Two collateral ligaments, accessory collateral ligaments, volar plate which prevent hyperextension of digital joints, fibrous flexor sheath which attached to volar plate, intrinsic and extrinsic muscles were contribute to the stability of the digital joints. Among them, two collateral ligaments were most important as a static stabilizer. Especially, the instability of fingers due to the rupture of ulnar collateral ligament of metacarpophalangeal joint of thumb and radial collateral ligament of index will attenuate the pinch power and maybe a cause of chronic painful limited finger motions. So, they should be repaired if ruptured completely. During the period of May 1980 to Oct. 1985, 17 cases of ruptured collateral ligaments 5 cases in thumb, 12 cases in fingers were treated surgically and followed up for average 8 weeks. The results were that normal range of digital joint motion were obtained in 14 cases and instabilities were disappeared in 16 cases and pain free in 12 cases. Therefore, careful clinical evaluation to detact therupture of collateral ligament of dig.ital joint after hand injury and then appropriate management could restore the best function of hand.
Chronic Pain ; Clinical Study ; Collateral Ligaments ; Fingers ; Hand ; Hand Injuries ; Joints ; Metacarpophalangeal Joint ; Muscles ; Reference Values ; Rupture ; Thumb

No abstract available.
Femur* ; Phlebography* ; Prognosis*

No abstract available.
Sarcoma, Ewing

PURPOSE: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. MATERIALS AND METHODS: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). RESULTS: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. CONCLUSION: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.
Chondrosarcoma ; Curettage ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden

No abstract available.
Gastrectomy* ; Stomach Neoplasms*

Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach.
Constriction, Pathologic* ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pancreaticojejunostomy* ; Stents*

We report a case of hypertrophic lupus vulgaris in the right knee of an 18-year-old man. The lesion, an erythematous scaly hypertrophic plaque, had grown for 12 years without any trestment leaving an atrophic scar. Histopathologically, the lesion consisted of s granuloma composed of epithelioid cells and lymphocytes. Lsboratory examinations including hematology, blood chemistry, urinalysis, and chest roentgenography were normal. The Mantoux test was strongly positive. Treatment with anti-tuberculosis medieation resulted in a good response.
Adolescent ; Chemistry ; Cicatrix ; Epithelioid Cells ; Granuloma ; Hematology ; Humans ; Knee ; Lupus Vulgaris* ; Lymphocytes ; Radiography ; Thorax ; Urinalysis

No abstract available.

PURPOSE: We report a distinctive lesion in the articular cartilage of the talar dome in anterior bony impingement syndrome of the joint. MATERIALS AND METHODS: Arthroscopic debridement was done in 68 ankles under the diagnosis of anterior impingement syndrome of the ankle joint between October 1994 and June 1996. There were 6 tram track lesions of talar dome of the 68 ankles. We evaluated arthroscopic findings of tramtrack lesion, injury mechanism, and treatment results according to the criteria of Ogilvie-Harris DJ et al. RESULTS: All six male patients were professional or collegiate soccer players. Average age was 29 years (26 to 34). All 6 cases were dorminant ankles. Trauma history was not definite in all 6 cases. All 6 patients were anterior impingement syndrome of the ankle and treated by arthroscopic removal of osteophytes. The cartilage lesions were full thickness defects, located in the anterior half of the medial aspect of the talar dome and were longitudinal with variable widths resembling a tram track, thus named ""tram track lesion"". Tram track lesion and osteophytes were contacted by ankle dorsiflexion. Overall, good and excellent results were achieved in five patients at a mean follow up of twenty-seven months. Two cases had recurrences of osteophytes. CONCLUSIONS: Tram track lesion of talar dome occurred by repeated scratching of the osteophyte of distal tibia and treated effectively by arthroscopic removal of osteophyte and debridement.
Ankle ; Ankle Joint ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Debridement ; Diagnosis ; Diphenhydramine ; Follow-Up Studies ; Humans ; Joints ; Male ; Osteophyte ; Recurrence ; Soccer ; Tibia

The importance of maintaining appropriate nutrition in the patient with serious multiple injuries may be overlooked by the orthopedic surgeon. Nutritional depletion has a significant effect on survival, wound healing, immunocompetence, fracture healing and rehabilitation of the patient. A prospective study was performed to determine the effect of preoperative nutritional status on the postoperative complications in forty patients who had been admitted to the hospital because of multiple injuries. The parameters that were used to determine the nutritional status included serum levels of albumin, transferrin, and hemoglobin; TCL(total lymphocyte count);and CHI(creatinine height index). The results were as follows: 1. Significant preoperative nutritional depletion of moderate or severe degree in at least one of the 5 indices was indentified in 25(62.5%) of the 40 patients. 2. Incidence of preoperative nutritional depletion ranged from 7.5% for hemoglobin to 52.5% for transferrin and the nutritional depletion averged 29.5% abnormality per nutritional index. 3. Twenty complications were observed in 18 patients. 4. The incidence of preoperative nutritional depletion was 83.3% in complication group and 45.5% in non-complication group. 5. Serum albumin level and serum transferrin level had significant predictive value of postoperative complication.
Fracture Healing ; Humans ; Immunocompetence ; Incidence ; Lymphocytes ; Multiple Trauma ; Nutrition Assessment ; Nutritional Status ; Orthopedics ; Postoperative Complications ; Prospective Studies ; Rehabilitation ; Serum Albumin ; Transferrin ; Wound Healing