Synovectomy of the knee in rheumatoid arthritis has been recommended as an effective procedure which improved symptoms such as pain, swelling, and limitation of motion. But some problems, such as limitation of range of motion, infection, long hospital days, occured in open synovectomy. Arthroscopic synovectomy yields reliable result compatible to open synovectomy with less invasiveness and postoperative morbidity. The authors analyzed 20 knees of 14 patients who has done synovectomy of knee in Kyung Hee University Hospital from September 1989 to October 1992. Of the 14 patients, thirteen were females and only one was male, ten knees were affected on the right and ten on the left respectively. Five knees were operated as open synovectomy and fifteen knees as arthroscopic synovectomy. In six patients, both knees were operated either open or arthroscopic synovectomies. The preoperative diagnosis of 20 knees were rheumatoid arthritis as clinically, serologically and radiologically, 13 knees are confirmed as pathologically. Average hospital days after operation were 19 days in open synevectomy and 11 days in arthroscopic synovectomy. Average operation time were 72 minutes in open synovectomy and 84 minutes in arthroscopic synovectomy. No complication occured as a result of these synovectomies. After average follow up of 19 monthes, 1 knee from 5 knees in open synovectomy and 3 knees from 15 knees in arthroscopic synovectomy had pain and intermittent swelling as postoperatively. And only 1 knee in open synovectomy had loss of range of motion. No other patients lost motion in their knees. Preoperatively 17 knees showed radiographic change of rheumatoid arthritis and 16 knees showed no progressive radiographic deterioration at final follow up. And patients overall showed a significiantly increased functional status postoperatively. In conclusion, the result obtained after arthroscopic synovectomy are comparable with those obtained after open synovectomy. In addition arthroscopic procedure had lessened postoperative morbidity as loss of range of motion, postoperative infection, long hospital days and useful as palliative surgery in advanced rheumatoid arthritis.
Arthritis, Rheumatoid ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Palliative Care ; Range of Motion, Articular

From January 1985, to June 1986, 7 cases in which supracondylar and intercondylar fractures of the femur were treated at our orthopaedic department using the Extensile Approach for an anatomical reduction and firm internal fixstion, show successful results in follow up stuides. l. All 7 cases were type III fractures of Neers classification. 2. Among the 7 cases treated surgically using the Extensile Approach, 5 cases showed excellent and good results and the remaining 2 csses showed one fair and one failed results. 3. Probably due to the additional open proximal tibia and patella fracture and delayed surgery from trauma one case had a fair results. The case which failed wss due to ipsilsteral ligamentous injuries and a nerve injury in addition to the femur fracture and slso the impossibility of early knee joint exercise due to associated injuries. 4. None of the results of the 7 csses had any relationship with the patients age. 5. One case of postoperative skin necrosis developed around the tibial tuberosity and was treated successfully by a cross leg flap. 6. In comminuted supracondylar and intercondylar fractures of the femur, the Extensile Approach is thought to be an excellent surgical technique by means of a wide surgical field for an anatomical reduction and firm internal fixation with the repair of associated ligamentous injuries.
Adult ; Classification ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Leg ; Ligaments ; Necrosis ; Patella ; Skin ; Tibia

Congenital pseudarthrosis of the tibia was accepted as one of the most difficult disease in respect of the frequency and treatment for the orthopaedists. Since April, 1984, we experienced 3 cases of congenital pseudarthrosis of the tibia, one 2 year-old boy involved left tibia only and the other 4 year-old female involved bilaterally, obtained solid bony union in all which were treated by massive surgical management that contained vascularized bone graft and electric stimulation. Several complications were faced such as refracture, valgus deformities of the ankle, skin irritation sign, angular deformities. But refracture was healed without delayed or nonunion by simple plaster cast immobilization. The vascularized bone graft snd electric stimulation is thought to be more improved methods for the treatment of congenital pseudarthrosis of the tibia. Althought solid bony union was obtained in congenital pseudarthrosis of the tibia, periodic follow-up and adequste management must be mandatory up to the end of the bony growth.
Ankle ; Casts, Surgical ; Congenital Abnormalities ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Pseudarthrosis ; Skin ; Tibia ; Transplants

Lowe et al. have described a disease characterized by organic aciduria, decreased renal ammonia production, hydrophthalmos, and mental retardation, this disease is now called as Lowe's syndrome or oculo-cerebro-renal syndrome which manifests growth plates, metabolic acidosis, and characteristic eye changes, including bilateral cataract, glaucoma and nystagmus. It is a congenital hereditary affectation. Most of the patients with this syndrome are male sex. We report a new case of Lowe's syndrome in a 5-year old girl.
Acidosis ; Ammonia ; Cataract ; Child ; Female ; Glaucoma ; Growth Plate ; Humans ; Hydrophthalmos ; Intellectual Disability ; Male

No abstract available.
Anterior Cruciate Ligament*

For the management of adult dysplastic hips with early degenerative arthritis, we can prevent further progress of secondary degenerative changes of the hip by a Rotational Acetabular Osteotomy, which effectively corrects the preoperatively inadequate acetabular coverage of the femoral head. Biomechanical advantages of this procedure are, l. An adequate coverage of tl; femoral head then enlarges the actual weight-bearing surface area, and so diminishes the resultant force per unit area of the acetabular weight-bearing surface and femoral head. 2. The resultant forces are also diminished by a medial shift of the femoral head. 3. The shearing force is decreased by the reduction of roof obliquity. 4. Because of the rotation of the original articular surface, remodeling the post-operative acetabular articular surface as Chiari operation is not necessary, and so can be performed even on elderly patients.
Acetabulum ; Adult ; Aged ; Head ; Hip ; Humans ; Osteoarthritis ; Osteotomy ; Weight-Bearing

Soft tissue coverage of heel defects has long been a difficult problem. In 1982, Iron reported eight cases of heel defects in children using an ipsilateral posterior thigh flap with use of the Hoff-man's skeletal fixation apparatus for immobilization. We report three cases of heel defects treatment in children using ipsilateral posterior thigh flap and detach flap in an average 13 days with aid of single photon emission computed tomography(SPECT) for evaluation of circulation status of flap.
Child ; Fracture Fixation ; Heel ; Humans ; Immobilization ; Iron ; Thigh ; Tomography, Emission-Computed, Single-Photon

It would be naive to assume that any operative procedure is the solution to the problem of sacral pressure sore in the field of the orthopaedic surgery. The procedures outlined here involve the creation of compound myocutaneous flaps of the gluteus maximus muscle, skin, and the subcutaneous tissue. The myocutaneous flap us- ing the gluteus maximus muscle is a vascular flap instead of a random flap, with better blood supply for healing and advantage of an increased amount of cushion effect. We present an alternative method which will provide satisfactory and substantial soft tissue coverage in sscral pressure sores.
Methods ; Myocutaneous Flap ; Pressure Ulcer ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Operative

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

Rhabdomyosarcoma which was first described by Weber has generally been considered asan uncommon tumor. Pack and Eberhart were of the opinion that rhabdomyosarcoma represented 13.9 percent of soft tissue sarcomata. Recently it was classified as four types such as pleomorphic, embryonal, botryoid and alveolar type by many authors. We have experienced two cases of embryonal rhabdomyosarcoma, one arised within left leg and the other within right foot. The former(3 months old, female) showed tumor mass at birth, the latter(13 months old, male) showed at 1 month after birth.
Chungcheongnam-do ; Foot ; Leg ; Parturition ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal