We have experienced 40 cases of the tibial shaft fractures treated with Küntscher nail from 1979 to 1986. Authors analysed these cases and our own experimental study concerned with the shape of Küntscher nail. The shape of Küntscher nail for the tibial shaft fractures should be designed according to the type and location of the fracture. The proximally bent and distally straight nail is used for the extension fracture, proximally and distally bent nail or entirely bent nail is inserted for the flexion fracture of the tibia. The large nail(over 13 mm in diameter) may produce injury to the patella because it has minimal flexibility. In order to permit easy driven down of nail and prevent this injury, the nail should b. bent into three to four segments and the length of the longest segment should not exceed the permissible length of straight nail (Permissible length is distance from entrance of nail to posterior cortex of the upper fragment, where tip of the (nail impinged-about 12cm) The midpoint of the middle segment of dual dent nail is placed at the fracture site. The middle segment of the nail may bent anteriorly for flexion fracture and posteriorly for extension fracture, securing the dynamic fixation of the fracture.
Patella ; Pliability ; Tibia

1. Thirty one fractures of the shaft of the tibia were treated by Küntscher intramedullary nailing (closed 26 cases) from Dec. 1979 to Oct. 1985. 2. The fractures were classified into extension type(62%) and flexion type(38%). 3. The straingt nail with bent proximally was used for the extension fractures and the nail with a curve near of each end for the flexion type. 4. In the most cases of simple fracture, we used Küntscher nail of 12mm diameter.interlocking were used in addition to a Küntscher nail(static 13 cases, dynamic 8 cases). In the case of interlocking, nail should be at least 13mm in diameter. 5. The nail was inserted just above or superolateral to the tibial tubercle. 6. The bony union was demonstrated radiographically at 14.4 weeks, and hopitalization period was less than 2 weeks in twelve cases and 3 weeks in the three cases. 7. The major complication were delayed union(1 case) and infection(2 cases).Posterior angulatory deformity greater than 5° appeared in two cases. 8. The cross leg pedicle graft combined with Küntscher nailing would be preferable procedure in the case of open fracture with skin defect.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Open ; Leg ; Skin ; Tibia ; Transplants

Authors analylsed 384 hips of 269 patients with osteonecrosis of the femoral head in adult, who were diagnosed and treated between August 1976 and March 1986 at the Department of ()rthopaedic Surgery, Kyung Hee University Hospital. These are investigated in terms of history, clinical data and reontgenogram, retrospectively. In 269 patients, nontraumatic femoral head necrosis (NTFHN) were 199 patients (74.0%) and traumatic femoral head necrosis (TFHN) were 70 patients (26.0%). The male was more affected in ratioof 3.1: 1, especially higher in NTFHN about 4: l. In alcohol-induced necrosis all were male patients, but in polyvinyl pyrrolidone(PVP)-storaged cases 63% were female patients. The peak incidence of age distribution was at 6th decade(average 53.9 years) in the TFHN ahd 5th decade(average 44.2 years) in NTFHN). The most frequent probable etiologic frctor in NTFHN was idiopathic (71 patients, 35.8%), followed by alcohol-induced (68 patients, 34.2%), steroid-induced (27 patients, 13.6%) and PVP-storaged (19 patients, 9.5%). The bilateral involvement in NTFHN was 112 patients (53.6%). The idiopathic cases (42.0%) were lower than steriod-induced (81.9%), alcohol-induced (76.5%) or PVP-storaged (63.2%) in the bilaterality. The associated diseases in NTFHN were hepatopathy (12 patients), diabetes (7 patients), pulmonary tuberculosis (6 patients) and dermatopathy (5 patients). And the underlying diseases in steroid-induced were nephrotic syndrome (4 patients), arthralgia (4 patiehts), rhematiod arthritis (3 patients), dermatopathy (4 patients) and systemic lupus erythematosus (1 patient). 61.4% of TFHN was diagnosed within 2 years after trauma, 56.7% of NTFHN had the duration of symptom over one year. The initial reontgenogram stage according to Ennekings classification was average stage 1V. In NTFHN cases, there were no significant relationship between etiologic factors and initial reotgenographic stage or duration of symptom. But there were significant corelation between Enneking's reontgengraphic stage and clinical findings (range of movement of joint, Harris hip score, duration of symptom). In more severe cases than Enneking's radiologic stage IV, Harris hip score not provide any information to select a proper treatment.
Adult ; Age Distribution ; Arthralgia ; Arthritis ; Classification ; Epidemiologic Studies ; Epidemiology ; Female ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Nephrotic Syndrome ; Osteonecrosis ; Polyvinyls ; Retrospective Studies ; Tuberculosis, Pulmonary

So-called, the double channel pylorus has been, relatively rarely, reported through out the world. All reported cases were almostly those of gastroduodenal fistula as a complication of peptic ulcer disease. The congenital forms of double pylorus were reported even more rarely. We found three cases of double channel pylorus in 25,000 cases endoscopy done at our unit. All those three cases were thought to be acqired form endoscopically, radiographically and histologically. One of those was undergone to operative resection because of uncontrollable bleeding and the others were on medical theraphy with satisfaction.
Endoscopy ; Fistula ; Hemorrhage ; Peptic Ulcer ; Pylorus*

PURPOSE: The PerFix(R) plug is preformed as a Marlex mesh hernia plug, and consists of a fluted outer layer combined with an inner arrangement of eight mesh "petals." In contrast to hand-rolled hernia plugs, which can collapse on themselves, the PerFix(R) plug's petals maintain the device's open conelike shape. The fluted design allows the plug to more readily conform to the configuration of any indirect or direct defect. METHODS: Bewteen January 1996 and April 2000 126 conventional herniorrhaphies (C group: Bassini: 23, Shouldice: 15, McVay: 5, Lichtenstein: 83) were performed, and between May 2000 and April 2002, 124 PerFix(R) plug repairs (P group) were completed. The operation times, lengths of hospital stay, visual analogue pain scales, time of analgesics use, and complication and recurrence rates were compared between these two groups. RESULTS: The operation times and lengths of hospital stay for groups C and P were 56.4 vs. 31.1 minutes and 4.4 vs. 2.8 days, respectively, so where significantly shorter in the P group (P<0.01). The times of use for the analgesics, AAP and Nubaine, were 6.6 vs. 0.6 times and 1.7 vs. 0.9 times, in group C and P, respectively, so were significantly fewer in the P group (P<0.01). There were 5 recurrences (3.9%) in the C group during the follow up period (2~6 years), but there were none in the P group during the follow up period (5 months~2 years). The complications were similar in both groups. CONCLUSION: Compared with conventional surgical techniques, including the Lichtenstein tension free method, the PerFix(R) plug method is the most simple, and shows superiority in the following areas; the operation time, length of hospital stay, times of analgesics use and recurrence. However, with regard to the recurrence, longer follow up and observation periods are required.
Analgesics ; Follow-Up Studies ; Hernia ; Hernia, Inguinal ; Herniorrhaphy* ; Length of Stay ; Nalbuphine ; Pain Measurement ; Polypropylenes ; Recurrence

No abstract available.
Arteries* ; Hemorrhage* ; Ligation*

BACKGROUND: Degenerative lumbar scoliosis (DLS) progresses with aging after 50-60 years, and the genetic association of DLS remains largely unclear. In this study, the genetic association between collagen type II alpha 1 (COL2A1) gene and DLS was investigated. METHODS: COL2A1 gene polymorphism was investigated in DLS subjects compared to healthy controls to investigate the possibility of its association with COL2A1 gene. Based on a single nucleotide polymorphism (SNP) database, SNP (rs2276454) in COL2A1 were selected and genotyped using direct sequencing in 51 patients with DLS and 235 healthy controls. The SNP effects were analyzed using three models of codominant, dominant, and recessive. Logistic regression models were calculated for odds ratios (ORs) with 95% confidence intervals (CIs) and corresponding p-values, controlling age and gender as co-variables. RESULTS: SNP (rs2276454) in COL2A1 was significantly associated with the degenerative lumbar scoliosis in the codominant (OR, 1.90; 95% CI, 1.17 to 3.10; p = 0.008) and dominant models (OR, 3.58; 95% CI, 1.59 to 9.29; p = 0.001). CONCLUSIONS: The results suggest that COL2A1 is associated with the risk of DLS in Korean population.
Aged ; Asian Continental Ancestry Group ; Collagen Type II/*genetics ; Female ; Humans ; *Lumbar Vertebrae ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Scoliosis/ethnology/*genetics

