Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

A case of situs inversus totalis was observed in the cadaver of a 35 year old Korean female and the anatomical structures were investigated. The fact that she had received intestinal resection due to tuberculosis of intestines was confirmed. The results are summarized as follows : 1. All thoracic and abdominal viscera were completely transposed and in the left lower quadrant of abdomen, it was observed that the distal portion of the small intestine, cecum, appendix and part of the ascending colon had been resected. 2. Classic mirror-image dextrocardia with patent foramen ovale (large diameter, 7mm), sinusitis in the left maxillary sinus, bilateral thoracic duct, variation of the opennig site of the common bile duct and the main pancreatic duct, and maldvelopment of the left adrenal gland were observed together with the sinus inversus totalis.
Abdomen ; Adrenal Glands ; Appendix ; Cadaver ; Cecum ; Colon, Ascending ; Common Bile Duct ; Dextrocardia ; Female ; Foramen Ovale, Patent ; Humans ; Intestine, Small ; Intestines ; Maxillary Sinus ; Pancreatic Ducts ; Sinusitis ; Situs Inversus* ; Thoracic Duct ; Tuberculosis ; Viscera

Lumbar spinal stenosis is a common category of spinal disease in which a decrease in the volume of the spinal canal results in compression of the neural elements. Its pressure symptoms are characterized by vague back-pain and chronic sciatica. The goals of surgical treatment in lumbar spinal stenosis are the relief of pain and the preservation or restoration of neurologic function. Extensive laminectomy in lumbar spinal stenosis results in postoperative instability and postoperative vertebral subluxation with pain, restricted movement, and further neural compression occurs after decompressive laminectomy. Therefore internal fixation devices have been used in these circumstances to prevent postoperative instability while the fusion being consolidated. From February 1988 to October 1988, 36 patients of lumbar spinal stenosis had undergone operations with decompressive laminectomy and segmental spinal instrumentation with transpedicular screws at the department of Orthopaedic Surgery, Yonsei University College of Medicine. In 18 patients degenerative changes in lumbar spine were the principal aetiologic factor:7 patients had spondylolisthetic spinal stenosis:ll patients had combined spinal stenosis. All patients were followed up for periods varying between twelve and ninteen months. According to Kim's criteria, the postoperative results were as follows;excellent in 17 cases(47.2% ), good in 15 cases(41.7% ) and fair in 4 cases(11.1% ). The study revealed that segmental spinal instrumentation with transpedicular screws provided a rigid fixation, early ambulation, minimal fusion and reducing of recovery period were possible. In conclusion, segmental spinal instrumentation with transpedicular screws is a good and reliable method of stabilization after extensive decompressive laminectomy.
Early Ambulation ; Humans ; Internal Fixators ; Laminectomy ; Methods ; Sciatica ; Spinal Canal ; Spinal Diseases ; Spinal Fusion ; Spinal Stenosis ; Spine

No abstract available.

No abstract available.
Leukemia*

Distal radioulnar is a part which has a rotational movement through the function of distal radioulnar joint and extensor carpi ulnaris. The injury mechanism in this area is usually a trauma largely due to traffic accidents. In general these injuries to the distal radioulnar joint are treated by a closed reduction. However, the isolated distal ulnar fracture without radial fracture, which is often called the night stick fracture, is difficult to treat by a closed reduction and a cast immobilization alone, especially if there is a displacement or fracture segment impinging soft tissue or severe comminution. Nonunion has been the frequent outcome with this method of treatment and limitation of rotation of forearm and distal radioulnar joint have occurred due to long period of immobilization or malunion. Thus, a different treatment modality such as open reduction and internal fixation and early active joint motion has arisen as a better treatment modality. In this study, 8 cases of isolated distal ulnar fracture without radial fracture have recieved the operation and the early active joint movement, if a displacement was present either at the time of injury or after the initial closed reduction. As a result, this method has enabled the patients to reduce the rate of complication of nonunion and to recover limitation of joint motion in a shorter time period.
Accidents, Traffic ; Forearm ; Humans ; Immobilization ; Joints

