Capitellar fracture was first described by Hahn in 1853. It is rare, espically in children, and has been occurred 0.5% to 1% of incidence of all elbow injuries. Factures of the capitellum can involve a significant portion of the articular surfaces. It is desirable to reduce and internally fix the capitellar fragment, if possible, because this restores the artucular surface and augment joint stability. Three patients with displaced fractures of the capitellum(capitulum humeri) were treated by open reduction and internal fixation using Herbert screws, which stabilized the joint, allowed anatomical reduction, and gave rigid fixation. Postoperatively, early motion of the joint was allowed. All fractures were united without evidence of avascular necrosis and final follow-up was excellent.
Child ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Joints ; Necrosis

Injuries to the extensor mechanism include a wide range of injuries from minor one to massive defect. And the methods of treatment must be individualized according to the anatomical site, extent and chronicity of injuries. The extensor mechanism is a triangular thin sheet like structure, the function of which cannot be explained completely by the Tubiana's church-steeple like diagram. Authors think that the extensor mechanism should be repaired or reconstructed as a triangular sheet. The tension of the repaired or reconstructed tendon was estimated as good when the neutral extensions were obtained in all the MP, PIP and DIP joints after the completion of sutures. Also authors think that stable sutures are mandatory for the early rehabilitation postopoeratively. Seventy-five patients have been treated by the authors from 1982 to 1994. According to zonal classification, forty-two patients were injured in Zone I. 5 in Zone II, 21 in Zone III, 5 in Zone IV and 2 patients were unclassified due to massive defects of the extensor mechanism. Mostly bony mallet injuries were treated by open reduction and K-wire fixation. Acute tendinous mallet injuries were treated by conservative splinting and old injuries were treated by anatomical plication of the terminal extensor tendon. Old buttonhole deformities were generally treated by the central tendon plication. Massive defects were managed by skin coverage and reconstruction of the extensor mechanism by using a tendon graft which was tailored like a triangular thin sheet. With author's treatment principles, excellent or good results were obtained in about 87%. Consequently, authors emphasize that an anatomical repair or reconstruction is a keystone in the treatment of injuries to the extensor mechanism.
Classification ; Congenital Abnormalities ; Fingers ; Fluconazole ; Humans ; Joints ; Rehabilitation ; Skin ; Splints ; Sutures ; Tendons ; Transplants

Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
Anti-Bacterial Agents ; Child ; Esophageal Stenosis ; Esophagus ; Granuloma ; Granulomatous Disease, Chronic* ; Humans ; Recurrence ; Steroids

The coexistence of the variants of porokeratosis is very rare. We report a case of coexistence of linear porokeratosis with disseminated superficial actinic porokeratosis (DSAP). A 43-year-old wornan first noticed a brownish papule on the left side of groin in early infancy. She developed multiple discrete or confluent keratotic plaques in linear fashion on the left lower extrernity and trunk in childhood. These leaions became pruritic in summer. Two years ago, she developed multiple scattered small annular lesions on the face and forearms. Her family history showed no abnormalities. Biopsy specimene from the groin and trunk showed eornoid lamella.
Adult ; Biopsy ; Forearm ; Groin ; Humans ; Porokeratosis*

Four children with medically refractory multiform seizures were submitted for section of the corpus callosum for last 3 years. These patients had medically intractable generalized seizures diagnosed preoperatively as the Lennox-Gastaut syndrome characterized by a combination of seizure patterns, most frequently drop attack with generalized tonic-clonic, generalized tonic and atonic seizure. Guided by pre- and intra-operative electroencephalographic monitoring, the section was carried out in the anterior 2/3 or 4/5 part of callosum. Five to 28 months' postoperative follow-up suggests good results:Three patient showed no more drop attack except intermittent focal myoclonic seizures in 1 case and one patient had generalized seizures less in frequency than preoperative state. Corpus callosotomy seems to be an effective surgical approach for the intractable epilepsy with drop attack of multifocal origin, but longer follow-up is needed.
Child* ; Corpus Callosum ; Electroencephalography ; Epilepsy* ; Follow-Up Studies ; Humans ; Seizures ; Syncope

Isolated lateral ventricle after ventriculoperitoneal shunt for hydrocephalus can occur by obstruction of foramen of Monro. Two cases of isolated lateral ventricles after ventriculoperitoneal shunt are reported. Patients showed neurological deterioration and brain CT scan revealed unilateral dilatation of lateral ventricle after ventriculoperitoneal shunt. They were successfully managed by another shunt system into dilated lateral ventricle.
Brain ; Cerebral Ventricles ; Dilatation ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

No abstract available.
Transplants*

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

Synovial Sarcoma is a very rare and highly malignant tumor. It is prevalent near the joints. Its peak incidence is from 3 rd to 6 th decade. It occurs almost at the upper and lower extremities and is also called as Sarcomesothelioma, Synovial Endothelioma, Malignant Synovioma and Synovioma. Three cases of Synovial Sarcoma which was treated at the department of Orthopedic Surgery, Seoul Red Cross Hosp. from 1968 to 1977 was reported.
Incidence ; Joints ; Lower Extremity ; Orthopedics ; Red Cross ; Sarcoma, Synovial ; Seoul

Cnical analysis of pyogenic hip in children was made on 18 patients, who had been admitted in the dept. of orthopedic surgery, Seoul Red Cross Hospital from Jan. 1972 to Dec. 1976. The following results were obtained: 1. The incidence of the pyogenic hip was slightly higher in male than female as 11 versus 7 and it was higher in the age group of 5~7 years and 11~13 years. 2. The most of the etiological microorganism was coagulase positive stap hylococcus aureus. 3. Penicillin was resistant to staphylococcus aureus in about 75% of cases, and orbenin and Lincocin were most sensitive in 58.2% of cases. 4. All cases treated with arthrotomy and irigation or drainage, but prognosis was different by method of surgical approach and method of treatment. 5 In reference with progoosis early hospitalization, early diagnosis and early treatment were counted to be imperative as known.
Child ; Coagulase ; Drainage ; Early Diagnosis ; Female ; Hip ; Hospitalization ; Humans ; Incidence ; Lincomycin ; Male ; Methods ; Orthopedics ; Penicillins ; Prognosis ; Red Cross ; Seoul ; Staphylococcus aureus