The trestment of extensive soft tissue injury of the extremities is known to be one difficulty in the field of Orthopedic Surgery. The authors present a study of 55 free vascularized scapular flaps, 12 free vascularized parascapular flaps and 9 combined scapular and latissimus dorsi flaps for extensive soft tissue injury of the extremities at the Department of Orthopedic Surgery, Severance Hospital from March 1983 to December 1988. The results of the study are as follows:1. The pedicles of the flap were consistent in length and diameter. 2. The flap was uniform and relatively thin in thickness in free scapular and psrascapular flaps 3. There was no limitation to motion of the shoulder despite excision of the scapular and parascapular flap. 4. Primary closure of the donor flap was feasible in almost all cases. 5. Reconstruction of a 1arge soft tissue defect was possible with scapular and parascapular flap in one stage. 6. The free vaseularized scapular flap and parascapular flap would be recommended of one-stage reconstructional surgery for extensive soft tissue defects.
Clothing ; Extremities ; Humans ; Orthopedics ; Shoulder ; Soft Tissue Injuries ; Superficial Back Muscles ; Tissue Donors

BACKGROUND: The concentration of the blood including ACTH, catecholamine, serum prolactine, cortisol is increased due to responding on stress by carrying out endotracheal intubation upon the mutiple trauma patients who were taken to the emergency room. Diazepam is a kind of benzodiazepine pharmacon and common pharmacon used for stability of the patients, relief and pretreatment as a booster for the relaxation of skeletal muscle. This research aims to know how effectively medication of diazepam before endotracheal intubation helps to constrain the reaction on the part of cardiovascular system due to laryngoscopy and endotracheal intubation, and makes concentration of catecholamine in blood changed. METHODS: The subjects are consisted of the patient asked for endotracheal intubation instantly, suffering from caput trauma (GCS 8.0) among the multiple trauma patient, more than 20-year-old who were taken to the emergency room in Chosun university hospital from October 1, 1995 to September 30, 1996. They were decided into 2 classes, 30 people each class, and one (group I ) was carried out endotracheal intubation without injecting diazepam,0.3 mg/kg, and the other (group II) was done with the endotracheal intubation by injecting diazepam, 0.3mg/kg. Group I and group II were measured blood pressure and heart rate before intubation and at 1, 3, 5, 7 minute after endotracheal intubation, sampled arterial blood from femoral artery, and then compared and analyzed. All of the data were recorded by mean, standard deviation, and percentage and repeated measures ANOVA test was used for the statistical test and the data was regarded as statistically significant when p value is below 0.05. RESULTS: 1) They were no significant differences statistically between 2 groups in the distribution of the age, weight, sex of the patients. 2) The changes in the systolic blood pressure had no statistical significance in the comparison between group I and group II, but diastolic blood pressure and the change of heart rate had statistical significance because p value was shown below 0.05. 3) Norepinephrine of blood was significantly lower in group II than group I. 4) Epinephrine of blood was significantly lower in group II than group I. CONCLUSION: It was shown that medication of diazepam before endotracheal intubation made stability of the patients and it changed significantly the reaction on the part of cardiovascular system from stress caused by laryngoscopy and endotracheal intubation. So it will be a good thing to inject diazepam for pretreatment to bring relief of the patients and cardiovascular stability before endotracheal intubation.
Adrenocorticotropic Hormone ; Benzodiazepines ; Blood Pressure ; Cardiovascular System ; Diazepam* ; Emergency Service, Hospital ; Epinephrine ; Femoral Artery ; Heart Rate ; Humans ; Hydrocortisone ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Multiple Trauma* ; Muscle, Skeletal ; Norepinephrine ; Prolactin ; Relaxation ; Young Adult

The Tikhoff-Linberg procedure is a limb-sparing surgical option to be considered for bony and soft tissue tumors in and around the proximal humerus and shoulder girdle. The authors reported 6 cases of the Tikhoff-Linberg procedure for tumors around the shoulder Joint at the Department of Orthopedic Surgery of Severance Hospital from March 1988 to August 1989. 1. The 6 cases were composed of 2 osteogenic sarcoma, 2 chondrosarcoma, 1 chondroblastoma, and 1 giant cell tumor cases. 2. The tumors were completely removed by the Tikhoff-Linberg procedure without amputation or disarticulation of the upper extremity. 3. The distal clavicle, upper humerus and or parts or all of the scapula were resected. 4. The Tihkoff-Linberg procedure was performed for patients whose tumors did not involve the neurovascular bundle in the axilIa. 5. The function of the hand and forearm after the Tihkoff-Linberg procedure are near normal in all cases. 6. The Tikhoff-Linberg procedure would be recommended as a limb-sparing operation for tumors around the shoulder joint that were required wide resection without disarticularion or forequarter of the upper extremities.
Amputation ; Chondroblastoma ; Chondrosarcoma ; Clavicle ; Disarticulation ; Forearm ; Giant Cell Tumors ; Hand ; Humans ; Humerus ; Orthopedics ; Osteosarcoma ; Scapula ; Shoulder Joint ; Shoulder ; Upper Extremity

