Eighty primary Harris-Galante Porus (HGP) total hip replacements were performed at Severance Hospital from January 1986 to January 1989. A minimum of 18 months follow-up was available for 80 hips in 72 patients, whose mean age was fifty two years. The most common presenting diagnosis was avascular necrosis (47.5%) followed by fused hips (10%), tuberculosis (10%), rheumatoid arthritis (7.5%). Complications included three calcar cracks and two immediate dislocations and 6 cases of mild myositis ossificans. There were no infections and no revisions. The mean Harris hip score was 93 points (range, 74–100 points) at two years. The thigh pain was in nine patients (11 per cent) at one year and in three patients (3 per cent) at two years postoperatively. Radiographic analysis revealed that, a progressive radiodense femoral line developed in 21 hips (26 per cent); a progressive acetabular line in 3 hips (4 per cent); and decreased proximal femoral density in 28 hips (35 per cent). There were no position change of the acetabula and femoral compent. We conclude that the early overall clinical results of HGP total hip replacements are encouraging, at average 30 months. The prognostic significance of the radiographic changes such ar radiodense lines, the changes of the proximal femur and cortical thickening, have to be determined with longer follow-up. Long term follow-up of uncemented HGP total hip replacement is necessary to evaluate the efficacy of such implants.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Diagnosis ; Dislocations ; Femur ; Follow-Up Studies ; Hip ; Humans ; Myositis Ossificans ; Necrosis ; Thigh ; Tuberculosis

This study consisted of 66 peritrochanteric fractures which were treated by the modified Gamma nail (Asian Pacific nail) from August 1993 to October 1995. Sixty-one intertrochanteric fractures and five subtrochanteric fractures were treated in our institution. Average length of follow-up was 15.0 months. Four patients died during follow-up. The results were as follows; Lag screws were ideally introduced in 55 (83%) cases. The mean length in lag screw sliding was 4.3 mm in stable trochanteric fractures and 5.7 mm in unstable ones. Fifty-one out of 62 patients (82%) were returned to their previous ambulatory status. Intraoperative complications were as follows; distal crack (3 cases); rotation of femoral head (2 cases); entry point crack (I case); medialization of proximal fragment (7 cases); and missing of the interlocking screw (1 case). All of these complications did not affect the outcome. All medial cortical gaps were closed after sliding of lag screws. Three distal cracks did not propagate to the shaft. Postoperative complications were a case of superior cut-out, and two second fractures after falls. Callus formed more early in the stable trochanteric fractures (5+/-2.1 weeks) than unstable fractures (7.3+/-2.1 weeks). It was statistically significant. Union time between stable and unstable trochanteric fractures was not statistically significant. In conclusion, the Asian Pacific (AP) nail could appropriately fix the osteoporotic peritrochanteric fractures in elderly patient. It could offer early rehabilitation to these patients and decrease the mortality and morbidity.
Aged ; Asian Continental Ancestry Group ; Bony Callus ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Head ; Hip Fractures ; Humans ; Intraoperative Complications ; Mortality ; Postoperative Complications ; Rehabilitation

Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

Mirizzi syndrom is a rare disorder characterized by obstruction of common hepatic duct due to impacted gallbladder neck or dystic duct stone and is an uncommon cause of obstructive jaundice. Authors experienced one case of Mirizzi syndrome mimicked lobulated intraductal tumor.
Gallbladder ; Hepatic Duct, Common ; Jaundice, Obstructive ; Mirizzi Syndrome ; Neck

Mechanically the symphysis pubis serves to anchor the ends of the two weight bearing arches of the pubis-the femorosacral and ischiosacral arches. Under normal conditions it has been found to exceedingly resistant to separation. Sacroiliac strain is also uncommon because the sacroiliac ligaments are very strong and the movement which produce a torsion strain upon the joint is more likely to cause a strain of thinner capsular ligaments surrounding the small lumbosacral joints. We experienced a case of separation of the symphysis pubis and 2 cases of sacroiliac strain during and after spontaneous labor.
Joints ; Ligaments ; Pubic Bone ; Weight-Bearing

No abstract available.
Erythrocytes*

No abstract available.
Erythrocytes*

Severely comminuted tibial condylar fracture is a major threat to the structures and function of the knee joint. Recently, anterior approach with Z-tenotomy of the patellar tendon was introduced for these complicated fractures. It provides wide exposure of the tibial articular surface for maximum joint reconstruction. The purpose of this study was to describe the operative technique and to evaluate the clinical results of this method. We had performed operative treatment in 13 cases (12 patients) of severely comminuted Schatzkers type II, V, and VI tibial condylar fractures through anterior approach from December 1993 to April 1996. Twelve cases out of 13 (92%) showed acceptable results according to Blokkers criteria. There was no superficial or deep infection. On the basis of these results, we suggest that the anterior approach is a valuable aid in the operative treatment of severely comminuted tibial condylar fractures.
Joints ; Knee Joint ; Patella* ; Patellar Ligament* ; Tenotomy* ; Tibia

Fractures of the femoral neck in children are rare and usually severe violence to occur, which accounts for the high frequency of associated injuries. Since the femoral neck in children has many anatomic and physiologic differences, not only are there many difficulties during the treatment period, but complications such as post-traumatic coxa vara, avascular necrosis of the femoral head, and premature epiphyseal closure may occur, sixty-two cases in sixty patients of fractures of the femoral neck in children which were treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1987 and at Young-Dong severance Hospital, Yonsei University college of Medicine from May. 1983 to Dec. 1987 were analyzed both clinically and radiologically. The following results were obtained: l. Of the 62 cases, the ratio of boys to girls was approximately 2:1 and the highest incidence was between 4 to 6 years old. 2. The main cause of fracture was traffic accidents, which occurred in 33 cases(53.2%). 3. According to the classification of Delbet and Colonna, the cervicotrochanteric fracture was the most common type(41.9% of the cases) and 29 cases(46.8%) were displaced fractures. 4. Thirty two cases(51.6%) were treated by conservative treatment and twenty eight cases (45.2%) by closed reduction and internal fixation. 5. Common associated injuries were genito-urinary tract injury, soft tissue injury, long bone fracture and pevic bone fractures. 6. All cases were followed for from 14 months to 15 years, average 8 years. 7. The results were analyzed according to Ratliff's assessment and 41 cases(66.1%) showed good results. 8. The total number of cases with complications was 33(53.2%). The most common complication being coxa vara and premature epiphyseal closure(32.2%). 9. Secondary treatment was done in 7 cases and correction osteotomy was done in 4 cases which had showed a good results. The authors found that for the treatment of type IV fractures, closed reduction followed by plaster of Paris immobilization was adeguate but for type I, II, III after early closed reduction, internal fixation was performed as soon as possible using threaded pins as the internal fixation device. The results were poor in type I and type II, fractures with severe displacement, and in cases in which the treatment was delayed due to associated injury.
Accidents, Traffic ; Calcium Sulfate ; Child ; Classification ; Coxa Vara ; Female ; Femur Neck ; Fractures, Bone ; Fractures, Closed ; Head ; Humans ; Immobilization ; Incidence ; Internal Fixators ; Necrosis ; Osteotomy ; Soft Tissue Injuries ; Violence

No abstract available.
Spine*