Endoprosthetic replacement has gained an accepted place in the management of the neck fracture of femur in the elderly and those with failed previous internal fixation in which any further attempt to attain osteosynthesis is often doomed to failure. Total 37 cases of femoral head replacement, which had been done at several medical institutes in Honam area during the past six years from January of 1964, could be reviewed. The results were summerized as follows: 1. Thirty-seven patients were comprised of 11 men and 26 women. 2. Their average age was 68 years old and 28 (76%) of them were over 60 years of age. 3. Primary replacement surgery was done in 26 cases, which included displaced fresh facture (14), neglected fracture (10), and pathological fracture (2). Secondary replacement was performed in 11 cases, in which were failed reduction (6), nonunion (2) and avascular necrosis after initial internal fixation (3). 4. The prosthesis inserted was the Austin Moore type with fenestration in 12 cases and the Thompson type in 25. 5. Associated general disease, a total of 23 in number, could be diagnosed in 18 of them all. These included senlle psychosis (5), hypertension (5), diabetes mellitus (4), asthma (3), hemiparesis (2), cardiac disease (2), and tumor (2). 6. No grave complication was experienced. Durlng the hospitalization, however, there were superficial wound infection in four, large hematoma in two, trochanteric fracture, transient sciatic palsy and temporay mental confusion in one respectively. 7. At the time of follow-up, average 2.2 years and all over six months postoperatively, the results in 23 cases were excellent or good in 19, fair in two, and poor in two.
Academies and Institutes ; Aged ; Asthma ; Diabetes Mellitus ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Fractures, Spontaneous ; Head ; Heart Diseases ; Hematoma ; Hospitalization ; Humans ; Hypertension ; Male ; Neck ; Necrosis ; Paralysis ; Paresis ; Prostheses and Implants ; Psychotic Disorders ; Wound Infection

No abstract available in English.
Aged ; Femur ; Humans

The deformity of the hip in Legg-Calve
Acetabulum ; Arthrography ; Congenital Abnormalities ; Epiphyses ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Necrosis ; Osteoarthritis ; Risk Factors

No abstract available.
Arthroplasty, Replacement, Hip* ; Ceramics*

Medial approach open reduction (MAOR) for congenital dislocation of the hip, as is well known, is the most anatomically direct approach to the major obstacle to reduction. For the study on this method of open reduction, the authors reviewed 15 children who underwent MAOR and followed up to at least 1 year after operation with an average of 3 years and 2 months. The results were as follows: 1. The age distributions of the 15 children were; 1 child in below 12 months of age, 10 in 13 to 18 months, and 4 in 19 to 24 months. 2. The acetabular index was high before operation with an average of 32.7° (25-43). This improved makedly in the follow-up period to an average of 20.6° (13-29) . 3. The average of acetabulum-head index was 70.6° and the average of CE angle was 19.7° in the follow-up. 4. The complications were 2 cases of avascular necrosis and 1 case of redislocation. No contracture of joint was observed. 5. For the residual dysplasia of acetabulum,innominate osteotomy of Salter was performed in 2 children and was scheduled in the other 5 children. 6. It can be stated that MAOR is a very safe, simple and effective method of open reduction.
Acetabulum ; Age Distribution ; Child ; Contracture ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Joints ; Methods ; Necrosis ; Osteotomy

In the instance wherein concentric reduction cannot be achieved by closed method, open reduction is indicated. Prolonged and forceful attempts to reduce the refractory hips are not without risk to the circulation of the femoral head and open reduction is certainly a less traumatic way to obtain reduction in these hips. The authors performed clinical analysis in 30 patients with congenital dislocation of hip who were treated by open reduction between 1978 and 1987, The results are as follows :1. The results of treatment in 30 patients were acceptable in 22(73.3%), uncertain in 4(13. 3%), and unacceptable in 4 patients(13.3%). 2. Comparing the results depending on the presence of prior treatment or not, acceptable results were obtained in 86.4%(19 out of 22) of patients without prior treatment and in only 37.5%(3 out of 8) of patients with prior theatment by such as Pavlik harness and closed reduction. 3. The surgical approaches for open reduction were medial and anterior routes. The approach was selected depending on the age of patients and the severity of dislocation. The medial approach was used in patients under the age of 18 months. In mild degree of dislocation, the age limit of medial approach was extended to 24 months of age. The anterior approach was used in patients over 19 months of age.
Dislocations ; Head ; Hip ; Humans ; Methods

