Among two groups of navy recruits undergoing training, one consisting of 500 enlisted men and another 100 newly enrolled midshipmen, 18 reported to Chinhae Naval Hospital with fatigue fractures during the period from February though September 1969. Following observations were made on these cases: 1. The incidence of fatigue facture was 1.4 percent among the enlisted men and 11 per cent among the midshipmen. 2. There were 6 cases of complete fraeture and 2 cases of incomplete fracture. In the remaining 10 cases, only periosteal reaction was evdent roentgenographically with no visible fracture line initially: fracture lines, however, became apparent on subsequent examinations in all the cases. 3. The fractures involved the femur in 4 cases and the tibia in 14 cases, a ratio of 1:3. 5 in latter s favor. 4. The site of predirection in the femur was the distal one third of the shaft, occurring in 3 of the cases. In the tibia the junction of the upper and middle thirds was most frequently affected, occurring in 10 of the cases. 5. All the cases in our series healed without any complications.
Fatigue ; Femur ; Fractures, Stress ; Humans ; Incidence ; Male ; Tibia

Treatment for the femoral shaft fractures in adolescents is somewhat controversial. These fractures have been treated nonoperatively, but adolescents tolerate prolonged immobilization less well than younger children and conservative treatment in this age group may result in more complicationssuch as malunion, shortening and angular deformities more often than those in the younger age group. Recently there has been a tendency to choose the operative method rather than traditional traction and casting technique for femoral shaft fractures in elderly children and adolescent The purpose of this study is to find better treatment for the femoral shaft fractures in adolescents. Fifty six femoral shaft fractures in 56 patients aged 10 to 14 years old were treated with traction followed by casting, open reduction and internal fixation with plate, closed intramedullary nailing, or external fixation using A-0 external fixator, and evaluated respectively for at least 1 year. External fixation may be benefit to patients with concomittant injuries and result in psychological settle down, early mobilization out of bed, short hospital stay, save of cost,and early return to daily living activities without any disadvantages such as malunion, leg length discrepancy or awareness of growing arrest in spite of negligible pin tract infection. Result of this study suggests that external fixation for the femoral shaft fractures may be an one of the attractive treatment option in adolescents.
Activities of Daily Living ; Adolescent* ; Aged ; Child ; Congenital Abnormalities ; Early Ambulation ; External Fixators ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Leg ; Length of Stay ; Traction

The “delta phalanx”, first named by BlundeII Jones in 1964, is a triangular(“delta-shaped”) or trapezoidal phalanx with C-shaped epiphyseal plate causing progressive angular deformity of the digit with growth. Neither splinting nor physical therapy is effective in improving the condition. Surgical correction is indicated and several methods of correction have been reported. Authors have experienced a rare case of “delta phalanx” occuring in the proximal phalanx of the syndactylous digit.
Congenital Abnormalities ; Growth Plate ; Splints ; Syndactyly

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

The traditional treatment for the femoral shaft fractures in children is closed reduction by continuous traction, usually for 2–3 weeks, until the fracture has achieved partial stability, followed by spica cast immobilization. Fifty three cases, from 3 to 10 years of age, has been treated with closed reduction and immediate application of hip spica csst; all of them were closed fractures of femoral shaft and were not associated with head, abdominal, or vascular injuries. Any angulations in excess of acceptable ranges were corrected with wedging the cast; any overridings in excess of acceptable ranges were corrected by skeletal traction for 1 week, followed by incorporation of the pin to the cast. The resultant overriding and angulation of fragments were within acceptable ranges, and complications were not significant.This method of treatment not only is likely easy in nursing care and comfortsble to the patients but also has some advantages of short stay in the hospital, better utilization of hospital beds, and costsaving. This immediate hip spica cast immobilization seems to be a good method of treatment for the femoral shaft fracture in children.
Child ; Clinical Study ; Fractures, Closed ; Head ; Hip ; Humans ; Immobilization ; Methods ; Nursing Care ; Traction ; Vascular System Injuries

The goals of orthopaedic management of pelvic ring injuries are to achieve anatomical reduction and secure fixation of fragment and mobilize the patient as early as possible. Previously, pelvic ring injuries have been treated by a wide variety of conservative methods. Their application, however, necessitated a prolonged period of recumbency with associated likelyhood for many complications and did not facilitate accurate reduction and stabilization of most types, resulting in pelvic deformity, non-union and late sacroiliac joint instability. During the past decade, experience with techniques of external and internal fixation of the pelvis has grown and the goals of the methods include provision for sufficient pelvic stability in satisfactory position so that immediate postoperative bed-to-chair transfers can be undertaken and complications due to prolonged recumbency and pelvic deformity can be markedly reduced. We reviewed 47 cases of unstable pelvic ring injuries treated at the depatment of orthopaedic surgery, Dongkang Hospital from January 1984 to December 1987, and the results were as follows ;1. The highest incidence was in the 4th decade and sex ratio between male and female was 1.6:1 2. The most common cause of injury was traffic accident (68.2%) followed by falling down accident (19%) 3. Associated injuries occurred in 28 cases (60%): injuries of the extremities were most common (30%) followed by head injury (13%) and genitourinary tract injury (11%). 4. According to classification of Pennal et al, lateral compression injury was most common (51.1%). Bucholz Group II injury was 57% of all and Group III, 43%. 5. Operative methods, with which 21 cases were treated, were anterior external fixation with AO apparatus or symphyseal plating in Bucholz Group II injuries ; and external fixation, internal fixation (anterior and/or posterior) or both, in Group III injuries. 6. Advantages of operative treatment of unstable pelvic ring disruptions were, by giving stability, early mobilization; easy care of associated injuries, open wounds and nursing; prevention of possible complications of prolonged recumbent position; rapid reduction of pain; and prevention of late complications such as lumbosacral or pelvic pain and gait disturbance.
Accidental Falls ; Accidents, Traffic ; Classification ; Congenital Abnormalities ; Craniocerebral Trauma ; Early Ambulation ; Extremities ; Female ; Gait ; Humans ; Incidence ; Male ; Nursing ; Pelvic Pain ; Pelvis ; Sacroiliac Joint ; Sex Ratio ; Wounds and Injuries

