Some modifications of the step-cut osteotomy for the correction of cubitus varus are described. It involves a 90 step-cut on the proximal humeral fragment after the initial transverse osteotomy; the distal fragment is translated medially to avoid an unsightly lateral condylar prominence at the elbow; and the osteotomy was fixated using two crossed pins with additional tension band wires or a plate and screws. Ten patients were treated by this method with uniform success. They were followed up for at least one year. The preoperative humeral-elbow-wrist (HEW) angle averaged -17.9. The final HEW angle averaged 8.6. No loss of correction or motion occurred. Complication was a transient ulnar neurapraxia. All of the patients were satisfied with the excellent cosmetic results. The author recommends this modification of the step-cut osteotomy as safe and effective.
Congenital Abnormalities* ; Elbow ; Humans ; Humerus* ; Osteotomy*

No abstract available.
Giant Cell Tumors* ; Giant Cells* ; Spine*

In our review of 36 hematogenous osteomyelitis nine cases were subacute form. Distal tibia was the most commonly involved location(four of nine patients). According to the modified Robert's classification cross-physeal lesions were the most common type(four of nine patients). In most of the cases the clinical findings and laboratory data were not much helpful for current diagnosis. Four patients had radiographic findings similar to those of tumors such as Ewing' s sarcoma, osteoid osteoma or bone cyst. Magnetic resonance imaging was useful in the identification of early lesions. In three patients Staphylococcus aureus was isolated by bacterial culture of biopsy specimen. In the remaining six patients diagnosis was made by histological evaluation. All patients except one were treated by curettage and antibiotics. In the other patient the disease showed a tendency of spontaneous healing without operative intervention and antibiotics. Cross-physeal lesion seemed to be a typical finding of the subacute osteomyelitis.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Child ; Classification ; Curettage ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Osteoma, Osteoid ; Osteomyelitis ; Retrospective Studies ; Sarcoma ; Staphylococcus aureus ; Tibia

We describe an extra-articular triplane fracture of distal tibia in a twelve-year-old boy. This variant of the triplane fracture has been largely ignored in the literature. The clinical significance of recognizing this fracture is that, although it constitutes an epiphyseal fracture, it remains extra-articular. We treated this case by open reduction and internal fixation of both distal tibia and fibula. However, unlike the standard triplane fracture that exits through the tibiot alar joint, this variant may be treated acceptably with less that an anatomical reduction, therefore avoiding the need for surgical management.
Fibula ; Humans ; Joints ; Male ; Tibia

We preset a rare case of traumatic rupture of the iliacus muscle associated with paralysis of the femoral nerve. It occurred in a healthy 17 year old boy immediately after a fall on his back during the Taekwondo practice. The clinical picture is characterized by pain in the groin, a tender mass in the iliac fossa, flexion contracture of the hip, and a complete paralysis of the ipsilateral femoral nerve. This condition rarely occurs in individuals without bleeding tendency
Contracture ; Femoral Nerve ; Groin ; Hemorrhage ; Hip ; Humans ; Male ; Paralysis ; Rupture

BACKGROUND: The purpose of this study is to assess the range of shoulder motion using an indirect evaluation method without physical examinations of patients based on questionnaires regarding several specific arm postures referenced by patient's own body parts. METHODS: Nine criteria of specific shoulder motion including 4 forward flexion, 2 external rotation, and 3 internal rotation were decided as reference position which can represent a certain shoulder motion. Flexion contains postures such as lifting arm to waist-height, shoulder-height, eye-height, and raising arm above head with arm touching ears. External rotation comprises grasping ears and placing hands on back of the head. Vertebral height in internal rotation is determined by calculating the samples' motions, which are holding on to trouser belts, opposite-elbow, and scapula. These postures are included in questionnaires for patients to evaluate the validity and effectiveness of this indirect method. RESULTS: The range of flexion was 77degrees (60degrees to 100degrees), 96degrees (87degrees to 115degrees), 135degrees (115degrees to 150degrees), and 167degrees (150degrees to 175degrees) when arms go up to waist, shoulder, eye, and high vertically. Range of external rotation was 39.6degrees (30degrees to 50degrees) when grasping ears and 69.2degrees (60degrees to 80degrees) with the hands on the back of the head. Range of internal rotation was L4 when placing trouser belts, T12 for holding opposite elbow, and T9 for reaching scapula. The mismatch rates of flexion, external rotation, and internal rotation were 11.6%, 9.6%, and 7.8%. CONCLUSIONS: The range of shoulder motion using this method is expected to be applied to an established shoulder scoring system which included shoulder motion evaluation item.
Arm ; Ear ; Elbow ; Hand ; Hand Strength ; Head ; Human Body* ; Humans ; Lifting ; Physical Examination ; Posture ; Range of Motion, Articular ; Scapula ; Self-Assessment ; Shoulder Joint ; Shoulder* ; Telephone ; Surveys and Questionnaires

No abstract available.
Spine*

No abstract available.
Ankle Fractures* ; Ankle*

No abstract available.
Animals ; Cautery* ; Cryosurgery* ; Dogs* ; Femur* ; Phenol*

We analyzed 27 cases of Legg-Calve-Perthes disease that were treated by operative methods at the Department of Orthopedic Surgery, Yonsei University College of Medicine from 1975 to 1981. The modalities of treatment were innominate osteotomy in 17 patients; subtrochanteric osteotomy of femur in 4 patients; and adductor-iliopsoas tenotomies in 6 patients. Most of the cases were in Catterall group III or IV diseases with two or more of “head at risk”signs in the preoperative roentgenogram. All but one case were aged more than 7 years at the time of surgery. In all cases clinical and radiological evaluations were performed until the affected femoral head had been fully regenerated. The average period of follow-up was 2 years and 11 months. Final result by Catterall's criteria was good in 15 cases (56%), fair in 7 cases (26%) and poor in only 5 cases (18%). Among 17 cases treated by innominate osteotomy, 13 cases (76%) were in good result and there was no poor result; 15 cases (86%) showed normal containment at the last follow-up x-ray. To compare these end results with those of noncontainment treatment reported by many authors, we were encouraged to proceed our current policy of early definitive containment surgery especially in patients with poor prognostic factors. In cases of estabilshed femoral head deformities that can be confirmed by preoperative arthrography, adductor-iliopsoas tenotomies were useful to restore normal range of motion of hip joint and to prevent further subluxation of the femoral head. The significant prognostic factors at the time of surgery were the patients age; stage of disease; involvement of femoral head; and finally early established irregularities of the femoral head. In every cases of Legg-Calve-Perthes disease these factors should be carefully assessed to make proper decision for the choice of the most effective modality of treatment.
Arthrography ; Congenital Abnormalities ; Containment of Biohazards ; Femur ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Legg-Calve-Perthes Disease ; Orthopedics ; Osteotomy ; Reference Values ; Tenotomy