No abstract available.
Amputees* ; Arthroplasty, Replacement, Hip* ; Humans

The displaced intracapsular hip fracture continues to be difficult to manage. Despite significant advances in the technique of internal fixation, the incidence of non-union and avascular necrosis remain high. As a result, prosthetic replacement has been advocated as a solution to this proplem. But the criteria for the management of these fractures by internal fixation, hemi-arthroplasty, total hip replacement have not been clearly well defined, So, we reviewed the result of 28 internal fixation, 7 hemi-arthroplasty, 16 total hip replacement patients at Wonju Christian Hospital. The results obtained from obove patients in the review of esrly ambulation, early and late orthopedic complications, and hip function by Harris hip scoring were as follows ; 1. The average age of the patients were 64-year in the internal fixation, 72-yesr in the hemi-arthroplasty and 70-year in the initial total hip replacement. 2. The most common cause of injury was slip down and the most common type was the fracture of the base of femoral neck. 3. Among the internal fixstion group, the only 11 cases coulddo crutch walking within 2 weeks. But 5 cases(71%) in the hemi-arthroplasty and 11 case(74%) of the of the total hip replacement could do crutch walking within 2 weeks. 4. There was no specific differences in the early post operative complications between three groups. Avascular necrosis of the femoral head and non-union still exist in the internal fixation group and acetabular erosion and protrusion of metallic head occurs frequently in hemi-arthroplasty group. The late complication became increasingly higher in the internal fixation and hemi-arthroplasty group than the total hip replacement group. 5. The measured hip function at the final follow-up showed good end results(57% in the internal fixation, 71% in the hemi-arthroplasty and 81% in the total hip replacement).
Acetabulum ; Arthroplasty, Replacement, Hip ; Early Ambulation ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Gangwon-do ; Head ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Necrosis ; Orthopedics ; Walking

We conducted a retrospective study of 104 patients to examine the efficacy of two methods of urinary bladder management after total hip arthroplasty under spinal anesthesia. Patients who had total hip replacement was randomly assigned either to Group I, in which indwelling catheters were placed during the operation and removed the next morning, or Group II, in which urinary retention was managed by intermittent catheterization as needed. After the removal of the indwelling catheter, the patients in Group I had a lower incidence of urinary retention than those in Group II. Bladder distention(volume above 700ml) was more common in Group II and was associated with an increased need for subsequent long-term catheterization. There was no significant difference between the groups in the rates of urinary tract infection. We conclude that the short-term use of an indwelling catheter after extended surgery, such as joint replacement, reduces the incidence of urinary retention and bladder overdistention, without increasing the rate of urinary tract infection.
Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Catheterization ; Catheters ; Catheters, Indwelling ; Humans ; Incidence ; Joints ; Retrospective Studies ; Urinary Bladder* ; Urinary Retention ; Urinary Tract Infections

This is a follow up study on consecutive series 50 patients of total hip arthroplasty to assess for transient leg-length inequality. The authors report a clinical experience of 50 patients who have been pelvis tilt before total hip replacement. Retrospectively reviewed for the presence of pelvic obliquity preoperative and at the 1, 3 and 6 months follow-up visits. The results were as follows. Fourty-eight patients(96%) with functional leg length inequality related pelvic obliquity were improved within 6months postoperative follow up period after total hip arthroplasty. Two patients(4%) had persistent functional leg length inequality that affected factors-old age, female and soft tissue tightness due to pelvic obliquity. We believe that in most of these patients, the transient functional leg length inequality has a self-limited course, whereas in a small number, the profoud sense of inequality remains.
Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Humans ; Leg Length Inequality* ; Leg* ; Pelvis ; Retrospective Studies ; Socioeconomic Factors

From Jan. 1987 to May 1994, we carried out cementless total hip arthroplasties using hydroxyapatite-coated Omnifit system, and among these, 63 cases in 49 patients were followed up more than 24 months. The average Harris Hip Score was 46.3 points preoperatively, 95.4 points at POD 1 year and 96.2 points at POD 2 years. Two patients (3%) complained thigh pain at POD 2 years. On the radiologic findings, endosteal bone formation was noted in 34 cases (53,9 %), radiolucent lines were seen at the non-coating region of distal stem in 41 cases (65.3%), which were less than 2mm and not progressive. Cortical hypertrophy was noted in 5 cases (8.4%), and calcar atrophy was observed in 31 cases (49 %).
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Atrophy ; Durapatite* ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Thigh

No abstract available.
Arthroplasty, Replacement, Hip* ; Humans ; Passive Cutaneous Anaphylaxis*

