There are many controversies concerning diagnostic and therapeutic guidlines for injuries to the collateral ligaments of the fingers, which improperly treated, may develop serious late sequale of joint function. Eleven cases of collateral ligament injuries to fingers which occured between June 1976 and June 1986 were reviewed and the following results were obtained. 1. There were 8 males and 3 females, and eight of the 11 cases (73%) were younger than 30 years of age. 2. In 5 cases, the injury was a sports related injury, while slipped down injury caused the injury in 5 other cases. 3. The ratio of acute to chronic injury was 7:4. 4. There were 6 cases of proximal interphalangeal joint of the fifth finger, 3 cases of metacarpophalangeal joint of the first finger and 2 cases of proximal interphalangeal joint of the third finger. 5. The ratio of ulnar collateral ligament to radial collateral ligament was 7:4. 6. Preoperatively, stress X-rays of the both the involved and the contralateral sound joints taken in all cases and analysed. 7. The most common ruptured site of ligament was substance portion, which was found in 7 cases. 8. Primary repair were performed in 8 cases, reconstruction with tendon of palmaris longus muscle in 2 cases and reconstruction with tendon of flexor digitorum superficialis in 1 case. 9. All patients were followed for at least 6 months, and the average was 3 years. 10. Normal range of motion and stable joints were observed in 10 of the 11 cases at the final follow up.
Collateral Ligaments ; Female ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Male ; Metacarpophalangeal Joint ; Reference Values ; Sports ; Tendons

Cauda equina syndrome has been described as a complex of low back psin, bilateral sciatica, saddle anesthessia and motor weakness in the lower extremity that progress to paraplegia with bladder and bowel incontinence. The syndrome is uncommon, accouting spproximately 1–16% of reported cases of lumbar disc herniation, but needs urgent diagnosis and surgical treatment. Clinical observations were carried out on 8 cases of cauda equina syndrome in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from June 1980 through June 1986 and the following results were obtained. 1. The highest incidence, 5 cases(63%), occured in 40 49 year old age group and the sex distribution was 5 males and 3 females. 2. Eight cases fell into two clinical groups. group 1(3 cases) presented with a sudden onset without any previous history of low back pain and group 2(5 cases) presented with a incidious onset with history of recurrent low back pain. 3. Preoperative myelogram revealed a totsl block to the flow of the contrsst medium in all cases. 4. Wide laminectomy and discectomy were performed in all cases within 2 weeks after the onset of bladder symptom and 3 cases with two levels of disc prolapse were found. 5. Among total 11 levels of disc prolapse, there was 5 levels of L5-S1, 4 levels of L4-5 and 2 levels of L3-4. 6. The duration of the preoperative bladder symptom was 3.3 days in group 1 and 6.4 days in group 2. 7. With a minimum of 6 months follow up, motor power wss fully recovered in 5 cases, sensory in 6 cases and bladder function in 4 cases.
Cauda Equina ; Diagnosis ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Lower Extremity ; Male ; Paraplegia ; Polyradiculopathy ; Prolapse ; Sciatica ; Sex Distribution ; Urinary Bladder

Vascular injury is a serious but rare complication of hip procedures. Most of vascular complications reported in articles occured in vessels around hip joint and femoral artery. To date, report of popliteal artery occlusion during or after total hip arthroplasty was absent. The authors have experienced one case of popliteal artery occlusion after total hip arthroplasty. It was suspected that the cause of occlusion of this particular case was a excessive maneuvering of limb during operation and then, artheromatous plaque fracture or thrombosis made occulusion in popliteal artery. Angiographic embolectomy using a catheter was performed and circulation of limb was recovered. To reduce the risk of vascular complications after total hip arthroplasty procedure, we recommend a thorough evaluation of lower extremity circulation in risky patient. And if a vascular insult is suspected either during or soon after the procedure, then a vascular consultation with arteriography including popliteal artery should be obtained urgently. Delay in treatment could result in a deleterious outcome.
Angiography ; Arthroplasty, Replacement, Hip* ; Catheters ; Embolectomy ; Extremities ; Femoral Artery ; Hip ; Hip Joint ; Humans ; Lower Extremity ; Popliteal Artery* ; Thrombosis ; Vascular System Injuries

We have observed that the companion shadow of the upper rib may be misinterpreted as a small pnemothorax or pleural plaque associated with asbestosis. To observe the radiographic characteristics of the normal companion shadow, we analyzed, on the posteroanterior(PA) chest radiographs, the companion shadow of 50 normal cases. Factors such as occurrence on each rib, the sharpness of the margin, the relative position to the rib, the shape and the thickness were observed. Also, we analyzed the displaced pleura of 4 pneumothorax cases to differentiate their frndings from the findings of normal companion shadows. On 50 normal chest radiographs, 192 compaion shadows were observed on the first to fourth ribs. In 173 of those shadows, the visceral margin of the companion shadow on the second rib simulated pneumothorax more closely than those on any othe rivs due to its apical location and thinness. In six of 50 normal cases, the companion shadow on the first or second rib showed an inw rdly convex lower margin, mimicking pleural plaque. The compaion shadow was suggested on the plain chest radiograph by the following characteristics imultiplicity(47/50), thicker than normal pleura(3/4), persistent on serial filma with the same shape and specific location(4/4).
Asbestosis ; Friends* ; Humans ; Pleura ; Pneumothorax ; Radiography, Thoracic ; Ribs* ; Thinness

No abstract available.

No abstract available.

