The results of 17 fractures of tibial shaft treated with Rush nails under the image intensifier and early weight bearing are reported. Thirteen of these fractures were closed. All fractures were united between 12 and 21 weeks clinically, 17 and 26 weeks radiologically after operation. All cases were healed without significant complications, such as fracture disease. The advantages of this method were as follows; 1) normal knee motion and early weight bearingare possible during healing. 2) There is a relatively rapid restoration of bone continuity. This method of treatment for tibial shaft fractures were indicated as follows; 1. Mid-shaft fracture. 2. Segmental fracture of shaft. 3. Expectation of compression force at fracture surface by weight bearing. 4. Open fracture of shaft.
Fractures, Open ; Knee ; Methods ; Tibia ; Weight-Bearing

The Kuntscher nail has been used widely for the treatment of femoral shaft fracture with the advantage of early weight bearing and early joint movement. But it has some disadvantages that are harmful in bone-union by the wide intramedullary reaming, and rotation and bending of the device. Schneider devised four flanged nail to be able to eliminate the disadvantage of the Kiintscher nail. The author have experienced the 16 cases of Schneider nailing in the fractures of femoral shaft at the Department of Orthopaedic Surgery, Ewha Womans University Hospital from Feb., 1982 to Apr., 1984. The following results were obtained. 1. There were common in male (14 cases) and active ages (13 cases). 2. The most common cause was trauma with 14 cases and the other was pathological fracture. 3. Indications of Schneider nailing were wide than those of Kiintscher nailing. 4. Usual intervals between the injury and operation was one week. 5. Mean operating time was one hour and 25 minutes, and blood loss during the operation was 410cc. 6. After treatment, we usually permitted the exercises of quadriceps setting and non-weight bering walking within 1 week, partial-weight bearing walking within 4 weeks and full weight bearing walking within 4 months. 7. The results of 13 cases among 15 cases were better than good. 8. There were no complications such deformities as rotation, shortening and angulation because of specialized structure of Schneider nail. Also, Schneider nailing could prevent the nonunion and infection because there was need of reaming the medullary canal.
Congenital Abnormalities ; Exercise ; Female ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humans ; Joints ; Male ; Walking ; Weight-Bearing

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

Twenty nine cases of segmental tibial fracture were treated at Ewha Womans University Hopital, Department of Orthopedic Surgery, during the period from January, 1970 to December, 1984. The following results were obtained. 1. Most common fracture level was type I, high middle segment, occurred about 12 cases (41.4%). 2. In view of the higher incidence of open fracture (16 cases, 55.1%) and comminuted fracture (22 cases, 75.9%), fracture was caused by high velocity. 3. Various external and internal fixation methods were applied, but higher union rate was seen in the cases of Küntscher nailing and plating with bone graft. 4. Excluding the cases of type V, average union rate was 28.5 weeks and open fracture (ave. 29.6 weeks) required more longer union rate than closed fracture (ave. 26 weeks). 5. Higher rate of complication (21 cases, 72.4%) was noted than other types of tibial fracture. 6. Good result was obtained for treatment of 5 cases of delayed union or non-union by plating and bone graft than any other methods.
Clinical Study ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Tibia ; Tibial Fractures ; Transplants

There are many procedures for the treatment of acromioclavicular separation but there are still controversies concerning the best management of these injuries. The cases of 20 acromioclavicular separations and 3 distal end fractures of clavicle were treated by conservative method with modified Kenny Howard sling-halter using long arm cast at the department of Orthopedic Surgery, College of medicine,Ewha Womans University, during the thirty six months period from March 1982 to February 1985. The following results were obtained. 1. The average duration of immobilization was 5 weeks at the grade II of acromioclavicular separation and fracture of distal end of clavicle and 6 weeks at the grade III of acromioclavicular separation. 2. The functional results were 17 excellents(73.8%), 5 goods(21.9%), and 1 fair(4.3%). 3. The complications were 3 frozen shoulders(13.0%), 2 subluxations(8.6%), and 1 skin necrosis on the elbow(4.3%). 4. The authors immobilized the upper extremity with long arm cylinder cast of 90° flexion position instead of initial harness, so that it was applied easily and the patient felt very comfortable. 5. When the fracture and severe displacement were occurred at the midthird of the clavicle, it could be reduced and maintained with the long arm cylinder cast and strap.
Arm ; Clavicle ; Female ; Humans ; Immobilization ; Methods ; Necrosis ; Orthopedics ; Skin ; Upper Extremity

Since ossification of posterior longitudinal ligament in cervical spine (O.P.L.L.) was presented at first by Tsukimoto in 1960, many cases have been reported in Japan. But very few cases were reported outside of Japan, including Korea. It is yet unknown what mechanism is the cause and why it is prevalent among the Japanese. And so, there are various theories on the cause. With progression, this lesion cas cause cervical myelopathy and radiculopathy. The treatment of O.P.L.L. is divided into conservative and operative treatment, and the latter is composed of anterior fusion,anterior decompression and posterior decompression. We experienced 3 cases of O.P.L.L. of which two cases were treated by anterior fusion and one tred by anterior decompression with partial removel of ossification mass from March, 1985 to May, 1986. On the follow-up, results were excellent to good. We report our experience in treatment of O.P.L.L. and recommand to be concerned about the lesion.
Asian Continental Ancestry Group ; Decompression ; Follow-Up Studies ; Humans ; Japan ; Korea ; Longitudinal Ligaments ; Ossification of Posterior Longitudinal Ligament ; Radiculopathy ; Spinal Cord Diseases ; Spine

