PURPOSE: Recently, there are many good reports on the arthroscopic management of tibial condylar fractures. But, it may be appropriate for selected tibial condylar fractures and also needs a skilled technique. So we report the results of the tibial condylar fractures treated by the arthroscopy and limited percutaneous fixation or the arthroscopic-assisted management with conventional internal fixation without arthrotomy. MATERIALS AND METHODS: From June 1996 to December 1997, we treated 22 cases of the tibial condy- lar fractures including relatively comminuted one and analysed the results of patients who have been observed at least 1 year with Porters knee evaluation criteria. RESULTS: In 18 out of 22 cases, the results were Acceptable on symptoms(excellent 3, good 15, fair 4), in 18, on function(excellent 10, good 8, fair 3), in 21, on appearance(excellent 12, good 9, fair 1) and in 20, on radiographic appearance(excellent 11, good 9, fair 2). Overall results were Acceptable in 18 cases(82%) and Unacceptable in 4 cases(18%). CONCLUSION: The arthroscopic-assisted management with conventional internal fixation without arthrotomy can be the recommendable treatment for the tibial condylar fractures, including relatively comminuted one, without complications.
Arthroscopy ; Humans ; Knee

PURPOSE: We tried to outline the incidence and characteristics of meniscal tears in recent lesions and chronic insufficiency of the ACL. MATERIALS AND METHODS: Through this retrospective study of 103 reconstructions of the anterior cruciate ligament (ACL) performed between Jun 1996 to Sep 1998, according to a more accurate evaluation, ACL-deficient knees can be classified into two different stages (recent, chronic injuries). RESULTS: Overall, there was a significantly increasing incidence of meniscal tears in chronic injuries (P<0.05). A predominance of lateral meniscal tears were demonstrated with recent injuries, whereas the incidence of medial meniscal tears increased significantly with chronic injuries (P<0.05). CONCLUSIONS: This study highlights the increase of lateral meniscal lesion in recent ACL rupture and increase of severe meniscal lesion, especially medial meniscus, with progressive worsening of knee instability after an ACL injury. Although not significant, meniscal tears in the recent injuries were more amenable to repair. The results suggest that maximal meniscal preservation is best achieved with ACL reconstruction shortly after injury.
Anterior Cruciate Ligament* ; Incidence ; Knee* ; Menisci, Tibial ; Retrospective Studies ; Rupture*

No Abstract Available.
Hidradenitis*

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

1. A Case of osteosarcoma is reported which arose 8 years after synovima of the knee had been locally excised. The patient is a 51-year-old housewife who had received irradiation therapy upon her knee for 30 days post-operatively. Following irradiation, asymptomatic latent period lasted 8 years when mass appeared on the site, which was biopsied and diagnosed as osteosarcoma one year later. 2. This case generally suffices the McKennas criterias for irradiation-induced osteosarcoma, 3. It seems to be worthwhile to keep an eye upon the prognosis of this possible case of irradiation- induced osteosarcoma, which is largely reported to be very grave.
Humans ; Knee ; Middle Aged ; Osteosarcoma ; Prognosis ; Sarcoma, Synovial

Functional-Below-Knee Total Contact Cast characterized by early weight bearing and free motion of affected knee joint during the cast immobilizaton has brought to significant result on trearment of tibial fractures, and is considered to take early bony union by establishment of almost physiological environment on fracture site during immobilization. For recent 2 years, writers have experienced many tibial fractures to treat with Functional Below-Knee Total Contact Cast. In them, clinical data and results of 17 cases which were studied well are reviewed, and method of cast application is illustrated.
Clinical Study ; Immobilization ; Knee Joint ; Methods ; Tibial Fractures ; Weight-Bearing

OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

Klippel-Feil syndrome is characterized by congenital fusion of cervical vertebrae with a wide range of associated anomaly. The authors present a 50-year-old Klippel-Feil syndrome patient with a minor trauma followed progressive quadriparesis. He had typical radiologic findings of type II Klippel-Feil syndrome and presented progressive myelopathy due to cord compression at foramen magnum level with cervical instability. The patient underwent craniocervical decompression and fusion. The authors reviewed the pertinent literatures and discussed this rare syndrome.
Cervical Vertebrae ; Decompression ; Female ; Foramen Magnum ; Humans ; Klippel-Feil Syndrome* ; Middle Aged ; Quadriplegia* ; Spinal Cord Diseases

