Associated general diseases, a total of 69 in number, could be diagnosed in 54 patients of them. These included hypertension(18 patients), cardiovascular disease(10 patients), and diabetes mellitus(8 patients). 5. The average diameters of the ceramic head were 49.8 mm in men and 45.1 mm in women. 6. The types of femoral stem were cemented stem(Xenophor 900 stem) in 45 hips and noncemented stem(Autophor 900S stem) in 41 hips. 7. The early postoperative complications, a total of 9 in number, were encountered and these included death in hospital(3 patients), trochanteric fracture(2 patients), pneumonia (1 patient), and others(3 patients). 8. The late postoperative complications, a total of 9 in number, were encountered and these included acetabular erosion(4 hips) and heterotopic ossification(5 hips). 9. Forty-nine hips could be followed more than 1 year with average follow-up of 19.9 months. The hip function of these 49 hips were excellent in 13 hips, good in 24 hips, fair in 8 hips, poor in 3 hips and bad in 1 hip. 10. In conclusion, it can be stated that the femoral head replacement with ceramic head prosthesis is very promising in reducing the incidence of acetabular erosion and maintaining the regained hip function.
Acetabulum ; Ceramics ; Female ; Femur ; Follow-Up Studies ; Gwangju ; Head ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Jeollanam-do ; Male ; Necrosis ; Pneumonia ; Postoperative Complications ; Prostheses and Implants

No abstract available.
Ligaments* ; Polytetrafluoroethylene*