No abstract available.
Adult* ; Child* ; Humans ; Tuberculosis, Spinal*

A statistical observation ryas made on Genito-Urinary-Tract injuries of Korean Army Personnel in Vietnam War during the period of November, 1965 to November, 1966. and the following results were obtained. 1. The Genito-Urinary-Tract injuries were 15 cases(5.3 per cent) among 825 war causalities. 2. As for the causes of injuries, 25 cases (55.5 per cent) were caused by gunshot, 9(20.O per cent) by booby trap, 5(11. O per cent) by mortar, 3(6.6 per cent) each by crush and grenade. 3. Concerning the frequency of injuries in each organ, 12 cases (6. 6 per cent) each were observed in urethra, in scrotum and testis, 10 (22.2 per cent) in kidney, 8 (17.7 per cent) in bladder, and 3 {6. 6 per cent) in penis. 4.The incidence of Genito-Urinary-Tract injuries associated with the other organs was as follows. In kidney injuries, Z cases were associated with intestine, 4 with liver, 3 with spleen and one each with radial nerve and iliac vessel. In bladder injuries. 2 cases were associated with pelvic bone, and one with spleen. In urethra injuries, 6 cases were associated with pelvic bone and 2 with intestine. 5. As for the multiplicity of Genito-Urinary-injuries, 4 cases were observed in scrotum, testis and urethra, and 3 each in urethra and bladder, and scrotum and testis. 6. The evacuation time from battle fields to the evacuation hospital was one hour in average by helicopter
Aircraft ; Humans ; Incidence ; Intestines ; Kidney ; Liver ; Male ; Military Personnel ; Pelvic Bones ; Penis ; Radial Nerve ; Scrotum ; Spleen ; Testis ; Urethra ; Urinary Bladder ; Vietnam*

No abstract available.
Cerebral Palsy* ; Contracture* ; Hip* ; Muscle Spasticity*

No abstract available.
Replantation*

Osteitis condensans ilii is one of the rare disease which represents an alteration in the normal bony architecture of that portion of the ilium alongside the sacro-iliac joint: namely condensation without involvement of joint space or adjacent sacrum. We analyzed clinically 9 cases of osteitis condensans ilii who were treated at the Department of Orthopedic Surgery, Medial college of Yonsei University. The results were as follows :l. All patients were women and oldest patient was 47, the youngest 23 years of age. 2. The pain occured following delivery in 3 cases and in one case ofter trauma. There was urinary tract infection in one case. 3. All patients complained low back pain and the pain extended to buttock in 2 cases whereas the radiating pain to lower extremity in 4 cases. 4. In 4 cases was a positive straight leg raising test elicited. 5. In 3 cases the blood sedimentation rate was increased above normal. 6. All patient succeed in relieving pain with conssrvative treatment. In 2 instances steroid was used. 7. There were combined diseases in 4 cases : herniated nucleus pulposus in 2 cases, rheumatoid arthritis in 1 case, osteoarthritis in 1 case.
Arthritis, Rheumatoid ; Blood Sedimentation ; Buttocks ; Clinical Study ; Female ; Humans ; Ilium ; Joints ; Leg ; Low Back Pain ; Lower Extremity ; Orthopedics ; Osteitis ; Osteoarthritis ; Rare Diseases ; Sacrum ; Sclerosis ; Urinary Tract Infections

Correction and stabilization for deformed feet were performed on 372 feet in 309 patients under 17 years old age at the Sam Yook Rehabilitation Center. Review of statistics, technical problems, and complications has led to followings :1. Cerebral palsy and residual poliomyelitis were the most common etiology. 2. Equinovarus deformity and its conjoined cavus deformity were the most common deformity. 3. In soft tissue surgery, tendo calcaneus lengthening was the most common procedure, and next, plantar fasciotomy. 4. In bone surgery, triple arthrodesis was the most common procedure, especially Ryerson technique. 5. Almost patients impraved their stand and gait pattern by operation.
Achilles Tendon ; Arthrodesis ; Cerebral Palsy ; Clubfoot ; Congenital Abnormalities ; Foot Deformities ; Foot ; Gait ; Humans ; Poliomyelitis ; Rehabilitation Centers

A neglected Monteggia fracture can pose a significant clinical problem because of decreased range of motion of the elbow, increased cubitus valgus, progressive damage and elbow instability. Factors leading to misdiagnosis include swelling of soft tissue, overlying of bones on radiographs and lack of inclusion of the elbow on the radiograph at the ulnsr fracture. Therefore, a radiograph that includes the elbow at the ulnar fracture should be taken. A line drawn through the shaft and head of the radius into the elbow should align with the capitulum in any projection, thereby assisting in the correct diagnosis. Three cases of neglected Monteggia fracture were treated by open reduction of the radial head with repair or reconstruction of the annular ligament and osteotomy of the ulna, and satisfactory results were obtained.
Child ; Diagnosis ; Diagnostic Errors ; Elbow ; Head ; Humans ; Ligaments ; Monteggia's Fracture ; Osteotomy ; Radius ; Range of Motion, Articular ; Ulna