The author reviewed 148 cases of phalangeal and metacarpal fractures of the hand, excluding distal phalangeal and carpal bones, in 75 patients treated at the Department of Orthopaedic Surgery, Dong-Kang Hospital, from January, 1984 to December, 1987. We obtained the following results ; 1. Better results were obtained in younger patients, transveres or spiral fractures, and cases immobilized in MP joint flexion. 2. Factors that led to worse results included older age, comminuted fracture, wide displacement, intra articular fracture, associated tendon injury, intraarticular pin placement. 3.In case of K-wire fixation, dorsal placement of the wire revealed better result than volar one.
Carpal Bones ; Clinical Study ; Fractures, Comminuted ; Hand ; Humans ; Joints ; Tendon Injuries

The patella is an important component of the extensor mechanism of the knee. It serves to increase the mechanical advantage of the quadriceps muscle by increasing its lever arm. Therefore, if possible, when the patella is fractured, it should be repaired rather than excised. Present surgical techniques for the patellar fractures utilizes principles of anatomic reduction with repair of any associated retinacular tears, rigid internal fixation, and early institution of joint motion exercises. To compare the efficacies of the commonly used wiring techniques, we performed tension tests with transversely bisected patellar models fixed with circumferential wiring, Magnuson wiring, modified tension band wiring and modified tension band wiring combined with circumferential wiring. Also, we reviewed 66 surgically treated patellar fractures from Jan. 1984 to Dec. 1988, when we had given every effort to preserve the patella using modified tension band wiring or modified tension band wiring combined with circumferential wiring. l. According to the results of the tension tests, modified tension band wiring and Magnuson wiring were more rigid than circumferential wiring and the rigidity of modified tension band wiring was much increased when combined with circumferential wiring. 2. Of the 66 cases, 46 cases were treated with modified tension band wiring combined with circumferential wiring, and the remainder were treated with modified tension band wiring. 3. On the whole, good and excellent results were achieved in 87.9% (58 cases). Unsatisfactory results were obtained in 15.0% of cases treated with modified tension band wiring and in 10.9% of cases treated with modified tension band wiring combined with circumferential wiring. 4. Most of the unsatisfactory cases were so severely comminuted that could not be achieved anatomic reduction, rigid internal fixation and early joint motion exercises.
Arm ; Exercise ; Joints ; Knee ; Methods ; Patella ; Quadriceps Muscle ; Tears

Carpometacarpal and metacarpophalangeal joints of the thumb exhibit relatively wide range of motion, which may act as a shock absorber. So dislocation of these joints are relatively rare. Furthermore, a complete dislocation of the thumb metacarpal by simultaneous dislocation of carpometacarpal and metacarpophalangeal joints is a very rare injury, and only a few cases were reported in the English literatures. The authors will present a case of a complete dislocation of the thumb metacarpal in a 31 years old female.
Dislocations ; Female ; Humans ; Joints ; Metacarpophalangeal Joint ; Range of Motion, Articular ; Shock ; Thumb

In the assessment of thoracolumbar fractures, computed tomography (CT) is superior to other imaging modalities especially when a more definitive assessment of the posterior elements of the spine or the neural canal is desired. We evaluated 55 patients with acute thoracolumbar burst fractures, and correlated the amount of neural canal impingement (NCI), demonstrated on computed tomographic scans, with each patients neurologic status, level of injury and extent of recovery when neural deficit was present. The results were as follows ; l. Average NCI was significantly higher in cases with neurologic deficits (57.3%) than in cases with no deficit (29.8%). But the range of NCI was much overlapped between the two groups (32-100% with deficits vs. 8-69% with no deficit). 2. In cases with neurologic deficits, average NCI was significantly higher in lumbar spine (75.0%, range; 61-100%) than in thoracolumbar spine (49.2%, range; 32-87%). 3. There was no neurologic deficit in cases with NCI less than 30% in thoracolumbar spine and less than 60% in lumbar spine. 4. In thoracolumbar spine, there was more significant relationship between NCI and patient's neurologic status in T12 than in Ll. 5. The NCI did not directly correlate with the extent of recovery of neurologic deficits when present.
Humans ; Neural Tube ; Neurologic Manifestations ; Spine