Fifty-eight primary total hip arthroplasties with hyhrid cemented femoral component using contemporary cementing technique and cementless acctahular cup were followed for a minimum 3 year(ranged, 36 to 67 months, mean 4.1 years). Thc average age of the patients at the time of the operation was 54 years(ranged, 22 to 73 years). The preoperative common diagnosis were avascular necrosis of femoral head in 38 hips and miscellaneou. in 20 hips. The mean Harris hip score was 61 in preoperative and 91 in postoperative at last Follow-up. 5-1 hips(92%) were rated excellent and good clinically. One hip was revised for aseptic loosening of the femoral stem at 52 months follow-up. Radiographically no acetahular component was loose. Three femoral stems were definitely loose, one stem was classfied as prohahle loosenine and another one was ratde as possible loosening. There was no progressive radiolucent dermaation ol' cement-hone interf'ace in stable fermoral steni. Non progressive cement-bone radiolucency was lound seven hips in zone 1, two hips in zone 6, one hip in zone 2 and one hip in zone 7 at last follow-up. There were two postoperalive dislocations. Other complications included superficial infection(two hips) and sciatic nervc palsy(one hip). Our experience showed that the hyhrid hip replaccment with improved cementing technique provided satisfactory results at minimum 3 year follow-up study and emphasized the importantance of careful cementing techniques in survival ot cemented I'cmoral stem.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Dronabinol ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis

The majority of fractures of the distal humerus in adults involves the articular surface and also shows the shape of T or Y type and comminuted fracture, this type of fracture is rare in human fractures. The fracture of the distal humerus occurs more frequently in adults than children and has more complications and is more difficult to treat. There are various rnethods of treatments. The Orthopedic Surgery dept of Keimyung Univ. School of medicine has carried out the follow-up studies among 26 cases of inpatients with comminuted fractures, of the distal humerus (who have been admitted to the hospital) from the period beginning Jan, 1978 to May, 1983, and the results are as follows: 1. There were more frequently occured in male (53.8%), and mean age was 43.5 years. 2. There were no bilateral fractures and more common in right side (57.7%) 3. Traffic accidents were the most frequent cause (46.1%), followed by slipping down(38.5%), falls from height, and athletic injuries. 4. The Tyte IIl (50.0%) was most common by Riseborough and Radin classification followed by the order of type IV, type II and type I . 5. In the case of operative treatment, the duration of immobilization took a shorter period than with conservative treatment and the former showed a relatively good prognosis. 6. Better prognosis was obtained by using K-wire fixation, especially in the case of severe comminuted type IV fracture.
Accidental Falls ; Accidents, Traffic ; Adult ; Athletic Injuries ; Child ; Classification ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Humerus ; Immobilization ; Inpatients ; Male ; Orthopedics ; Prognosis

The fat embolism is a complication which occurs rarely in cases of long bone of lower extremity and pelvic bone fractures or after severe injury of soft tissue, and may result in an embolism in the lungs, brain, heart, kidneys and other important vessels when fat globules flow from bone marrow into such areas. There has been much adverse criticism about the pathogenesis of fat embolism including the incidence, diagnosis and treatment of it, and studies on this subject have been prevalent in recent years. The following results have been obtained through the study of 9 cases of fat embolism at the Department of Orthopaedic Surgery, Dong San Medical Center, Keimyung University during the period from 1973 to 1984. 1. By sex and age distribution, most of the patients were under the age of 40 and there were more male than female patients. 2. Seven cases were caused by traffic accidents and two were caused by falls accompanied by multiple fractures of the femur and pelvic bone. 3. Symptoms generally occured within 48 houres after trauma, however some cases were within 12 houres, some were 5 days and others 12 days. Clinical symptoms which were present at the time admission revealed increased erythrocyte sedimentation tates and decreased hemoglobin and platelete in most cases. Bilateral infiltrates and cotton ball appearances were found in all cases on thoracic radiology, but no fat globules were found in the urine or in frozen sections of clotted blood. 4. Blood gas analysis was performed in 4 cases and Pa02 under 60mmHg found in all cases increased gradually after treatment. 5. Of the 9 cases with fat embolism 6 cases completely recovered and three cases expired.
Accidental Falls ; Accidents, Traffic ; Age Distribution ; Blood Gas Analysis ; Blood Platelets ; Blood Sedimentation ; Bone Marrow ; Brain ; Clinical Study ; Diagnosis ; Embolism ; Embolism, Fat ; Female ; Femur ; Fractures, Multiple ; Frozen Sections ; Heart ; Humans ; Incidence ; Kidney ; Lower Extremity ; Lung ; Male ; Pelvic Bones

Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.
Acetabulum ; Child ; Diagnosis ; Dislocations* ; Dronabinol ; Follow-Up Studies ; Hip Joint ; Hip* ; Humans ; Retrospective Studies

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

No abstract available.
Knee Joint* ; Knee*

A total of 189 cases of primary bone tumors reviewed and analysed clinically and pathologically at the Department of Orthopedic Surgery, Presbyterian Hospital, Taegu, Korea during the 15 years period from july, 1964 to june, 1979. The results were obtained as follows: 1. In 189 cases of primary bone tumors, 87 cases (46%) were benign and 102 cases (54%) were malignant. 2. Osteochondroma was the most common benign bone tumor (31.0%) and followed by simple bone cyst (14.9%), enchondroma (14.9%) and giant cell tumor (13.8%). 3. Osteosarcoma was the most common primary malignant bone tumor (45.0%) and followed by fibrosarcoma (17.7%) and chondrosarcoma (12.8%). 4. 22 cases were solitary and 5 cases were multiple Iesions of osteochondroma. The knee joint area was the most common site of osteochondroma (59.2%) and peak incidence was in the second decade. 5. Simple bone cyst was 13 cases. The sex distribution of simple bone cyst showed 5.5 times of the male predominence. The knee joint area was the most common site of simple bone cyst (76.9%) and its peak incidence was in the first and second decade (61.5%). Seven of 13 cases of simple bone cyst were seen pathological fracture and three of its cases were recurred. 6. In 13 cases of enchondroma, 6 cases were solitary and 7 cases were multiple lesions. The common site was phalanges of the hand and its peak incidence was in the second and third decade of life. 7. Giant cell tumor was 16 cases and to be divided into pathologically Grade 1 & 11 12 cases (75%) and Grade III 4 cases (25%). The sex distribution of giant cell tumor was 8 males and 8 females. The average age of giant cell tumor was 36.1 years with the peak incidence in the third and forth decade of life. 8. The average age of osteogenic sarcoma was 23.1 years with the peak incidence in the second decade of life. The sex distribution of osteogenic sarcoma was 25 males (54.3%) and 21 females (45.7%). The common sites of osteogenic sarcoma were distal femur and proximal tibia and proximal humerus in 41 cases (89.1%). 9. The average age of fibrosarcoma was 28.1 years with the peak incidence in the second and third decade of life. The sex distribution of fibrosarcoma was 12 males (66.6%) and 6 females (33.3%). The common site of fibrosarcoma were femur and tibia in 9 cases (50%). 10. Chondrosarcoma were 13 cases. The sex distribution of chondrosarcoma showed 5.5 times of the male predominence. The knee joint area was the most common site of chondrosarcoma (46.1%) and its peak incidence was in the third and forth decade of life.
Bone Cysts ; Chondroma ; Chondrosarcoma ; Daegu ; Female ; Femur ; Fibrosarcoma ; Fractures, Spontaneous ; Giant Cell Tumors ; Hand ; Humans ; Humerus ; Incidence ; Knee Joint ; Korea ; Male ; Orthopedics ; Osteochondroma ; Osteosarcoma ; Protestantism ; Sex Distribution ; Tibia