Bone tumor in the trochanteric area is not infrequent and it is important to differentiate the tumors in this area for diagnosis, early settings of therapeutic plans and prognostic previsions. Twenty-one cases of benign bone tumors in the trochanteric area treated at Dept. of Orthopedi Surgery, College of Medicine, Ewha Womans University Hospital, from January 1975 to December 1983 were analysed and following results were obtained. l. of 21 cases, 10 cases were fibrous dysplasia, 6 cases were simple bone cyst, 3 were giant ce tumor and 2 were aneurysmal bone cyst. 2. Pathologic fractures were accompanied in 6 cases; 3 of fibrous dysplasia, 2 of simple bone cy: and 1 of aneurysmal bone cyst. 3. After treatment with curettage, bone graft and instrumentation, 3 cases recurred; 2 cases of fibrous dysplasia and 1 of simple bone cyst. 4. As prognostic factors, completeness of curettage, amount and source of bone graft were considered to be important.
Aneurysm ; Bone Cysts ; Clinical Study ; Curettage ; Early Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Transplants

Femoral shaft fractures are usually accompanied with extensive soft tissue injury due to high energy force and are difficult to manage for functional stress with weight bearing. According to Boyd(1965), femoral shaft is the first of non-union among the long bone shafts. And because of inadequate internal fixation, poor immobilization and infection, non-union of femoral shaft is still of interest to all the orthopaedic surgeons. During past 10 years, 19 cases of non-union of the femoral shaft were treated at dept. of Orthopaedic Surgery, Ewha Womans University hospital and following results were obtained. l. Of 19 cases, male between 20-40th age group was predominent. Prevalent type and site was mid. 1/3 comminuted fractures(p > 0.05). 2. Initial treatment was 10 cases of intramedullary nailing; 8 of plate fixation; 1 of screw fixation. Bone graft was added to 10 cases. 3. The probable causes of non-union were complex; 11 of inadequate interal fixation, 4 of poor external immobilization and 4 of infection. 4. 4 cases of infection were managed with control of infection and fixation. And 11 cases were fixed with plate and the other 4, with intramedullary nailing. All were supplemented with autogenous bone graft. 5. Postoperative immobilization was done with 15 cases of hip spica cast and 4 of long leg cast for average 9.3 weeks. 6. All were united at average 8.9 months. Limitation of motion of knee was remained in 3 cases in spite of physiotherapy. Severe osteoporosis was noted in 3 cases and leg length shortening with limping was found in 1 case.
Adult ; Clinical Study ; Female ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Immobilization ; Knee ; Leg ; Male ; Osteoporosis ; Soft Tissue Injuries ; Surgeons ; Transplants ; Weight-Bearing

In 1943, Alberto Inclan reported tumoral calcinosis in 3 cases at major joints. This condition usually showed large, painless calcified mass in major juxtaarticular sites, and evidence of familial or racial predisposition in blacks but abnormal values of serum calcium and phosphorus, association with renal disease, metabolic disorder and collagen disease are seldom seen. Tumoral calcinosis in large joints such as hip, knee, elbow and shoulder was reported several cases. Tumoral calcinosis in hand and foot is very rare and not reported yet in this country. Recently, authors experienced a case of tumoral calcinosis in both hands and right foot and cured without recurrence in 1 year follow up.
African Continental Ancestry Group ; Calcinosis ; Calcium ; Collagen Diseases ; Elbow ; Follow-Up Studies ; Foot ; Hand ; Hip ; Humans ; Joints ; Knee ; Metabolic Diseases ; Phosphorus ; Recurrence ; Shoulder

Spondylolisthesis, frequently encountered problems with increasing incidence, has been recognizid as an important clinical entity in orthopaedic field. Several methods were applicated as operative treatment of spondylolisthesis; posterior fusion or H-graft, posterolateral fusion, anterior fusion, fixation with internal devices and etc. During the past 12 years from March 1972 to February 1984, 34 patients among the 42 patients were treated surgically at Department of Orthopaedic Surgery of Ewha Womans University Hospital and following results were obtained. 1. The average age was 45.2 years(19 ~ 64 years) and female was predominent(64.7%). Isthmic type was 17 patients(50.0%), degenerative type was 13 patients(38.2%) and dysplastic type was 4 patients(11.8%). Below 40 year old, dysplastic and isthmic type were predominent and degenerative type was more common in the age group above forties. 2. The most prevalent site was L5-Sl; 21 cases(61.8%) and L4-5; 13 cases(38.2%) in orders. In isthmic type L5-Sl was 13 cases and in degenerative type, L4-L5 was 9 cases. By Meyerding classification, grade I was most common(26 patients, 76.5%). 3. The clinical pictures were low back pain only and little improvement with conservative treatment(type I: 9 patients), low back pain with sciatica(type II: 13), type II plus neurologic signs such as motor weakness, sensory change or change of D.T.R(type III, 10) and little low back pain with mainly sciatica(type IV, 2). 4. Of 34 patients, anterior interbody fusion were done in 10 patients ; posterior and posterolateral fusion with decompression were done in 22 patients. Only laminectomy were done in 2 patients(type IV). 5. Fusion rate was observed in 21 patients(95.5%) among 22 patients with posterior or posterolateral fusion and 8(80%) among the 10 patients with anterior fusion. Postopertive functional results by Gill's criteria were excellent or good in 31 patients(91%). 6. There were no difference in fusion rate and functional results in operative methods.
Classification ; Clinical Study ; Decompression ; Female ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Neurologic Manifestations ; Spondylolisthesis