The conventional therapy for supracondylar fracture of the femur is open reduction and internal fixation with plate and screws. But, wide dissection of the thigh with the following devascularization of the distal femur caused a high incidence of complications like joint stiffness, delayed union, nonunion, infection and loosening or breakage of plate and screws. On the contrary, interlocking intramedullary nailing does not need the exposure of the fracture so that soft tissue dissection and devascularization can be minimized. Undoubtedly, rapid healing by abundant formation of callus is promoted, irrespective of the degree of comminution. We reviewed 9 cases of interlocking intramedullary nailing for supracondylar and intercondylar frtures of the distal part of the femur at Pusan National University Hospital from November 1993 to December 1995. The mean time to union was 14 weeks (range, 11-23weeks). According to Rating System of Neer et al., excellent was 7 cases, satisfactory in 1 case and unsatisfactory in 1 case. Interlocking intramedullary nailing was applied to Type A, C1 and C2 of the AO classification but considered difficult to apply to Type B and C3. For the firm fixation and the prevention of nail breakage, the nail should be inserted deepest in order to place two distal screws as distally as possible from the fracture site. If necessary the distal tip of nail was cut off for use. Interlocking intramedullary nailing does not need the exposure of fracture site. Satisfactory result could be obtained by reducing complications such as joint stiffness, delayed union, nonunion, infection and breakage of implants caused by wide dissection of the thigh with the following devascularization of the distal femur for the open reduction and internal fixation with plate and screws. It also could be obtained by performing early ROM exercise with firm, fixation.
Bony Callus ; Busan ; Classification ; Femur* ; Fracture Fixation, Intramedullary* ; Incidence ; Joints ; Thigh

Bone scan measuring bone metastasis were analysed in fifty five patients diagnosed as malignant tumor, seven were primary bone tumor and forty eight were metastatic tumor, who treated in Kyung Hee Hospital from March 1981 to January 1982. The results were as follows: l. In 55 patients, positive bone scan were found in 76.4% of the patients and positive X-ray were found in 56.4%. 2. 7 patients with primary bone tumor showed all positive bone scan, 45 patients with metastatic tumor showed positive bone in 72.9%. 3. Among the patients with metastatic tumor who no clinical symptoms, positive bone scan were found in 59.3% and positive X-ray in 26%. 4. Most common metastatic site was femur in primary bone tumor and vertebra in metastatic tumor. 5. In 48 patients of metastatic tumor, positive bone scan within negative X-ray were found in 56%, negative bone scan within positve X-ray were found in 5%. 6 The lesions showed clod area on bone scan were considered of positive finding as compared with clinical symptom and X-ray finding.
Diagnosis ; Femur ; Humans ; Neoplasm Metastasis ; Spine

No abstract available.
Calcaneus* ; Osteomyelitis*

No abstract available.
Hip Joint* ; Hip*

No abstract available.
Hyperostosis, Sternocostoclavicular*

We, at Department of Orthopedic Surgery, College of Medicine, Pusan National University, applied epiphyseal distraction as a method of limb lengthening, using unilateral one-plane pin fixator(ORTHOFIX) and bilateral multi-plane ring fixator(SEQUOIA) to three children with limb length discrepancies and angulation deformity due to injury of epiphyseal plate, and obtained following results. l. At first case, on whose distal femoral physis, bone bridge occupied about 20% of total epiphyseal plate and distributed mainly on the lateral side. At 10 days of distraction, epiphysiolysis occurred from the lateral side at first and angulation deformity was corrected. Epiphysiolysis on the medial side of physis appeared apparently after 60mm distraction. Bone lengthening of 4.2cm and correction of 25 valgus deformity were achieved after 72mm distraction for about 10 weeks. The percentage of increase in the initial length achieved was 11.67% and healing index was 27.86. 7 months later, loss of lengthening of 2.7cm was observed and it was considered that this was due to relatively short corticalization phase. 2. At second case, on whose distal tibial physis, bone bridge occupied about 40% of total epiphyseal plate and distributed on the medial side. At 10 days of distraction, epiphysiolysis occurred on the medial side of the epiphyseal plate, but not on the lateral side and instead of further lengthening, valgus deformity of the ankle appeared. It was thought that asymmetric distraction was attributed to the difference between the force applied on the medial side and that applied on the lateral side of the epiphyseal plate by unilateral one-plane pin fixation. 3. At third case, on whose distal tibial physis, bone bridge occupied about 75% of total epiphyseal plate. No epiphysiolysis occurred. there was a difficulty in observation of epiphysiolysis because ring fixator was overlapped with the epiphyseal plate on radiographs.
Ankle ; Bone Lengthening ; Busan ; Child ; Congenital Abnormalities ; Epiphyses, Slipped ; Extremities ; Growth Plate ; Humans ; Methods ; Orthopedics

The sequential use of ⁹⁹mTc-methylene diphosphonate(⁹⁹mTc-MDP) and ⁶⁷Ga imaging is thought to be useful to diagnose acute hematogenous osteomyelitis, and to determine whether it is active or inactive in chronic osteomyelitis. We compared the results obtained by the sequential use of ⁹⁹mTc-MDP and ⁶⁷Ga imaging with those obtained by the surgical culture and biopsy in 31 patients who were supposed to have the osteomyelitis and admitted to Pusan National University Hospital from July 1987 to July 1989. The results were as follows:l. According to the diagnosis at discharge, 4 cases were normal, 20 cases active osteomyelitis, and 7 cases inactive osteomyelitis. 2. Four normal cases were negative both with ⁹⁹mTc-MDP and with ⁶⁷Ga. Twenty cases of active osteomyelitis showed positive results both with 99mTc-MDP and with ⁶⁷Ga. And of 7 cases of inactive osteomyelitis, 6 cases showed positive ⁹⁹mTc-MDP and negative ⁶⁷Ga, 1 cases was negative both with ⁹⁹mTc-MDP and with ⁶⁷Ga. 3. It is suggested that in active osteomyelitis both ⁹⁹mTc-MDP and ⁶⁷Ga were positive, in inactive osteomyelitis ⁹⁹mTc-MDP positive and ⁶⁷Ga negative and in normal or wastive ostemyelitis both ⁹⁹mTc-MDP and ⁶⁷Ga negative. 4. The sequential use of ⁹⁹mTc-MDP and ⁶⁷Ga imaging was particularly useful to diagnose acute hematogenous osteomyelitis in the case of the obscure diagnosis and supposedly normal radiological finding and to determine whether chronic osteomyelitis is active or complicated by an acute flare-up.
Biopsy ; Busan ; Diagnosis ; Humans ; Osteomyelitis ; Technetium Tc 99m Medronate

Soft tissue reconstruction of the hand remains a challenge for the hand surgeon, who must choose whether to use a local flap, a distant flap or a free flap. Local flaps, derived from tissue immediately adjacent to the primary defect, are the first choice. But there is a shortage of skin in the hand and there are regions of the hand that should not be used as donor sites since cover of the resultant secondary defect with a skin graft would be inappropriate. We used island flaps for the small soft tissue defects in the hand which were difficult to cover with a conventional skin graft or local flap. The results were as follows; 1. The causes of the soft tissue defects were traumatic amputation in 4 cases, camptodactyly in 4 cases, replantation in 3 cases, infection in 3 cases and tumor in 1 case. 2. The sites of the soft tissue defects were thumb tip in 6 cases, fifth finger PIP joint volar aspect in 3 cases, index tip in 2 cases, thumb volar and dorsal surface in 2 cases, third and fourth MP joint dorsal surface in 1 case, fourth finger PIP joint volar aspect in 1 case and first interdigital web space in 1 case. 3. The donor flaps were fourth finger neurovascular island flap in 8 cases, reverse dorsal matacarpal flap in 5 cases and first dorsal metacarpal artery flap in 4 cases. 4. The sizes of the flap were from 1. 0×1. 5cm to 2.0×4.0cm and and average of 1.5×2.0cm. 5. The flaps were survive completely with a touch sensat,ion except 2 cases which were covered by reverse 5th dorsal metacarpal flap.
Amputation, Traumatic ; Arteries ; Fingers ; Free Tissue Flaps ; Hand ; Humans ; Joints ; Replantation ; Skin ; Surgical Flaps ; Thumb ; Tissue Donors ; Transplants

BACKGROUND: Recently, according to many studies, variable factors have been known to be associated with physical fitness. The factors such as obesity and inactivity are associated with poor physical fitness, but regular exercise is associated with good physical fitness. In our country, these studies are not yet reported. And so, this study was designed to investigate the factors associat,ed with physical fitness. METHODS: From May 1st, until July 30th 1996, we recruited the 411 subjects who visited the Health Promotion Center at Seoul National University Hospital. Data related to sex, age, exercise, job, cigarette smoking, alcohol consumption were obtained by self-administered Questionnaire. Obesity index was calculated by the percentage of standard body weight. And VO2max were obtained by submaximal bicycle ergometer test. High level exercise group was defined as the persons who had taken exercise more than 3 times a week and 20 minutes per session, and moderate exercise group was defined as the persons who had taken exercise one or two times a week and 20 minutes per session, and sedentary group was defined as the persons who had taken exercise more than 20 minutes less than one time per week. RESULTS: The subjects were 230 males(56%), total numbers were 411. The results were as follows. Compaired to women and nonexercise group, men and exercise group had high VO2max(p<0.005). The relationship between VO2max and age showed negative, and the VO2max of obese group(obesity index>_120) was greater than that of nonobese group. Any significant relationships between VO2max and job, disease were not found. In multiple regression analysis, significant relationships between VO2max and age, sex, exercise type, and obesity index were observed(p<0.01). CONCLUSIONS: We concluded that there were significant relationships between VO2max and obesity index, exercise group.
Alcohol Drinking ; Body Weight ; Female ; Health Promotion ; Humans ; Male ; Obesity ; Physical Fitness* ; Seoul ; Smoking ; Surveys and Questionnaires

No abstract available.
Child* ; Humans ; Humerus*