Femoral fracture, dislocation of the hip, or tasumatic amputation of the ipsilateral lower extremity is a rare injury. There has been only a few reports describing their managements. All amputated limbs are vulnerable to fracture, which occur frequently around the hip. Conservative treatments are not always adequate for the managements of fracture and dislocation of the hip and operative procedures are needed in almost patients. Among various operative measures, prosthetic replacement surgery may be indicated in cases of non-united fracture of the femoral neck, avascular necrosis of the femoral head, pathological fracture, or osteoporosis. We performed two cases of total hip replacement for the non-united fracture of the femoral neck(case 1) and the avascular necrosis of the femoral head(case 2) in the ipsilateral lower limb amputees, each. The early results were known to be very satisfactory postoperatively. The first patient was followed for 17 months and the second patient for 22 months. 1. P.C.A. femoral stems and acetabular cups were used without cement in both cases. A operative time was 2 hours and 22 minutes in the first case, 1 hour 45 minutes. in the second case. 2. There were no significant intraoperative or postoperative complications. 3. The functions of each hip were evaluated postoperatively by the method of Jesse and showed satisfactory results. 4. During the follow-up period, roentgenogram showed no significant bony changes around the femoral stems and acetabular cups. 5. The prosthetic replacement is also valuable for the treatment of the fracture-dislocation of the hip in the lower limb amputee.
Acetabulum ; Amputation ; Amputees ; Arthroplasty, Replacement, Hip ; Dislocations ; Extremities ; Femoral Fractures ; Femur Neck ; Follow-Up Studies ; Fractures, Spontaneous ; Head ; Hip ; Humans ; Lower Extremity ; Methods ; Necrosis ; Operative Time ; Osteoporosis ; Postoperative Complications ; Surgical Procedures, Operative

Although the clavicle is probably the most commonly fractured bone, nonunions are rare. We experienced 19 cases of clavicle nonunions, trested at the Depatment of Orthopedic Surgery of Wonju Christian Hospital, between January 1980 and June 1988(seven years and six months). This study focused on predisposing factors in relation to nonunion of clavicle and treatment. The factors predisposing to nonunion were middle and lateral 1/3 of clavicle, primary open reduction, severe trauma with associated injury and persistent gross displscement of fregment. Among the 19 patients, 16 patients were treated with semitubular plating and iliac bone grafting, 2 patients with the resection of the distal fregment and one patient was treated with treated with K-wire fixation and bone graft. All patients achived good union by the postoperative 10.7 week on average and symptomes disappeared. It was concluded that symptomatic nonunion of the clavicle could be trested by operation, and the procedure of choice seemed to be rigid internal fixation with plate applied in compression and bone graft.
Bone Transplantation ; Causality ; Clavicle ; Gangwon-do ; Humans ; Orthopedics ; Transplants

The treatment of frozen shoulder should initially be conservative, with the emphasis on passive stretching of the capsular structures. If the patient's clinical progress stalls or the condition worsens, and his or her life style is disturbed enough, manipulation under gerneral anesthesia is indicated. The Authors practiced the passive manipulation under the general anesthesia on 7 patients of frozen shoulder, who had been treated at the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine, from March 1988 to April 1989. The results obtained were as follows:l. All seven patients achieved nearly full range of motion with minimal or no pain. 2. After 3 months of follow-up, all seven patients showed neither signs of readhesions nor recurrence of pain. 3. There were no complications, such as humerus shaft fracture and dislocation of shoulder.
Anesthesia ; Anesthesia, General ; Bursitis ; Dislocations ; Follow-Up Studies ; Gangwon-do ; Humans ; Humerus ; Life Style ; Muscle Stretching Exercises ; Range of Motion, Articular ; Recurrence ; Shoulder

This is a follow-up study of 88 cases of cementless total hip replacement in 77 patients(59 males and 18 female), using AML, PCA and HGP prostheses, performed at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine, between September 1984 and December 1987. The follow-up period ranged from 18 to 56 months, the average being 34 months. The youngest patient was 21 and the oldest one was 79, the average being 47 years. The results were as follows:1. The average of Harris hip score was 89.7 points(Preop, 55.4 pints) at one year for 77 patients and 91.4 points at two years for 68 patients. 2. Radiographic analysis. a. Radiodense line:10 cases(11.4%) around the acetabular cup. 20 cases(22.7%) around the femoral stem. b. Calcar resorption:4 cases with AML stem(4/30), 2 cases with HGP stem(2/7). c. Subsidence:5 cases in PCA group(5/51).d. Radiological loosening:1 cases in PCA stem(1/51). 3. Intraoperative complications a. Femur neck fracture:15 cases(17%);5 cases in PCA group(5/51), 8 cases in AML group (8/31), and 2 cases in HGP group(2/7). b. Lateral collateral ligament tear:One case in PCA prosthesis(1/51). 4. Postoperative complications a. Prosthetic joint dislocation occured in 3 cases:1 case, closed reduction after tight adductor release:2 cases, cup reinsertion due to poor cup position. 5. Heterotopic ossification developed in 5 cases(5.7%) without significant loss of ROM. 6. Postoperative infection developed in 2 cases(2.3%):One superficial and the other deep. All were treated successfully with systemic antibiotics after irrigation and debridement.
Acetabulum ; Anti-Bacterial Agents ; Arthroplasty, Replacement, Hip ; Debridement ; Dislocations ; Femur Neck ; Follow-Up Studies ; Gangwon-do ; Hip ; Humans ; Intraoperative Complications ; Joints ; Lateral Ligament, Ankle ; Male ; Ossification, Heterotopic ; Passive Cutaneous Anaphylaxis ; Postoperative Complications ; Prostheses and Implants