No abstract available.
Spine

At Orthopedic Department of Kyung Hee University Hospital, we performed 20 total knee replacements in 12 patients who had rheumatoid arthritis and 18 total knee replacements in 13 patients who had osteoarthritis during the period from August 1982 to May 1986. All patients were female. Comparative analysis was done between the two groups with a follow-up period ranging from 1 year to 4 years 8 months, average being 2 years and 3 months. The average age of rheumatoid arthritis patients was 10 years younger than osteoarthritis patients. The improvement of range of knee motion after total knee replacement was greater in rheumatoid arthritis comparing to osteoarthritis. Preoperative flexion contracture was more severe in rheumatoid arthritis than osteoarthritis, but after total knee replacement the average degree of flexion conrcacture was no significant difference between two groups. The average of preoperative Hospital Surgery Knee Rating Scale was low in rheumatoid arthritis group than in osteoarthritis group, but postoperative Knee Rating Scale was similar in both groups. It seems that the problem of wound was more frequent in rheumatoid arthritis than in osteoarthritis.
Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Wounds and Injuries

No abstract available.
Surgery, Plastic*

The anterior cruciate ligament injury is one of the most common ligament injury of the knee joint, and anterior cruciate ligament is as important structure for stabilization as a primary restraint. Noyes reported that the diagnosis of a tek of the anterior cruciate ligament was made by the original treating physician in only 6.8%. And there are many controversies in its treatment. It is certain thatearly diagnosis and treatment are th most important clue. Authors studied 48 patients of isolated anterior cruciate ligament injury who were diagnosed by same physician from Jan. 1983 to Dec. 1985 after follow ups ranging from six mnths to 4 years, average beimng one year and two months. The results were as followings: 1. The most common cause was sports injury. 2. The most common sign and symptom were hemarthrosis in acute injury and giving way in chronic injury. 3. Anterior drawer test without anesthesia had 25% of diagnostic accuracy but pivot shift test under anesthesia 95.8%. 4. 31 cases in 48 cases (64.8) had associated meniscal injury. 5. In acute torn ACL, the primajy repair was preparable but conservative treatment with arthroscopic partial menisectomy was eful in chronic case.
Anesthesia ; Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Hemarthrosis ; Humans ; Knee ; Knee Joint ; Ligaments

At Orthopaedic Department of Kyung Hee University Hospital, we performed 50 total knee replacement in 32 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1987. We studied these cases and compared the results of total knee replacement surgery in preoperative ambulatory patients(group I ) with those in preoperative non-ambulatory patients(group II ). 1. Preoperatively, 19 patients were able to walk, and 13 patients were unable to walk. 2. 7 patients of bilateral TKR(36.8%) were included in group I, and 11 patients (86.9%) in group II. 3. The improvement of range of motion after TKR was greater in group II (34 degrees) and in group I, average postoperative range of motion was similar to the average preoperative ROM. 4. Flexion contracture was more markedly improved in group II. 5. In group I, the average preoperative knee rating score by Hospital for Special Surgery rating system was 38.8 and improved to 93.4 postoperatively. In group II, the average preoperative knee rating score was 27.4 and improved to 85.7 postoperatively. 6. Postoperatively most of the patients were able to walk without support except one cases of infection(group I ) and the other who had severe rheumatoid involvements in other joints (group II ). 7. Preoperative evaluation for involvements of cervical spine and surrounding soft tissue structure was necessary endotracheal anesthesia. 8. There was 2 cases of complications in group I, and 4 cases in group II.
Anesthesia, Endotracheal ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Humans ; Joints ; Knee ; Range of Motion, Articular ; Spine

No abstract available.
Lacerations* ; Spine*

Between Jan. 1976 and May 1987, Sixteen supracondylar fractures of the femur were treated by interlocking nailing. Of the 16 cases, 7 cases were intercondylar, 12 cases were segmental fractures of the femur, 4 cases were open fractures in the type of wound. 1. The simple supracondylar fracture involving the distal 9cm of the femur can be treated by interlocking nailing which makes firm fixation and allows early ambulation. 2. If the supracondylar fracture is accompanied with intercondylar fracture, careful reduction and transcondylar fixation by means of tibial bolt or cancellous screws are essential before the insertion of the nail. 3. The shape of the bent nail must be depended on the type of the fracture. If the nail is to be inserted into the anterolateral aspect of the distal fragment, the degree of bending of the nail is 400cm, and posteromedial is 110cm in radius. 4. The authors made several sagittal holes the at dorsum of the nail. So the screw can be easily inserted to the nail perpendicularly or obliquely, when the insertion of the screw through the transverse holes is difficult. 5. Of the 15 cases treated by interlocking nailing, 5 cases were excellent, 4 cases were good, 2 cases were fair, 4 cases were failure by schatzker assessment.
Early Ambulation ; Femur ; Fractures, Open ; Radius ; Wounds and Injuries

STUDY DESIGN: The purpose of this study was to determine whether facet joint orientation and/or tropism influences the prevalence of disc degeneration in MRI in young patients. OBJECTIVE: 41 patients with disc degeneration disease including HNP in MRI were assesed on facet joint angles and tropism between 18 and 30 years old. SUMMARY OF BACKGROUD DATA: The patients who had back pain had association between disc degeneration and facet tropism in adults. But some authors have suggested that facet tropism has no clinical relevance. Physiologic aging and premature disc degeneration induce a gradual loss of water and proteoglycan from nucleus pulposus. METHODS: We reviewed the 41 MRI of lumbar spine with disc degeneration and measured facet joint angles on the mid-disc cut, which was parallel to inferior vertebral end-plate of superior vertebra. In simple X-ray, we reviewed relation between the transitional vertebrae and disc degeneration. It was analyzed statistically the facet joint angles and facet tropism in each levels. RESULTS: The mean facet angles was more increased in upper vertebral facet joints but statistically nonspecific. The facet tropism was not significant in all lumbar levels and the effects of transitional vertebrae on disc degeneration were ignorable and unclear. CONCLUSIONS: No statistical relationship was found among the magnitude of the angle and facet tropism and the presence of disc degeneration at any levels in young patients.
Adult ; Aging ; Back Pain ; Equidae ; Humans ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging ; Prevalence ; Proteoglycans ; Spine ; Tropism* ; Young Adult* ; Zygapophyseal Joint

Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture in itself were noted, but we have analyzed 18 femur neck fracture of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slipdown accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. Undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with preexisting disease in the same hip joint (total hip replacement).
Aged* ; Arthroplasty ; Cause of Death ; Classification ; Female ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Hemiarthroplasty ; Hip ; Hip Joint ; Humans ; Methods ; Mortality ; Necrosis ; Osteoporosis ; Preexisting Condition Coverage ; Prognosis

No abstract available.
Granuloma* ; Subphrenic Abscess*