Osteochondritis dissecans of the femoral head following Legg-Calve-Perthes disease has been considered a rare complication. Catterall, in 1982, reviewed the literature and found only 54 reported cases proving the relative rarity of this condition. Of the 363 hips with Legg-Calve-Perthes disease treated at the Chonnam University Hospital for 15 years from 1973 to 1987, osteochondritis dissecans of the femoral head developed in seven(1.9%). The seven patients with osteochondritis dissecans were male and over seven years old at the time of diagnosis of Legg-Calve-Perthes disease. Since six patients had nearly silent hip, treatment was not advised. In remaining one patient, the lesion was drilled and grafted with bone chips. Spontaneous healing of osteochondritis dissecans was observed in three patients.
Diagnosis ; Head ; Hip ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Male ; Osteochondritis Dissecans ; Osteochondritis ; Transplants

Prevalent is the concept that tuberculosis has completely been put under control and the actual number of the patients is decreasing. This study has been undertaken in part to give substantial evidence to this general idea about the tuberculosis. Total 921 patients with skeletal tuberculous lesions, selected out of all the patients consulted to the department of orthopedic surgery during the 13 consecutive years from Jaunary of 1963 to December of 1975, were subjected to this analysis. 1. Overall incidence of patients with skeletal tuberculosis was 4.8% of all the patients visited during the 13 years. 2. Of 921 patients, males were 591 and females 330, which showed the men were affected 1.8 times more than women. 3. More than half of them (51,5%) occurred under the age of 19 years. 4. Three anatomical sites were predisposed to this affection; 58.5% in spine, 10.5% in hip, and 11.6% in knee. 5. With the above study it can be safely be said that the actual number and also the incidence of skeletal tuberculosis has not shown any trend of decline and accordingly its management should be more regulated and thorough.
Female ; Hip ; Humans ; Incidence ; Joints ; Knee ; Male ; Orthopedics ; Spine ; Tuberculosis ; Tuberculosis, Osteoarticular

The leprous involvement of the ankle joint and the upper surface of the talus is said to be a rare entity and this is in sharp contract to the Charcot joint of other causes in which the ankle involvement is relatively common. This can partly be explained by the concept that the articular branch of tibial nerve to the ankle joint is usually spare din leprosy, although the fibular nerve is affected around the knee level. During the survey of nearly 3000 leprous patients in the National Leprosy Center we selected 26 cases with obvious bone change of the ankle joint and the clinical study on these 26 cases was made with the following results. 1. The 26 cases consisted of 15 males and 11 females 2. Average age of the patients was 56 years and those over 50 years numbered 20(77%)and undre 39 years of age there was only one involvement. 3. Ankle destruction can be classified according to the causative factors attributable to its occurrence as follows: destruction of ankle joint following fracture of which four were Potts type and eight hyperdorsif-lexion injury: those following idiopathic arthritis in four, and those following subtalar incongruity due to calcaneal flattening in ten. 4. The results of this study which clarify the pathogenesis of ankle involvement in leprous patients may offer reliable preventive measures for each case of ankle destruction.
Ankle Joint ; Ankle ; Arthritis ; Arthropathy, Neurogenic ; Clinical Study ; Female ; Humans ; Knee ; Leprosy ; Male ; Peroneal Nerve ; Talus ; Tibial Nerve

The technique of muscle transposition has gained an accepted place in treating the wide skin defect with bony exposure in which conventional palliative care has rarely been successful. The principle of this procedure, popularized by Ralph Ger and significantly contributed by Bakajian, has been approved by many and now been adapted in the care of similar lesion throughout the entire body regions. This report comprises the results of muscle transposition experienced in 28 patients. The results were as follows: 1. Twenty-four cases of antetibial skin defect with bony exposure, resulted from chronic osteomyelitis, open fracture, chronic ulcer, and burn scar, were successfully managed with the transposition of single muscle or combination of them: medial head of the gastroenemius, the soleus, the flexor digitorum longus and the abductor hallucis. The extent and the level of the defect in each case were the sole indication of selection of the appropriate muscle and the number. 2. Four patients with decubitus ulcer in the sacral region were also managed by transposing the upper half of the gluteus maximus. 3. Subsequent skin coverage over the transposed muscle were uniformly successful in all cases and this technique seemed to afford a definite favorable influence upon the healing of fracture and the eradication of infection.
Body Regions ; Burns ; Cicatrix ; Fractures, Open ; Head ; Humans ; Osteomyelitis ; Palliative Care ; Pressure Ulcer ; Sacrococcygeal Region ; Skin ; Transplants ; Ulcer