Glomus tumor arises from the subcutaneous glomus body, which is an arteriovenous anastomosis involved in the regulation of cutaneous blood circulation and are widely distributed in the body, especially the hand. Twelve patients (male 3, female 9) with glomus tumors of the hand, who were operated from Jan. 1986 to Dec. 1994 were selected. The lesions were distributed in the distal phalanges of the thumb (6 cases), the index (3 cases), the ring finger (2 cases) and the little finger (1 case). All patients had the classic triad of symtoms: pain, tenderness and temperature sensitivity. Palpable mass (4 cases) and bluish purple discoloration in the skin (6 cases) were also presented. They had no trauma history and on the roentgenography, bone change detected in 2 cases. A simple excision with partial nail extraction was done in all cases. The symtoms were disappeared in all cases and no recurrence was found. For a complete cure, meticulous complete excision is the only recommended treatment.
Arteriovenous Anastomosis ; Blood Circulation ; Female ; Fingers ; Glomus Tumor* ; Hand* ; Humans ; Radiography ; Recurrence ; Skin ; Thumb

No abstract available.
Child* ; Fingers* ; Humans

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and important soft tissues such as collateral ligaments, cruciate ligaments and semilunar cartilages present a variety of problems in treatment and prognosis. Apley, Slee, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually a form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommend anatomical reduction of the fracture as possible and early knee motion. During 7 years period from January 1974 to July 1981, of the tibial condylar fractures treated at the department of orthopaedic surgery, Han Gang Shim Hospital, 41 cases that could be followed have been analysed according to the cause, classification, method of treatment and result. The following results were obtained from the analysis of 41 tibial condylar fractures. l. Of the 41 cases, 34 (83%) were male and 7 (17%) were female. 2. Of the 41 cases, 32 (78%) were due to traffic accident, 25 pedestrian, 7 occupant, 8 (20%) were due to fall from height. 3. Of the 41 cases, 31 (76%) were associated with other injuries. 4. Of the 41 cases, 30 were treated by conservative method with functionally acceptable result in 22 cases (73%) and 11 were treated by open reduction with functionally acceptable result in 9 cases (82%). 5. According to the Hohl and Luck's criteria, acceptable functional result was obtained in 31 (76%) cases.
Accidents, Traffic ; Classification ; Clinical Study ; Collateral Ligaments ; Female ; Hand ; Humans ; Knee ; Ligaments ; Male ; Menisci, Tibial ; Methods ; Prognosis ; Weight-Bearing

Ubiquitin-positive neuritic threads (UNTS) in the hippocampal CA 2-3 region are reported to occur exclusively in association with so-called diffuse Lewy body disease (DLBD). hi order to assess the association between the occurrence of Lewy bodies (LBs) and that of the UNTs, an immunohistochemical study on the hippocampus including the parahippocampal gyrus with antiubiquitin antibody (Chemicon Co., California, U.S.A.) was perfon-ned in four groups of patient's brains. All brains were selected from the large pool of brains referred to the Neuropadiology Laboratory of the University of Minnesota for studies of Alzheimer's disease. Group 1 consisted of 34 cases (20 male and 14 female) with LBs widespread in the frontal and temporal cortex and the brain stem nuclei (basal nucleus, substantia nigra, locus ceruleus and dorsal vagal nucleus) associated with varying degrees of degeneration of the substantia nigra; 21 (11 male and 10 female) combined with and 13 (9 male and 4 female) without Alzheimer's disease (AD) pathology. Group 2 included 12 cases (9 male and 3 female) in which LBs were observed only in the brain stem nuclei; 7 with and 4 without AD pathology. Group 3 consisted of 30 cases (9 male and 21 female) without LBs but with AD pathology and degeneration of the substantia nigra. Group 4 included 23 cases (11 male and 12 female) with neither LBs nor AD pathology but with degeneration of the substantia nigra. Ages of the patients varied among the groups. In the 46 cases in the first two groups with LBs. The mean age in the 28 cases with AD pathology was 77.3+/-8.9 and in the 18 cases without AD pathology it was 71.6+/-8.8 (P<0.05). In the 53 cases in groups 3 and 4 without LBs, which served as the controls, the mean ages were 80.8+/-7.7 and 74.0+/-9.7 respectively. UNTs were encountered in all (100%) of 34 cases of group I with widespread LBs which met the histological criteria of DLBD regardless of combined AD pathology. In 12 cases of group 2 with LBs confined to the brain stem, UNTs occurred in 3 (25%), 1 with and 2 without AD pathology. hi the group 3 cases with only AD pathology, UNTs occurred in 4 (13%) of 30 cases, while no UNTs were encountered in the 23 cases of group 4 without AD pathology or LBs. In conclusion, UNTs in the hippocampal CA 2-3 region occur invariably but not exclusively in association with widespread LBs, frequently when LBs are confined to the brain stem, and infrequently with AD pathology. It seems, therefore, that the UNTs are closely related to LBs and increase in ftequency as LBs spread beyond the brain stem with time, but the pathogenesis of the UNTs is little understood.
Female ; Male ; Humans