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Femur

Benign chondroblastoma of bone is a relatively rare primary bone tumor which develops in the 2nd to 3rd decade involving the epiphysis of the long bone. The over-all reported cases of the world have been lesser than 400 after determining the entity as benign chondroblastoma in 1942 by Jaffe and Lichtenstein. A case of the benign chondroblastoma with involvement of the greater trochanter of the femur of a 19 years old boy is presented. The conclusive diagaosis was led by histological examination. Considerable new bone formation and bony spicules which might be derived from previous multiple puncture made us to confuse with osteogenic sarcoma. The specimen was composed of reddish brown hemorrhagic and fragile tissue with scattered either yellowish gritty calcified material or bluish translucent ones. The postoperative course has been smooth and there has been no evidence of recurrence for postoperative 15 months.
Chondroblastoma ; Epiphyses ; Femur ; Humans ; Male ; Osteogenesis ; Osteosarcoma ; Punctures ; Recurrence

Squamous cell carcinoma is a primary malignant tumor of the skin arising from the epidermis with etiology unknown, and chronie irritations are considered as predisposing factors such as prolonged exposure to sunlight, chronic ulceration of the scar, persistent draining sinus of the chronic osteomyelitis. Habitual pipe smoking and exposure to heavy metal or chemical agents are also thought to be contributing factors to produce this tumor. Orthopaedic surgeons are occasionally concerned in case of patients with squamous cell carcinoma developed in the extremities particularly arising from the persistent draining sinus of the chronic osteomyelitis. We reviewed 12 patients with squamous cell carcinoma in the extremities treated at National Medical Center between 1963 and 1975. All cases were definitely diagnosed clinically and histopathologically. 1) Male to female ratio was 11:1. Average sge of the patients was 52. 2) Farmer is predominant in incidence as 10 out of 12. 3) Sites of invoIvement were buttock and lower extremities in all cases. 4) Predisposing factors of the tumor were chronic skin ulceration in 7 cases, persistent draining sinus of chronic osteomyelitis in two and unknown in three cases. 5) Duration of the skin ulceration or draining sinus before producing tumor was considerably long between 10 and 30 years in majority of the cases. 6) Duration of newgrowth before operation was less than one year in 5, between one and two years in three, and more than two years in four cases. 7) Pre-operative chest X-ray was normal in all cases. However X-ray of the bones of affected limbs showed no bony change in two cases, and various bony changes in 10 cases such as periosteal reaction, cortical erosion, findings of pre-existing chronic osteomyelitis etc. In detail, two cases revealed direct infiltration and active bony destruction into the cortex and medulla by tumor mass. 8) We performed amputation or disarticulation at various levels in 5 cases, radical excision in 3 and biopsy in one case. 9) Within 6 months postoperatively, four cases showed local recurrence of newgrowth as well as metastasis to the lung concomitantly. Three of them were the cases of radical resection. One of them developed distant metastasis to the clavicle.
Amputation ; Biopsy ; Buttocks ; Carcinoma, Squamous Cell ; Causality ; Cicatrix ; Clavicle ; Disarticulation ; Epidermis ; Epithelial Cells ; Extremities ; Farmers ; Female ; Humans ; Incidence ; Lower Extremity ; Lung ; Male ; Neoplasm Metastasis ; Osteomyelitis ; Recurrence ; Skin ; Skin Ulcer ; Smoking ; Sunlight ; Surgeons ; Thorax ; Ulcer

A case of postradiation sarcoma, found in a 52-year-old woman, who underwent a total hystrectomy under the diagnosis of cervical cancer 12 years ago, followed by radiation therapy. The tumor invasion was extensive involving the left innominate bon and upper end of the left femur including the head and neck. Histopathological findings revealed sarcomatous change with atypical osteoid formation and stromal proliferation. The case has been followed for 2 years since February 1974 and survives today.
Diagnosis ; Female ; Femur ; Head ; Humans ; Middle Aged ; Neck ; Osteosarcoma ; Pelvic Bones ; Sarcoma ; Uterine Cervical Neoplasms

