In the diagnosis of acute spinal trauma, meticulous physical examination and history taking is the most important tool and auxilliary support support can be given by plain X-ray, CT or myelography, etc. But these cannot show the state of cord injury directly. On the contrary, MRI shows the cord directly as well as the soft and bony tissues. We analysed retrospectively 39 patients who suffered from acute spinal trauma at the level of cervical and thoracic spine and had their spine MRI taken. We verified the meaningful correlation between the signal change in the spinal cord on MRI and the degree of neurologic deficit and prognosis, using Frankel classification and trauma motor index at the time of admission and the final follow-up.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neurologic Manifestations ; Physical Examination ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine

In 1974, bipolar endoprosthesis was first introduced by Bateman & Giliberty. It has theoretical advantages including minimizing acetabular wear, possible reduction of incidence of stem loosening, lessening of dislocation and easy revision procedure. Various methods for the treatment of fracture of the femur neck have been developed & performed, but it is still called “the unsolved fracture” in certain situation. But the role of it as primary treatment of fracture of the femur neck continues to be controversial. Current clinical results encourage its continued use and expansion of indication. Authors reviewed and analysed 21 cases of bicentric endoprosthesis and 1 case of Giliberty endoprosthesis those have been operated at the Department of Orthopaedic Surgery, National Medical Center from 1981 to 1983. Following results were obtained, l. According to disorder distribution, 14 cases were neglected fracture of femur neck, 2 old fracture, 1 idiopathic femoral head necrosis and 2 avascular necrosis & 1 non-union complicated by femoral neck fracture. 2. Among 20 cases, 8 cases were operated within 1/2 1 month after injury and 6 cases within 1 3months 3. Harris lateral appmach was used in 16 cases (80%) and Modified Gibson approach in 4 cases (20%). There were no significant differences in morbidity during operation and postoperative complication. 4. We used femoral stems those head diameter was 22 and 32mm(Charnley & Miiller type) and head pieces those diameter was 48-51 mm in male and 44–48 mm in Ifemale. 5. 3 cases were stiff in inner bearing without acetabular erosion. 6. In 6 cases more than 2 years followup 1 degree CE angle of Wiberg was increased in 2 cases of youngage respectively without associated hip joint pain. 7. Although inclination of head piece was vertical in 8 cases, fracture and dislocation were not found. 8. The circumference of head piece and opposite femoral head was measured and compared. There were 12 cases (mean 12.6 mm) that of head piece larger than opposite femoral head and 3 cases smaller than opposite femoral head. 9. There was 4 cases of complication (3 patients) and still no reoperation and revision converted to T.H.R. 10. With regard to average 18 months of follow-up, 7 cases of 81–90 Harris hip-rating score, 6 of 91–100, 4 of 71–80 and 3 of 61–70.
Acetabulum ; Dislocations ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Incidence ; Male ; Neck ; Necrosis ; Postoperative Complications ; Reoperation

No abstract available.
Constriction, Pathologic* ; Fetal Death*

The authors report a case of acute nontraumatic spinal epidural hematoma which extending from C4 to C6. A 70-year-old woman was presented with neck pain and left hemiparesis. T1-weighted magnetic resonance image revealed a mass isointense to the spinal cord and the mass was slightly enhanced after administration of gadolinium. T2-weighted images revealed high signal in the left posterolateral part of the spinal canal at the level of C4-C6. Evacuation of an epidural hematoma was performed with laminectomy. The pathological examination did not reveal any malformation within this hematoma. The patient showed complete recovery of the deficits. Medical investigation yielded thrombocytopenia and splenomegaly derived from liver cirrhosis. Thrombocytopenia and mechanical factor may be considered as etiologic factors in this case.
Aged ; Female ; Gadolinium ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Laminectomy ; Liver Cirrhosis ; Neck Pain ; Paresis ; Spinal Canal ; Spinal Cord ; Spine* ; Splenomegaly ; Thrombocytopenia

No abstract available.
Mass Screening* ; Prospective Studies*

Double contrast arthrography has been widely accepted as a method to diagnose the internal derangement of the knee. It is a safe and technically simple procedure permitting accurate diagnosis of lesions of the menisci. In 20 cases operated upon, with the diagnosis of internal derangement of the knee, we performed double contrast arthrography before surgery. We analysed the cases concerning the diagnostic accuracy of arthrography, its clinical significance and discrepancies between arthrographic findings and postoperative lesions. The results were as follows: 1. The cases consisted of 16 cases of meniscal lesion, 4 cases of ligamentous lesion and 3 cases of loose body. 2. In the meniscal lesions, 14 of the 16 cases (87.5%) were diagnosed accurately by arthrography, Therefore arthrography was more useful in diagnosing meniscal lesions as compared with clincal symptoms (69%). 3. In cases of ligamentous lesions arthrography was not significant-ly helfpful, in contrast clinical signs afforded important clues. 4. We encountered 1 case of false positive and 1 case of false negative.
Arthrography ; Diagnosis ; Knee ; Ligaments ; Methods