STUDY DESIGN: Retrospective study of 34 ankylosing spondylitis patients with kyphotic deformity who performed correction osteotomy. OBJECTIVES: To assess significance of chin-brow vertical angle for planning and evaluating correction of kyphotic deformity with ankylosis of cervical spine in ankylosing spondylitis patients. SUMMARY OF LITERATURE REVIEW: Accurate assessment and measurement of spinal kyphotic deformity is required when planning treatment and assessing its results. The most reliable measure of trunk deformity is the chin-brow vertical angle. MATERIALS AND METHODS: Thirty-four ankylosing spondylitis patients with cervical ankylosis who had underwent pedicle subtraction extension osteotomy for correction of kyphotic deformity were studied. The patients consisted of 32 male and 2 female patients. Mean age was 35.7 years. Most common apex of kyphosis was T12 in 11 cases. The levels of osteotomy were L1 in 3 case, L2 in 4 cases, L3 in 17 cases, and L4 in 10 cases. Radiographic assessment for sagittal balance was performed by measuring thoracic kyphosis, lumbar lordosis, and distance between the vertical line on anterosuperior point of T1 and that of S1. Chin brow-vertical angle was measured on the preoperative and postoperative clinical photo of the patients. Clinical outcomes were assessed by questionnaire measuring changes in physical function, indoor activity, outdoor activity, psychosocial activity, pain, and patient 's satisfaction with the surgery. RESULTS: Chin brow-vertical angle was 35.5 degrees preoperatively and 1.8 degrees postoperatively. Final follow-up radiograph showed an increase in lumbar lordosis from 5.5 to 43.2 degrees(an increase of 37.7 degrees) while thoracic kyphosis remain stable from 50.4 to 50.2 degrees. Sagittal imbalance significantly improved from 101.5 to12.7 mm. Decreased chin-brow vertical angle correlated negatively with correction angle while chin-brow vertical angle did not correlate with overall clinical outcome. However, the patients with chin brow vertical angle greater than 10 degrees or less than -10 degree had significantly low score concerning the item of horizontal gaze. CONCLUSIONS: The ankylosing spondylitis patient with cervical ankylosis, who had chin-brow vertical angle ranging from -10 to 10 degrees, had better horizontal gaze. Based on the results of this study, measurement of chin-brow vertical angle was recom-mended for planning correction of kyphosis and accurate evaluation of treatment outcome.
Animals ; Ankylosis ; Chin ; Congenital Abnormalities* ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Male ; Osteotomy ; Surveys and Questionnaires ; Retrospective Studies ; Spine ; Spondylitis, Ankylosing* ; Treatment Outcome

No abstract available.
Placenta Previa* ; Placenta*

Purpose: The purpose of this study was to investigate the effects of complex training on injury, flexibility, and muscle stiffness in high school male football players. Methods: A total of 60 football players were included in the study and were divided into three groups viz. the complex training group (CTG), 11+ training group (11 + TG), and traditional training group (TTG). Injuries were recorded based on the prospective investigation method after starting the study, and the flexibility and muscle stiffness of the subjects were evaluated. Results: The research results showed that the injury rate per match was significantly lower in the CTG and 11 + TG than the TTG. In the CTG, the flexibility of the hamstrings significantly increased and the stiffness of the rectus femoris (RF), biceps femoris (BF), and tensor fascia latae (TFL) muscles significantly decreased (p < 0.05). In the 11 + TG, the stiffness of the RF significantly decreased (p < 0.05). In the TTG, the flexibility of the hamstrings significantly increased (p < 0.05). Hamstring flexibility showed a significantly higher increase in the CTG and TTG compared to the 11 + TG (p < 0.05). Also, the stiffness of the RF and TFL muscles showed a significantly higher decrease in the CTG compared to the 11 + TG and TTG (p < 0.05). The stiffness of the BF muscles too showed a more significant decrease in the CTG compared to the TTG (p < 0.05). Conclusion The complex training method of the Fédération International de Football Association (FIFA) 11+ and self-myofascial release (SMFR) as a warm-up program, prevent injuries, enhance flexibility, and lower muscle stiffness of football players in high school. Thus, it is necessary to ensure the widespread use of the complex training program by instructors and players under the supervision of the Korea Football Association (KFA), given its reliability in preventing injuries and improving the performance of football players.