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

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

Subtrochsnteric varization osteotomy with open wedge technic was performed for the Legg-Calve-Perthes disease patients of 6 years to 9 years of age. Open wedge technic is less complicated with unwilling effect of postoperative leg shortening than closed wedge technic, but has seldom performed for the patients over 5 years of age because of possible delayed or nonunion of osteotomy site. Authors trial of this technic in a older patient(6 to 9 years of age) showed excellent post-operative result with noneventual post-operative course including delayed or nonunion.
Humans ; Leg ; Legg-Calve-Perthes Disease ; Osteotomy

Partial capital resection (cheilectomy, partial capitectomy, excision of a lip) has gained an accepted place in treating the Legg-Calve-Perthes disease with severely malformed femoral head in which containment surgery has rarely been successful. The clinical experiences in six children aged over 10 years who complained marked limitation of hip motion with severe collapse and subluxation of femoral head are presented. Postoperative results including clinical and radiological findings are quite promising.
Child ; Containment of Biohazards ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease

A study on the deformity of the hip in Legg-Calve-Perthes disease has been confined to the involved hip. Recently the morphological change of uninvolved hip has been investigated with histological and radiological means, by several authors. Their results, however, were inconclusive and there were much differences as to the pattern and incidence of abnormality. To elucidate and gain further insight into this differences, the authors have performed radiological observation on the opposite hip in 126 unilateral Legg-Calve-Perthes disease and have compared with that of normal 94 children. The results were as follows: 1. Surface irregularity; Surface irregularity was observed in both the disease group and the control group. The appearance rate in disease group (12.7%) was about two times that of control group (6.4%). 2. Thickness of articular cartilage: A change of thickness of articular cartilage was not observed. 3. Epiphyseal index; A statistically significant decrease in the disease group was observed with average epiphyseal index of 0.44±0.065 in the disease group and 0.50±0.095 in the control group respectively. 4. In conclusion, the authors could confirm the presence of more abnormality in the opposite hip of unilateral Legg-Calve-Perthes disease than previous recognition and became to have question on the reliability of the opposite hip as a normal reference in measuring the various quotients.
Cartilage, Articular ; Child ; Congenital Abnormalities ; Hip ; Humans ; Incidence ; Legg-Calve-Perthes Disease

In 1814, Monteggia first described a fracture of proximal third of the ulna with a dislocation of radial head. The clinical importance of this fracture is that when the ulna is fractured and shortened, the proximal radioulnar joint dislocate. Despite of its importance the reports of this fracture is relatively rare. The authors reviewed twenty-nine Monteggia fractures that were treated at 15 orthopedic institutes of Honam area over a four-year period (1981 through 1984), with particular emphasis on classification, causes of injury, level of fracture, direction of dislocation, treatment and results. The results were as follows: 1. Total 29 patients were 8 children and 21 adults. 2. The male was affected about 2 times more than female (19: 10). 3. Causes of injury were fall in 12, car accident in 12 and machinery injury in 5. 4. Classification into 4 type by Bado's method disclosed that type 1 accounts for 65.5% of cases, type 2 for 6.9%,type 3 for 13.8%, and type 4 for 13.8%. 5. Treatments of dislocated radial head were closed reduction in 24, open reduction in 3, and excision in 2. 6. Locational incidence of ulnar fracture were upper one third of ulna in 11, junction of upper and middle 1/3 in 2, middle one third in 15, and distal one third in 1. 7. Treatment of fractured ulna was different between child and adult. Eight children fracture were managed by closed reduction in 5 and open reduction with K-wire fixation in 3. Twenty one adult fracture were managed by open reduction and internal fixation in 20 and closed reduction in l. 8. Palsy of posterior interosseous nerve was observed in 3 patients (10.4%) and disappeared completely later. 9. The results (Bruce et al criteria) for the 19 patients followed 6 months and more were 8 excellent, 4 good, 1 fair and 1 poor.
Academies and Institutes ; Adult ; Child ; Classification ; Dislocations ; Female ; Head ; Humans ; Incidence ; Joints ; Male ; Methods ; Monteggia's Fracture ; Orthopedics ; Paralysis ; Ulna