The peripheral vascular occlusion in the diabetes was studied in fifty-nine male and forty-six female diabetic patients by means of doppler flow meter performed on the dorsalis pedis arteries & post. tibial arteries of the both lower limbs. Patients were divided into two groups, one with occlusion and the other without occlusion. Various predisposing factors causing peripheral vascular occlusions were examined. The results are summerized as follows: 1. Peripheral vascular occlusions were more prevalent in male than in female (male: 25.4%, female: 17.4%). 2. In male patients age, plasma cholesterol level & smoking were statically significant among the various predisposing factors between occlusion & nonocclusion groups. 3. In female patients, duration of diabetes mellitus and the sugar levels of fasting blood and post prandial 2 hours were statiscally significant.
Arteries ; Causality ; Cholesterol ; Diabetes Mellitus ; Fasting ; Female ; Foot ; Humans ; Lower Extremity ; Male ; Open Bite ; Plasma ; Smoke ; Smoking ; Tibial Arteries

The anterior cruciate ligament has been considered one of the basic stabilizers in the knee as a very complex in its function. A large number of treatment regimens and philosophies showed controversies in its treatment. And we have experienced recurrence of the instability after operation of the injured ligament. So, the authors devised a new operative technique for the loose anterior cruciate ligament, that is, distal davancement of the loose anterior cruciate ligament with a bone-block as a biomechanical fixation. We have performed 11 cases of the anterior cruciate ligament using distal advancement method. The results were as follows; 1. Eleven cases (92%) showed good results by the rating system of Cincinnati sports-medicine and Orthopaedic Center. 2. The distal advancement of the anterior cruciate ligament is technically simple and biomechanically reasonable, but further investigation is necessary to answer the question regarding the long term results.
Anterior Cruciate Ligament ; Knee ; Ligaments ; Methods ; Philosophy ; Recurrence

Thirty-nine cases of tuberculosis of the knee were treated at the Department of Orthopaedic Surgery, National Medical Center during the 10 yesrs from Jsn. 1977 to Dec. 1986. The results were as followings 1) Total cases of tuberculosis of bone and joint were 411. Among them, knee joint occupied 39 cases (9.5%) 2) Age and sex distribution were not remarkable. 3) Average duration of disease were 27 months. 4) In 56.1% of the pstients, chemotherapy wss given prior to admission. 5) Tbe main associated tuberculosis lesions were pulmonsry tuberculosis (53.9%). 6) Erythrocyte sedimentation rate was increased in 61.6%. 7) The incidence of associated running draining sinus were 25.6%, and majority of the causative microorganisrn was Staphylococcus aureus in complicated mixed infection. 8) Various treatment, such as conservative, synovectomy, curettage, and arthrodesis, had been carried out. 9) Overall recurrence rate was 9.1%.
Arthrodesis ; Blood Sedimentation ; Clinical Study ; Coinfection ; Curettage ; Drug Therapy ; Incidence ; Joints ; Knee Joint ; Knee ; Recurrence ; Running ; Sex Distribution ; Staphylococcus aureus ; Tuberculosis

The lateral syndesmosis malleolar complex is a factor of importance for congruence and stability of the ankle joint. The failures of function due to excessive talar motion or instability and incongruity, predisposes the osteoarthritis of ankle joint. The authors analysed 46 cases of lateral malleolar fracture with diastasis in our department during the years 1976 through 1986. The results obtained are as follows. 1. The most common cause of injury was slipping down and the other causes were falling down and traffic accident in order. 2. The types by Weber classification showed 21 cases of type BS(+) and 25 cases of type C. The most common type by Lauge-Hansen classification was supination-external rotation type(21 cases, 45.7%). 3. Partial diastasis was noted in 25 cases(54.3%) and total diastssis in 21 cases(45.7%). 4. Open reduction was performed in 43 cases. For the treatment of diastasis, 20 cases were treated with transfixation screws, 9 cases with repair of anterior inferior tibiofibulsr ligament and 11 cases with both method. 5. According to colton's criteria, the result was good in 24 cases(65%), fair in 10 cases (27%) and poor in 3 cases(8%). 6. The incidence of traumatic arthritis was 29.7%(11 cases).
Accidental Falls ; Accidents, Traffic ; Ankle Joint ; Arthritis ; Classification ; Clinical Study ; Incidence ; Ligaments ; Methods ; Osteoarthritis