A rare case of a metastatic lesion of breast carcinoma in the talus of the left foot, approximately 14 months after simple mastectomy including resection of axillary lymph node is reported. The operation was undertaken 14 months prior to this admission and gradual onset of pain, swelling and redness were noticed about the left ankle. X-ray showed irregular osteolytic changes on the superolateral aspect of the body and the superior aspect of the neck of the left talus without periosteal reaction, Metastasis was confirmed by biopsy and pathological findings were also submitted.
Ankle ; Biopsy ; Breast Neoplasms ; Breast ; Foot ; Lymph Nodes ; Mastectomy, Simple ; Neck ; Neoplasm Metastasis ; Talus

A endodermal sinus tumer (Teilum) is a highly malignant germ cell tumor showing a selective overgrowth of yalk sac endoderm intimately associated with the extraembryonic mesoblast. Several cases of the tumor originating from the ovaries have been reported in the literature. We present a case of the tumor with a rare origin from the sacrococcygeal region.
Endoderm ; Endodermal Sinus Tumor ; Female ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Sacrococcygeal Region

The principle of the tension band technique is to counteract the tensile forces acting across the fracture site and to convert them into compressive forces. We have experienced 37 fractures treated with tension band technique from 1975 to 1978 and the results are as followings; 1. 37 Cases of fracture were treated by tension band technique. Eight cases out of 37 were olecranon fractures. 16 cases were patellar fractures. 10 cases were malleclar fractures. and three cases were trochanteric fractures of the femur. 2. As post-operative immobilization, applied cast splint in almost of the cases except application of hip spica cast in trochanteric fracture. 3. The average duration of immobilization in each cases, 12 days in olecranon, two weeks in patella, four weeks in malleolus and six weeks in greater trochanter respectively. 4. The radiological union was obtained in seven weeks in olecranon, six weeks in patella, eight weeks in malleolus and six weeks in greater trochanter. 5. As complication, one case of nonunion in olecranon, one case of infection and, one case of wire breakage in patella and one case of traumatic arthritis in malleolus were noted, which needed further surgery. 6. In conclusion, tension band wiring is considered as a good method for the fractures involving joing, olecranon, patella, and malleolus because the technique has advantages such as rigid internal fixation, shortening the duration of immobilization and fracture healing and early mobilization of the neighboring joints.
Arthritis ; Early Ambulation ; Femur ; Fracture Healing ; Hip ; Hip Fractures ; Immobilization ; Joints ; Methods ; Olecranon Process ; Patella ; Splints

We meet much difficult problem to solve in the treatment of the forearm fractures which are not encountered in the treatment of fractures of the other long bone and there are many reports on the results of treatment of forearm fractures and many methods have been introduced. In the late 1950's ASIF compression plate was invented and developed by Muller, Allgower, and Willenegger and it has shown excellent union rate and functional results in the treatment of forearm fractures. From Jan. 1971 to Dec. 1979, we have experienced 71 cases of fresh or old forearm fractures treated by different methods and devices and among them, 53 patients, those were treated with compression plate and other various internal fixation devices, were possible to trace for more than 3 months. The Author divided the traceable patients into two groups, the one was the group treated with compression plate and the othtr one was the group treated with other various internal fixations, and compared the results in the aspect of healing time and functional results. The results were as follows; 1. Among 71 patients, 45 patients (36.6%) were fresh and 26 were old cases. Of 61 adult patients 21 cases (34.4%) exhibited severe soft tissue injury due to crushing machinary injury. 2. There was 24 (33.8%) cases of open fractures and the most common fracture site was middle one-third of both radius and ulna. 3. The period between operation and exercise was 7.3 weeks in fresh cases which were treated with compression-plate fixation and 10.3 weeks in old cases with other fixation devices. 4. The time of radlological union was comparatively rapid in compression-plate fixation group, acute cases and radial fractures when compared it with those treated with other fixation devices, old cases and ulnar fractures, respectively. Radiological union time in average was as follows; Radius, compression-plate fixation: 12.1 weeks ulna, compression-plate fixation: 12.4 weeks redius, other fixation devices 14.9 weeks ulna, other fixation devices 15.5 weeks 5. By Anderson's functional criteria, the ratio of excellent or good results was as follows, Acute compression-plate fixation: 87% Acute, other fixation devices 67% Old, Compression-plate flxation: 67% Old, Other fixation devices 23% 6. Achieved bony union in all cases in compression-plate fixation group and experienced 3 cases of non-union in the group treated with other fixation devices. Among 3, two cases of non-union were due to post-operative infection and technical failure and the other one was a solitary ulnar fracture which was treated with rush pin.
Adult ; Forearm ; Fractures, Open ; Humans ; Internal Fixators ; Radius ; Soft Tissue Injuries ; Ulna

The first metacarpal base fracture is classified as extra-articular fracture, intra-articular fracture and epiphyseal injury. Intra-articular fracture was firstly described in 1882 by Bennett and Rolando described about Y shape comminuted fracture in the first metacarpal base in 1910. In 1938, Robert wrote about oblique fracture injured by first metacarpal base fracture. First metacarpal base fracture can be adjusted easily by C/R, but it is difficult to maintain the good axis. In case of fail of reduction, malunion, joint stiffness and traumatic arthritis can be shown as complications and finally some problems in grasping and pinching are resulted. Therefore, firstly the most accurate reduction, secondarily effective method to maintain the condition and thirdly the protection of limitation of motion are goal of treatment. Authors reviewed 17 cases treated by 0/R & C/R for the past 5 years from 1975 to 1980 at National Medical Center, especially reviewed the cases of which observation more than 1 year was possible. The results were as followings: 1. The incidence of first metacarpal base fracture was 1.0% of all fractures & dislocations. 2. Out of 17 cases, there were 14 male and right side 9 cases and left side was 8 cases. 3. The most common case of fracture was injury at work and traffic accident, sports injury, slipping down and falling down. 4. The method of treatment were C/R & percutaneous pinning in 10 cases and 0/R & K-wire fixation were 7 cases. 5. The result of treatment showed 8 excellent, 1 good, 1 fair, out of 10 cases of C/R and percutaneous pinning. In 0/R and K-wire fixation, 4 excellent, 2 good, and 1 fair showed out of 7 cases. 6. Soft tissue infection was appeared from 1 case of open fracture which accompanied second metacarpal fracture as complication and it caused adduction contracture in first web space.
Accidental Falls ; Accidents, Traffic ; Arthritis ; Athletic Injuries ; Clinical Study ; Contracture ; Dislocations ; Fractures, Comminuted ; Fractures, Open ; Hand Strength ; Humans ; Incidence ; Intra-Articular Fractures ; Joints ; Male ; Metacarpal Bones ; Methods ; Soft Tissue Infections

Fractures of the phalanges of the hand are very common. Many are minor and likely to have a good result. However many other phalangeal fractures cause significant and prolonged disability. Non-union of the tubular bones of the hand are uncommon occurrence, but are often associated with functional deficits. The authors have reviewed 7 cases of non-union of the phalanges which were treated in the department of orthopaedic surgery, National Medical Center from 1978 to 1985. The results were summarized as follows: 1. The non-union of phalangeal bone was defined by clinical symptoms and signs and roentgenological examination. 2. The incidence of non-union of phalangeal bone fractures was 0.9% (7/771 cases.) 3. of 7 patients, there were 6 in male and 1 in female. 4. Non-union occurred more commonly in the second decade and the group between 10 and 30 years of age. 5. Seven cases, all were the right handed, but injury was developed in the left hands except two cases. 6. The causes of non-union were thought as open wound (7 cases), type of fracture (simple or comminution:3 cases), inadequate immobilization (4 cases) and overtraction (1 case). 7. of 7 cases, 4 cases were treated with bone peg graft and K-wire fixation and 2 cases with excision of distal fragment. 8. The clinical union was 9 weeks in average.
Clinical Study ; Female ; Fractures, Bone ; Hand ; Humans ; Immobilization ; Incidence ; Male ; Transplants ; Wounds and Injuries