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

Locking of the metacarpophalangeal(MP) joint of thumb in mild hyperextension is relatively uncommon problem. The most frequently recognized cause appears that proximal palmar ligament or volar plate were ruptured tranversely with its distal part riding over the volar prominence of the radial condyle of the first metacarpal head. We experienced two cases of locking of the MP joint of the thumb due to volar plate injury. Closed reduction was failed in both cases and open reduction was done by cutting the constricted ligament hundle over the radial condyle of the first metacarpal head. Our description of this mechanism is supported by expeimental evidence that we obtained from the cadeveric specimens. The height of radial side condyle of first metacarpal head is higher than ulna side of that by 1.76mm in both hands of 16 cadeveric specimen. So we are going to report these cases with a review of the literature, and suggest that the preferable location of surgical incision in open reduction is radial side of metacarpal head.
Hand ; Head* ; Joints ; Ligaments ; Metacarpal Bones* ; Metacarpophalangeal Joint* ; Thumb* ; Ulna ; Palmar Plate

No abstract available.
Humans

For measurement of the degree of osteoporosis, various methods have been used. The Saville's index of the lumbar spine is very simple method. With the object of studying the reliability and clinical usefulness of Saville's index, authors compared the Saville's index with anteroposterior(A.P.) and lateral Dual x-ray absorptiometry, and the Singh's index with the anteroposterior D.X.A. We took the D.X.A. and simple lumbar spine lateral view in 124 patients in same time and also performed D.X.A. and both hips anteroposterior views in 112 patients, then analyzed the correlation between the A.P. and lateral D.X.A., Saville's index and D.X.A., Singh's index and D.X.A. The results were as follows. 1. The correlation coefficient of the A.P. and lateral D.X.A. was 0.46 and appeared the low degree of correlation. 2. The correlation coefficient of the A.P. and lateral D.X.A. compared with Saville's index were 0.68 and 0.83, respectively. Saville's index appeared the higher correlation in lateral D.X.A. than A.P. D.X.A. 3. The correlation coefficient of Singh's index and D.X.A. was 0.84, appeared nearly the same results of Saville's index with lateral D.X.A. 4. Intrapersonal differences were 36% in Saville's index, 28% in Singh's index. Saville's index appeared higher intrapersonal error than Singh's index. The lateral D.X.A. is more accurate and precise method than A.P. D.X.A. because lateral D.X.A. reduces the influence of soft tissue calcification and degenerative changes of spine. As Saville's index is a grading method based on lateral view of lumbar spine, we think that it should be compared with the lateral D.X.A. Regarding this results, authors suggest that Saville's index is not any accurate measurement of bone quantity, but has clinical usefulness for evaluation of osteroporosis.
Absorptiometry, Photon ; Bone Density ; Hip ; Humans ; Methods ; Osteoporosis ; Spine

Although flexion and extension lateral views were known the most preferable diagnostic method of instability of lumbar spine, many authors had reported that there were some findings which suggested instability of lumbar spine in plain films. This study was undertaken to analyze clinical aspect and plain film findings of dynamic instability of lumbar spine and to suggest indication of dynamic X-ray to find out the causes of low back pain. A retrospective analsysis was perfomed on 30 patients who had dynamic instability of lumbar spine without spondylolithesis between January 1996 and March 1997. They were reviewed in sex, age, symptom duration and instability level, etiologic factor etc. And then their plain films and flexion and extension lateral views were reviewed. Following results were obtained. Dynamic instability was more frequent in women than in man and occured younger age in women. The mean symptom duration was 5 years and 10 months and simple degenerative change was the most common etiologic factor. In plain films, traction spur and dome shaped end plate were common findings and the L4-5 intervertebral disc space was most frequently involved(23/30 cases). Translation was occured more frequently in flexion position(23/30 cases). The mean dynamic translation distance was 4.7mm, the mean sagittal rotational angle was 16.2degreesand the mean angular displacement was 3.2degrees. Conclusively, among the diagnostic criteria af instability of lumbar spine, translational distance was the most common finding. Flexion and extension lateral views have diagnostic value in patients who complaint back pain from unknown origin, in old age, for prolonged symptom duration, or those who have findings associated with instability in plain films.
Back Pain ; Female ; Humans ; Intervertebral Disc ; Low Back Pain ; Retrospective Studies ; Spine* ; Spondylolisthesis* ; Traction

We present an unusual case of 31 year old lady with a longitudinal tear of flexor hallucis longus(FHL) caused by trauma. Tendonitis of the FHL, well known as dancers tendonitis, can be characterized by triggering of the great toe. As the foot is brought into plantar flexion with a forcible active contraction of the FHL, a snap is noted in the region of the posteromedial aspect of the ankle. Magnetic resonance imaging may be helpful in establishing diagnosis. The patient has obtained longterm satisfactory relief of her symptoms with surgical treatment. The literature on tendonitis of the FHL is reviewed with a reported case.
Adult ; Ankle ; Diagnosis ; Foot ; Humans ; Magnetic Resonance Imaging ; Tendinopathy* ; Tendons* ; Toes*

No abstract available.
Knee* ; Rabbits* ; Tendons*

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage

No abstract available.
Lymphangioleiomyomatosis* ; Tuberous Sclerosis*

We analysed 8 cases of gastrointestinal cytomegalovirus(CMV) infection including one autopsy, three surgically resected and four endoscopic biopsy cases. Involved sites were colon in four,stomach in three and small intestine in one. Three of them were associated with immu-nosuppressed condition but others had no clinical evidence of immune deficiency. Multiple aphthous mucosal ulceration was a common presentation, but one revealed a mucosal ulcer with segmental narrowing and thickening of wall. Microscopically, six showed cytomegalic inclusions in endothelial cells and fibroblasts, one in mucosal epithelial cells and the remaining one in both endothelial cells and mucosal epithelial cells. Immunohistochemical staining using monoclonal antibody against CMV confirmed postive result in seven cases. Serum IgM anti-CMV antibody was elevated in one case. We conclude that gastrointestinal CMV infection is currently not a rare condition and frequently associated with non-immunosuppressed condition, and thus a thorough histologic examination is required especially in the gastrointestinal ulcerative lesion. Once cytomegalic inclusion is suspected, immunohistochemical identification of CMV seems essential for specific diagnosis.
Biopsy