Twenty five cases of fractures of the femur & tibia on the same leg (floating knee) in 24 patients were treated in St. Mary's Hospital, Catholic Medical College and Center during the period 1977-1985. We studied all of these patients, divided by four groups according to the methods of treatment, retrospectively with analysis of treatment and end result. Our policy of treatment for these multiple fractures in single extremity was directed toward early weight bearing, active and passive knee exercise by early open reduction and rigid internal fixation for both fractures. The results obtained were as follows: l. Of 25 cases, 20 patients were male and 5 were female. 2. The right lower extremity has constituted 56% of the cases. 3. Average age of patients were 37 years. 4. Most common level of fractures was on middle one third of femur (71.4% ) and proximal one third of tibia (46.2%). Of these 25 cases, three cases of femur and one case of tibia were segmental fractures, and one case of femur and five cases of tibia were open fractures initially. 5. Of 28 cases of femur fracture, 23 were given operative treatment and five conservative method. But out of 26 cases of tibia fracture, each half cases of fracture were treated operatively and conservatively. 6. We analysed the final results of treatment by the time of fracture union roentgenologically and five lower limb functions clinically at the termination of treatment. The average time for fracture union was 20.5 weeks for femur and 21.9 weeks for tibia roentgenologically. The acceptable clinical results could be achieved in 18 cases (72%) of early open reduction and rigid internal fixation for both tibia and femur as early as possible after accident for early knee exercises. 7. The status of fractured tibia was the most important factor to treat these multiple fractures in single extremity because of troublesome to start knee exercise and weight bearing.
Clinical Study ; Exercise ; Extremities ; Female ; Femur ; Fractures, Multiple ; Fractures, Open ; Humans ; Knee ; Leg ; Lower Extremity ; Male ; Methods ; Retrospective Studies ; Tibia ; Weight-Bearing

No abstract available.
Neoplasm Metastasis* ; Vertebroplasty*

The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.
Aged ; Humans ; Spine ; Vertebral Artery

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Leukemia, Myeloid, Acute* ; Sarcoma, Myeloid*

No abstract available.
Animals ; Rats* ; Vitamin A* ; Vitamins* ; Wounds and Injuries*

Meningiomas had long been considered radioresistant and therefore the role of radiation therapy in its treatment remains controversial. Lately, however, most of the retrospective analysis of meningiomas indicates that radiation therapy does show some degree of beneficial effects not only for malignant but also for benign meningiomas with the advanced technology and increased amount of radiation therapy, the rate of growth of tumor had been successfully slowed and local recurrence rate is also reduced following subtotal resection. We have performed conventional high dose radiation therapy on 7 cases of meningiomas(four cases of meningotheliomatous meningiomas, and three cases of malignant meningiomas). Of the 7 cases, the residual mass of 6 had decreased in size and neurological improvement was also evident. However, the 7th case resulted in complicated hydrocephalus. These cases are presented and the effect of conventional radiation therapy is discussed together with the review of literatures.
Hydrocephalus ; Meningioma* ; Recurrence ; Retrospective Studies

This study was designed to determine the location of the mandibular canal on lower molar areas. Thirty-three patients were examined with multi-planar reformatted CT scan(Dentascan). Three kinds of measurements were performed. The first was the distances between the upper border of the mandibular canal and the root apices of the first and second molars, the second was the distance between the cortical plate of the mandible and mandibular canal, and the last was the location of the mandibular canal in the buccolingual plane. The obtained results are as follows. 1. The distance between the root apices of lower molars and the superior border of mandibular canal was largest at the mesial root of the first molar, and shortest at the distal root of the second molar(p<0.05). 2. The longest distance between the outer surface of the buccal cortical plate of the mandible and mandibular canal was measured from the distal root of the second molar, and this distance decrease gradually mesially(p<0.05). 3. The distance between the mandibular base and inferior border of mandibular canal was longest at the distal root of the second molar, and shortest at the mesial root of the first molar(p<0.05). 4. The location of mandibular canal was lingually positioned in relation to the axis of teeth and alveolar ridge in molar areas.
Alveolar Process ; Axis, Cervical Vertebra ; Humans ; Mandible ; Molar* ; Tooth

Surgical resection may not be the appropriate first treatment for all intracranial mass lesions, especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent of modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of streotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass lesions, using Brown-Roberts-Wells(BRW) and Cosman-Roberts-Wells(CRW) system. Procedures were undertaken with the patient under the local anesthesia for biopsy(78 procedures), cyst aspiration and/or Ommaya reservoir insertion(9 procedures), and brachytherapy(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery(2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5%(8 of 94 procedures). The postoperative complications were transient and not seriour, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73(94%) of 78 biopsy. We could not obtain a specific diagnosis in 3 cases(2 cases of reactive gliosis, 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy, stereotactic biopsy revealed astrocytoma grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seated and midline lesions.
Anesthesia, General ; Anesthesia, Local ; Astrocytoma ; Biopsy* ; Brain Neoplasms ; Craniotomy ; Diagnosis ; Gliosis ; Humans ; Hydrocephalus ; Inflammation ; Mortality ; Oligodendroglioma ; Postoperative Complications

Surgical resection may not be the appropriate first treatment for all intracranial mass lesions, especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent of modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of streotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass lesions, using Brown-Roberts-Wells(BRW) and Cosman-Roberts-Wells(CRW) system. Procedures were undertaken with the patient under the local anesthesia for biopsy(78 procedures), cyst aspiration and/or Ommaya reservoir insertion(9 procedures), and brachytherapy(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery(2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5%(8 of 94 procedures). The postoperative complications were transient and not seriour, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73(94%) of 78 biopsy. We could not obtain a specific diagnosis in 3 cases(2 cases of reactive gliosis, 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy, stereotactic biopsy revealed astrocytoma grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seated and midline lesions.
Anesthesia, General ; Anesthesia, Local ; Astrocytoma ; Biopsy* ; Brain Neoplasms ; Craniotomy ; Diagnosis ; Gliosis ; Humans ; Hydrocephalus ; Inflammation ; Mortality ; Oligodendroglioma ; Postoperative Complications