Giant cell tumor is an uncommon primary bone tumor of young adults with the highest incidence in patients 20 to 40 years of age. These tumors are most frequently found in the metaphyseal-epiphyseal region of the long bones, especially around the knee joint and the distal end of the radius. So the normal life expectancy and an active life style of the patient necessitate a reliable and durable surgical remedy for eradicating the tumor and preserving joint function. Furthermore, these have an unpredictable clinical behavior. Although almost always benign, these tumors are locally agressive and tend to have a high rate of rerurrence, and malignant transfomation is well known to be 6 15%. Thus the lesions produce a practically difficult therapeutic problem for the orthopaedic surgeon, and a satisfactory method of treatment has not yet been found. Clinical observations were carried out on 33 cases of giant cell tumor of bone in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from May 1975 through May 1985, and the following results were obtained. 1. The highest incidence, 23 cases (70%), accurred in the 21 40 year old age group, and the sex distribution was 18 males and 15 females. 2. The most frequent locations were the distal feuiur, proximal tibia and distal radius. Twenty four cases(73%) occurred around the knee joint. 3. The pathologic grading according to Jaffes criteria showed 10 cases(30.3%) in grade I, 20 cases (60.6%) in grade II and 3 cases(9.1%) in grade III. 4. As the primary treatment modality, currettage and bone graft were performed in 9 cases, currettage and bone cementing in 9 cases, amputation or disarticulation in 7 cases, enbloc excision with or without other procedures in 6 cases and currettage and radiotherpy in 2 cases. 5. Eight cases(24.2%) recurred after primary treatment and 6 cases of the 8 recurrences appeared within 2 years after primary treatment. 6. Four of the 9 tumors treated by currettage and bone graft recurred, as did two of the 9 tumors treated by currettage and bone cementing. No recurrence occurred in the 7 tumors treated by amputation or disarticulation. 7. As the secondary treatment modality for 8 recurrences, amputation or disarticulation was performed in 5 cases.
Amputation ; Disarticulation ; Female ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Humans ; Incidence ; Joints ; Knee Joint ; Life Expectancy ; Life Style ; Male ; Methods ; Radius ; Recurrence ; Sex Distribution ; Tibia ; Transplants ; Young Adult

We analysed the thirty three cases of the free vascularized bone graft performed in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from February 1982 to December 1989 and would like to report the results as follows. 1. There were 27 cases in men and 6 cases in women and the mean age was 27.3 years. 2. We have performed the procedure for the reconstruction of the large bony defects developed after massive trauma in 13 cases, core decompression of the avascular necrosis of the femoral head in 8 cases, tumoral resection in 6 cases, treatment of congenital pseudoarthrosis in 3 cases, and bone infection in 3 cases. 3. The most common recipient site was tibial shaft (18 cases, 54%) and the most common donor site was fibular shaft (23 cases, 69%). 4. The average length of bone defect (or grafted bone) in 23 cases of vascularized fibular graft was 9.8 cm and in 9 cases of vascularized osteocutaneous iliac bone graft, it was 5.8 cm. 5. The follow-up period was ranged from 13 months to 5 years 8 months (mean, 2 years 2 months). 6. All patients were evaluated clinically and roentgenographycally on the basis of fuctional recovery and bony union. Of the 33 cases, 31 cases (93%) showed satisfactory functional recovery with sound bony union. 7. It is highly expected that the vascularized bone graft is a one of the better alternatives for the reconstruction of the large bone defect and prevention of the early state of the avascular necrosis of the femoral head from progession.
Decompression ; Extremities ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Necrosis ; Pseudarthrosis ; Spine ; Tissue Donors ; Transplants

Benign tumors and tumor like lesions in the foot are uncommon and those that are malignant are rare. Metastatic cancer of bone distal to the knee and elbow is unusual. By contrast, non-tumorous lisions that cause swelling, pretuberance, or deformity are common. Fifty two cases of tumors on foot were treated at our department from Jan. 1970 to Dec. 1991, we have treated fifty two cases of foot tumor and analysed their clinical characteristics. Bone tumors were more frequent than soft tissue tumors (2:1). Among soft tissue tumors benign tumors were frequent than malignant(1.4:1), and fibroma was the most frequent tumor(30%). Benign soft tissue tumors occured frequently at Edward and Michael's Zone 3(57%). Benign bone tumors has higher incidence than malignant(20:1). Osteochondroma was the most frequent tumor (48%). Predilection sites for osteochondroma and enchondroma of foot was distal phalanges and mitatarsal bone, respectively.
Bone Neoplasms ; Chondroma ; Congenital Abnormalities ; Elbow ; Fibroma ; Foot ; Incidence ; Knee ; Osteochondroma

Dupuytren's contracture is caused by a proliferative fibroplasia of the subcutaneous palmar tissue. It is most common in those of Scandinavian and Celtic origin, although it has rarely been reported in Orientals. Many types of surgery are advocated, all with apparent success. Then operative result of 23 cases of Dupuytren's contracture including seven bilateral involvment was analyzed partial fasciectomy was performed in all cases by one surgeon. Average follow-up period was 18 months. We analyzed the results of the operation, to Honner s classification. Excellent result was obtained in 6 cases(26%), good in 14(61%) fair in 3(13%), and poor in 0(0%). The complication were 8(34%) case as followshematoma 4(17%), stiffness 3(13%), skin necrnsis 1(4%). All patrents were not performed that skin graft and total fasciectomy. The partial fasciectomy is suggested as one of the successful method for the treatment of Dupuytren's contracture.
Classification ; Clinical Study ; Dupuytren Contracture ; Follow-Up Studies ; Methods ; Skin ; Transplants