Acetabular fractures are relatively uncommon, but when they occur they often result in permanent disability due to management difficulties. Undisplaced acetabular fractures have a good prognosis but major displaced acetabular fractures have always given rise to difficulty and concern during treatment and have a variable prognosis in different reports. In order to restore excellant function to a displaced acetabular fracture, anatomic open reduction and secure internal fixation followed by early mobilization are neccessary. And in order to approach fracture of acetabulm safely and with maximum ease, it is neccessary to understand the pathologic anatomy. The authors studied the sex and age distribution, clssification according to roentgenographic findings, associated injuries and methods of treatment of 49 patients who were admitted to the department of orthopedic surgery of our hospital from January, 1976 to June, 1981 under the diagnosis of acetabular fracture. The results of treatment of 31 patients who were followedup over a 6month period were as follows: 1. The mean age was 37 years, the range being from 17 to 71. 2. The most common cause of injury was traffic accidents (38 cases: 77.6%) which was followed by falls from heights (5 cases;10.2%). 3. Thirty cases were treated by conservative mea ures and 19 by surgery. The results were as follows: Excllent-10(32.3%), Good-14 (45.2%), Fair-6(19.3%), Poor-1 (3.2%), 4. The one case that had a poor result was a “T” shaped fracture with a central dislocation, which was impossible to reduce surgically due to severe comminution. 5. If the grossly displaced fragments are present they should be reduced and fixed surgically. But only if anatomical reduction and secure internal fixation is possible, surgery should be done. With a severely comminuted fracture, medial wall fracture, or central fracture-dislocation, surgical treatment is difficult therefore conservative treatment is better. 6. It is of great help to have various methods of roentgenography, conventional tomography, and computed axial tomographic scan in order to understand the pathologic anatomy of complicated acetabular fractures. 7. If surgery is attempted, it is essential to achieve an anatomic reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach and fixative device.
Accidental Falls ; Accidents, Traffic ; Acetabulum ; Age Distribution ; Clinical Study ; Diagnosis ; Dislocations ; Early Ambulation ; Fractures, Comminuted ; Humans ; Orthopedics ; Prognosis ; Radiography

Ossifying fibroma is a relatively rare benign primary bone tumor which arises typically within the jaw bones and only rarely affects the long bones. In 1966, Kempson first described ossifying fibroma of the long bones because the lesion has a histologic pattern like the ossifying fibroma of the jaw. This rare lesion resembles monostotic fibrous dysplasia but can be differentiated from it on histologic and clinical grounds. Histologically, ossifying fibroma is characterized by osteoblasts rimming spicules of bone within a fibrous stroma with evidence of lamellar transformation of bone, and clinically by frequent recurrence and aggressive progression of the lesion. Because of its rarity, we present a case of ossifying fibroma which arised in the right tibia of a 34 month old boy.
Fibroma ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Humans ; Jaw ; Male ; Osteoblasts ; Recurrence ; Tibia

The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the articular surface and the supporting metaphysis of a major weight bearing joint. This fracture frequently accompanies soft tissue injury such as ligaments and menisci. So it often produces disability of the knee joint. Of the tibial plateau fractures which had been treated by open reductions at Keimyung University Hospital between May 1971 and December 1981, the 28 cases that were followed for 1 year to 3 years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone with one or more of the following deformities as shown by roentgenograms: a compression greater than 6-8mm and a split greater than 5mm of the condyle. Anatomical considerations and a clinical end result study of the 28 fractures emphasize that the unacceptable results were from comminution of the fracture, associated soft tissue injury, osteoporosis, infection and other conditions that prevent early knee motion. Twenty-two cases (79 per cent) out of Twenty-eight revealed the rating of “ACCEPTABLE” according to Roberts criteria.
Classification ; Clinical Study ; Congenital Abnormalities ; Joints ; Knee ; Knee Joint ; Ligaments ; Osteoporosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing