STUDY DESIGN: This study assessed the final functional results after treatment of thoracolumbar burst fractures and compared the relationship between the results and the parameters of reduction and state of the fractures. OBJECTIVES: To define prognostic factors affecting the final results and to present some precautions to minimize the treatment failure. SUMMARY OF LITERATURE REVIEW: In the treatment of the thoracolumbar burst fractures in which flexion loads are predominant, the sagittal contour is crucial to achieve permanent pain-free stability, but definitive therapeutic guidelines have remained a controversal topic. MATERIALS AND METHODS: We reviewed 37 thoracolumbar burst fractures with an average follow up period of 1.8 years: group 1 consisting of 20 cases treated conservatively and group 2 consisting of 17 cases treated surgically with posterior instrumentation. Finally functional results were analysed with the Denis'pain and work scores, and were compared between groups on anterior body height and local kyphosis. RESULTS: A satisfactory pain score less than or equal to P3 was in 15(75%) in group 1 and 15(88.2%) in group 2(p>0.05), but satisfactory work score less than or equal to W3 was in 12(60%) in group 1 and in 14(82.4%) in group 2(p<0.05). But, some loss of body height and local kyphosis in group 1 was not reversely related with functional outcomes. Eight cases in group 1 showing unsatisfactory result in work scores were analyzed as 4 osteoporosis(Jikei grade I, II/III), 3 associated compression fracture of the contiguous vertebra and one combined osteoporosis and compression fracture, showing significant loss of vertebral height and increase of kyphosis(p<0.01). CONCLUSIONS: Functional results of group 1 showing loss of vertebral height less than 50% and increased kyphosis less than 200 were comparable to those of group 2. The osteoporosis and associated compression fracture of adjacent vertebra were the risk group to develop posttraumatic kyphosis and might be added to the surgical indication of the thoracolumbar burst fractures.
Body Height ; Follow-Up Studies ; Fractures, Compression ; Kyphosis ; Osteoporosis ; Spine ; Treatment Failure

Open tibial pilon fractures present extensive soft tissue disruption and common complications such as sepsis or skin slough, and deserve special cosideration in addition to the challenging reconstructive problems. The purpose of this study is to assess the effectiveness of limited internal fixation and external fixation for the treatment of the open tibial pilon fractures, and to introduce some idea in Ilizarov device use. We reviewed 27 open tibial pilon fractures treated with limited internal fixation and external fixation from Feb. 1992 to Mar. 1996(follow-up range, 1 to 5 years). Fracture classification(Ruedi and Allgower) was type I in 5, type II in 10 and type III in 12, open wound type(Gustilo-Anderson) was II in 8, IIIA in 17 and IIIB in two. Secondary procedures were 16 soft tissue procedures, 13 bone graftings and 2 limb lengthening. Mean time for removal of the external fixators was 3.5 months(range, 6 to 21 weeks), and clinical union averaged 4.3 months(range, 12 to 25 weeks). At the time of last follow-up, radiologic grading(Burwell and Charnley) showed 13 good(48%), 10 fair(37%) and 4 poor results(15%). Objective functional grading(Ovadia and Beals) showed 5 excellent(19%), 15 good(56%), 6 fair(22%) and 1 poor(4%), and subjective grading 2 excellent(7%), 16 good(59%), 7 fair(26%) and 2 poor(7%). Common complications included 10 wound sepsis(37%), 6 posttraumatic arthritis(22%) and 5 malunions(19%). In conclusion, we cosider limited internal fixation and external fixation is an effective treatment modality till bone union for open tibial pilon fractures, and Ilizarov method using tension wires crossed only through the fracture fragments can provide a sufficient early and late stability.
External Fixators ; Extremities ; Follow-Up Studies ; Ilizarov Technique ; Sepsis ; Skin ; Tibia ; Transplants ; Wounds and Injuries

No abstract available in English.
Talus

Tarsometatarsal injury has not been paid much attention due to it is unusual frequency. But the cases of tarsometatarsal injuries are on the increase in proportion to the increasing "high energy trauma injury" resulted from the traffic and industrial accidents. The purpose of this study is both assessing the relative effects among clinical results, final radiologic findings, treatment results and symtoms. In view of the results so far achieved from 20 cases of tarsometatarsal fracture dislocation which had been treated at Sung-Ae general hospital from January 1990 to December 1993, the results were as follows: 1. Thirteen cases were treated by open reduction and 3 cases were treated by closed reduction with smooth pins but no reduction loss were experienced. 2. Traumatic arthrosis could be observed in 14 cases but there were no influences on the functional end results. 3. Anatomical results correlated with pain. 4. Anatomical or neraly anatomical reduction was considered as most important factor of prognosis.
Accidents, Occupational ; Dislocations ; Hospitals, General ; Prognosis

Due to the instability of intertrochanteric fractures in elderly patients, various methods of reduction and fixation were introduced to obtain stable reduction and solid union, But there have been many controversies regarding advantages between anatomical reduction group and non-anatomical reduction group. The authors analyzed the 68 unstable intertrochanteric fractures out of total 94 cases of intertrochanteric fractures treated from Jan. 1988 to Jan. 1994 with mean follow-up 17 months and evaluated the radiologic and clinical results between those two groups. The results were obtained as follows: 1. The most common cause was low energy injury and according to the Tronzo classification, the type III was most common in 54 cases (79.4%). 2. The average union time was 14.0wks (84%), the union rate was low in the medialized reduction group(A-P) and anterior displaced reduction group(A-P), anterior displaced and anatomical reduction groups(Lateral). 3. The compression length more than 10mm of lag screw was deep in medialized reduction group(A-P), another displaced and anatomical reduction groups(Lateral). 4. The average length of lag screw sliding was 9.2mm and depth sliding of 6.8mm (74%) was occurred within immediate postoperative 1 month.
Aged ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans

Fractures involving both tibial plataeus result form high energy trauma such as a traffic accidents or falls, and it is frequently accompanied by soft tissue injuries. Thus it is very difficult to treat these fractures satisfactorily and severe complications can be caused. The purpose of study is to analyze the clinical results, complication and factors influencing the results after open reduction and internal fixation of tibial bicondylar fractures. Twenty cases(19 patients) of tibial bicondylar fractures which had been treated by open reduction and internal fixation from January 1989 to December 1994 were analyzed after 1 to 5 years follow-up. The results were as follows. 1. By AO classification, the most common type was C3(13 cases). 2. According to Blokker's criteria, 5 cases was unsatisfactory and all of these cases were C3. 3. Unsatisfactory results were 3 cases of reduction loss(angular deformity), one case of deep infection and one case of unresolved peroneal nerve palsy. 4. Tibial tubercle osteotomy, bone graft and medial buttress plate were important for anatomical reduction and maintenance.
Accidental Falls ; Accidents, Traffic ; Classification ; Follow-Up Studies ; Osteotomy ; Paralysis ; Peroneal Nerve ; Soft Tissue Injuries ; Tibia ; Transplants

Congenital fibrosarcoma of neonate is a very rare malignant tumor prone to behave aggressively with a tendency to local recurrence without metastasis. It is characteristically composed of collagenous fibroblasts and herringbone pattern in histology. We experienced a case of congenital fibrosarcoma on the left thigh and report this case with some review in literature with 1½ year follow up.
Collagen ; Fibroblasts ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Infant, Newborn ; Neoplasm Metastasis ; Recurrence ; Thigh

PURPOSE: To analyze the effect of the growth control on human breast cancer cells with genistein treatment and to investigate the mechanism of genistein-induced G2/M arrest in T47D and MDA-MB231 breast carcinoma cells by Cdc25C expression. METHODS: We analysed the proliferartion of the two cell lines by using MTT proliferation assay, flow cytometric analysis, real-time quantitative RT-PCR and western blotting and investigated the effect of genistein on cell survival, cellular toxicity, cell cycle progression-related genes and their mRNA and protein alterations. RESULTS: The DNA flow cytometric analysis of both cell lines treated with genistein showed a dose-dependent growth inhibition and accumulation in the G2/M phase of cell cycle. The expression of p21 mRNA and protein increased in both cell lines following genistein treatment but p27 expression was unchanged. Furthermore, decreased Cdc25C expression with decreased polo-like kinase (PLK) 1 expression and increased PLK3 expression were observed after genistein treatment. The decreased level of Cdc25C in the nucleus was associated with decreased phosphorylation of Cdc25C by PLK1. The expression of PLK3 was increased with a dose-dependent and a time-dependent manner and was associated with decreased Cdc25C expression. Check point kinase (CHK) 1 and CHK2 revealed different expression patterns each other. The CHK1 expression was independent of the presence of genestein. CHK2 expression increased in MDA-MB231 cells associated with decreased Cdc25C expression but not in T47D. CONCLUSION: These results suggest that genistein induces a G2/M arrest in human breast cancer cells, the mechanism of which is due, in part, to decreased in Cdc25C phosphatase by a regulatory effect of PLK1, PLK3, and CHK2 as well as increased expression of the cyclin dependent kinase inhibitor p21(WAF1/CIP1).
Blotting, Western ; Breast ; Breast Neoplasms ; cdc25 Phosphatases ; Cell Cycle ; Cell Line ; Cell Survival ; Cyclins ; DNA ; Genistein ; Humans ; Phosphorylation ; Phosphotransferases ; RNA, Messenger

A basal cell carcinoma developed in the forehead of a 57-year-old man at the scar site from a blunt trauma that happened 10 months previously. The patient had never been noted to have premalignant or other malignant skin lesions. The significance of injury in the etiology of basal cell carcinoma is discussed.
Carcinoma, Basal Cell* ; Cicatrix* ; Forehead ; Humans ; Middle Aged ; Skin

Displaced fracture of the ankle are probably the most common skeletal injury managed today by open reduction and internal fixation. But, it is recommended that metallic implant might be removed to restore normal biomechanical forces on hone and to reduce discomfort directly under the skin. in order to reduce the resources needed for the removal of metallic fixation devices, absorbable impiants of biodegradable synthetic polymers were deveioped. However reports of clinical application of such implants have so far been very few. This prospective study represents the good resuits in 15 displaced non-comminuted closed malleolar fractures of the ankle treated using hiodegradahle internal fixation in department of orthopedic surgery of Kwang Myung Sung Ae general hospitai from June I 995 to December 1996. The results were as follows 1. All cases were united and the average time for union was 7.6 weeks. 2. As a results of comparison with normal side, a restriction of 10 degrees or more of dorsiflexion of the ankle joint was present in 4 cases, a restriction of 20 degrees or more of plantar tlexion was present in 2 cases, a restriction of supination was present in 3 cases and a restriction of plantar flexion was present in 4 cases. 3. According to Phillips functional scoring scale, 4 cases were excellent, 7 cases good, 4 cases fair and no cases were poor. 4. There were no complications in all cases.
Ankle ; Ankle Joint ; Orthopedics ; Polymers ; Prospective Studies ; Skin ; Supination