We performed a clinical analysis of the 106 cadaveric renal transplants among the 479 renal allograft patients operated between Jun. 1990 and Oct. 1996 to evaluate the graft outcome in patients with high-risk donor factors. Organ procurement were performed in 73 cases(64.4%) among 113 potential donors. In the remaining 40 cases, 22 cases were given up as organ donors due to medical causes, such as severe organ failure (n=9), HBsAg(+) (n=6), cardiac arrest (n=5),and sepsis (n=2). The incidence of acute tubular necrosis was significantly higher for age >50 yr, cold ischemic time(CIT) >24 hr and prolonged hypotension (P<0.05). Serum creatinine levels at postoperative week 1 and discharge were significantly higher for age >50 yr, CIT>24 hr and prolonged hypotension (P<0.05). The rejection rate did not show any difference. The one-year and two-year graft survival rate were significantly lower for age >50 yr (57.1% vs 87.2% in 1 yr and 57.1% vs 87.2% in 2 yr), for serum Cr>3.0(50.0% vs 87.1% in 1 yr and 50.0% vs 84.8% in 2 yr), for CIT>24 hr(33.3% vs 86.6% in 1 yr and 33.3% vs 84.3% in 2 yr) and prolonged hypotension(50.0% vs 88.0% in 1 yr and 50.0% vs 84.9% in 2 yr). In the multivariate analysis of these variables, serum Cr>3.0, CIT>24 hr and prolonged hypotension were significant factors for graft outcome. A comparison of the early graft function and the graft survival between high risk group (n=75) - age>50 yr (n=7), serum creatinine>3.0 mg/dl (n=4), CIT>24 hr (n=4), history of hypertension (n=17), use of high dose inotropics (dopa>20 microgram, dobu>15 microgram, n=30), episode of cardiac arrest (n=4), prolonged hypotension (<80 mmHg over 6 hr ,n=8), existence of DIC (n=12) or proteinuria (n=23)- and the ideal group (n=31) did not show any significant difference. We conclude that selective high-risk donors can be used to facilitate the expansion of a small donor pool to overcome the organ shortage. However more efforts to develop the preoperative tests to predict the postoperative graft outcome are neccessary to avoid primary nonfunction and delayed graft function, and to achieve a successful graft survival.
Allografts ; Cadaver* ; Creatinine ; Dacarbazine ; Delayed Graft Function ; Graft Survival ; Heart Arrest ; Humans ; Hypertension ; Hypotension ; Incidence ; Kidney Transplantation* ; Multivariate Analysis ; Necrosis ; Proteinuria ; Sepsis ; Tissue and Organ Procurement ; Tissue Donors* ; Transplants

42 knees with degenerative arthritis underwent arthroscopic lavage and 7 knees underwent arthroscopic lavage combined with multiple bone drilling in between 1994 and 1995 and followed average 12 months. Clinical evaluation using the hospita1 for specia] surgery knee scores (HSS scores) was done at last follow up and classified into 4 groups: excellent (90-99), good (80-89), fair (70-79) and poor (less than 70). The results were as follows: l. Of the 42 knees of the lavage group, 6 knees (16%) was excellent, 14 knees (33%) good, ]7 knees (40%) fair and 5 (11%) knees poor. Success group (Excellent & Good) were achived in 20 knees (49%). 2. Of 17 knees treated with arthroscopic lavage comhined with multiple bone drillig resulted in excellent in 9 knees (53%), good in 4 knees (23%), fair in 2 knees (12%) and poor in 2 knees (12%). Success group were achived in 13 knees (76%). 1n conclusion, we helieve that multiple bone drilling in conjunction with arthroscopic lavage has more favorable effect on the pain relief for degenerative osteoarthritis of the knee than arthroscopic lavage only.
Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Therapeutic Irrigation*