Historically, cerclage has gained a bad reputation because of the early unfavorable results with the Parham band and subsequent further poor results with wire cerclage. The treatment and management of elderly patients with fractures through osteoporotic bone is fraught with difficulties. The standard methods of internal fixation are not always satisfactory as metal plates and screws and intramedullary nailing do not hold well in osteoporotic bone. To overcome this problem, a system of straps and plates has been devised. We experienced 3 cases of femoral fractures using nylon cerclage system, such as the segmental fracture, oblique fracture in osteoporotic patient and the fracture below a hip prostesis. The end-result was satisfactory.
Aged ; Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Nylons

It was reported that many adverse effects occurred to the growth areas of the adolescent player due to repititous strain. The injuries mainly involved in the shoulder and elbow, and named as little leaguers Shoulder and Little Leaguers: Elbow in boy baseball player. But the stress fracture of olecranon epiphyseal plate was rare and reported in a few cases. We reported a case observed in an adolescent Judo Player.
Adolescent ; Baseball ; Elbow ; Fractures, Stress ; Growth Plate ; Humans ; Male ; Martial Arts ; Olecranon Process ; Shoulder

There are many controversies in ability of articular cartilage to heal full thickness defect. Generally, it is reported that full thickness defects of articular cartilage filled with organizing hematoma and granulation tissues, which converted to chondroid tissues. It is clear that the size of defect was related to the repair of articular cartilage. Though cartilagenous material fills the defect and restores the surface continuity, it may undergo degeneration, and lead to localized focus of osteoarthritis. Multiple drilling through subchondral bone could be a kind of treatment in articular cartilage defect. Author conducted an experiment for the full thickness defect of articular cartilage in rabbit. After multiple drilling of articular cartilage, the repair of defect was examined histologically until eighth week. Results were as followings ; l. At lst. week, the defect was repaired by fibrovascular proliferation and granulation tissue. 2. At 3rd. week, hyaline cartilage consisted of normal chondrocyte was formed. 3. At 8th. week, subchondral plste was regenerated completely. 4. All defects that were less than 3 mm. in diameter were healed. More repairs were observed in case with the wider defects if the defects were within 3mm. in diameter. 5. The metachromasia was observed with toluidine blue stain. The reformed cartilage shows slight purple(Grade II) to moderate purple(Grade III) at third week and near normal (Grade IV) at fourth week. In conclusion, multiple drilling may be an effective method of treatment in articular cartilage defect. It is considered that multiple drilling with a 3mm. Steinmann pin may be the most convenient and effective method of the cartilage healing.
Cartilage ; Cartilage, Articular ; Chondrocytes ; Granulation Tissue ; Hematoma ; Hyaline Cartilage ; Methods ; Osteoarthritis ; Regeneration ; Tolonium Chloride

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

No abstract available.
Knee* ; Passive Cutaneous Anaphylaxis*

As the number of primary total knee arthroplasties (TKA) have increased, there has been a corresponding increase in the number of revision TKAs. The purpose of the this study is to report on the follow-up results of 50 revision TKAs, and to assess their clinical outcome. From January 1990 to December 1995, 50 revision TKAs were perfomed in 43 patients, by one surgeon. Mean follow up time was 2.5 years (range, 1 to 6 years). The mean interval from the initial arthroplasty to revision was 4.6 years (range, 3 months-12.6 years). The causes of the revision were wear of polyethylene in 29 joints (58%), infection in seven (14%) and aseptic loosening in six. The revision components were fixed with cement in all cases. Additional fixations were obtained with modular stems (femoral 11 cases, tibial 13 cases), 9 tibial metal wedges, 7 femoral augmentations, and 12 allografts. The Knee Rating Scale of Hospital for Special Surgery was used for clinical assessment. The mean flexion contracture and further flexion of knee joint were 8.8degrees (range, 0-70degrees), 98.5degrees (range, 5-135degrees) preoperatively, and 3.7degrees (range, 0-15degrees), 112degrees (range, 75-135degrees) postoperatively. The Knee Rating Scale improved from 66.5 points (range, 15-83) to 87.5 points (range, 79-98). There were two cases of complications, dislocation of patella and superficial wound problem in each case. In conclusion, wear was the most common cause of failure of primary TKA. The results of revision in infected TKA were less favorable than that of wear and loosening. The prosthetic design and thickness of polyethylene were the most important factors related to wear. The tibial component of PCA and patellar component of Miller-Galante had significant wear problems.
Allografts ; Arthroplasty* ; Contracture ; Dislocations ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee* ; Passive Cutaneous Anaphylaxis ; Patella ; Polyethylene ; Wounds and Injuries

No abstract available in English.
Knee Prosthesis ; Knee

Fractures of the femur and tibia on the same leg encountered with forceful trauma. In these fractures, the treatment was difficult and the functional result was poor in most cases. Authors treated 22 fractures of femur and tibia on the same leg and analysed it. And the results were as follows. 1. The most common location of fractures was mid-third in both femur and tibia. 2. The shape of fractures was transverse or comminuted in most cases in femur and tibia. 3. Among the method of treatment of femoral fractures, the results were better in intramedullary-nailing group than plate and screw fixation group. There were three poor results in intramedullary-nailing group. These were attributed to the severity of combined tibial fractures. 4. Among the method of treatment of tibial fractures, the results were better in external fixation group which minimized the soft tissue injury than plate and screw fixation group. 5. According to the criteria of Karlstrom and Olerud, the final results were relatively good in 54% of cases. For the better results, it seemed to be needed initial careful planning and attention for the treatment.
Femoral Fractures ; Femur ; Leg ; Methods ; Soft Tissue Injuries ; Tibia ; Tibial Fractures

BACKGROUND AND OBJECTIVES: There is little clinical data on the results of using Sirolimus-Eluting Stent (SES) for treating In-Stent Restenosis (ISR). We performed this study to evaluate the clinical outcomes for implanting SES for treating ISR in a real world hospital environment. SUBJECTS AND METHODS: A total of 30 patients with 32 ISRs (males: 73.3%, mean age: 60.2) (focal lesions: 21.9%, diffuse intra-stent lesions: 34.4%, proliferative lesions: 21.9%, total occlusions: 21.9%) were treated with SES after balloon predilation was performed. We evaluated the clinical results and the performed coronary angiography after 6 months. RESULTS: All the procedures were successful. The mean SES diameter and length were 3.0+/-0.3 mm and 27.1+/-5.5 mm, respectively, and the mean acute gain was 2.42+/-0.38 mm. No in-hospital major adverse cardiac events (MACE) were observed. Twenty five patients with 27 lesions (84.4%) underwent coronary angiography at their 6 month follow-up. The late loss and loss index were 0.41+/-0.56 mm and 0.18+/-0.22, respectively. The binary restenosis rate was 7.4% (2/27 lesions). The rate of target lesion revascularization was 3.7% (1/27 lesion). The incidence of MACE at 6 months was 3.3% (1/30 patient). CONCLUSION: Treating ISR with SES is a safe and effective procedure for reducing ISR without the occurrence of acute or sub-acute thrombosis.
Coronary Angiography* ; Coronary Artery Disease ; Coronary Restenosis ; Follow-Up Studies ; Humans ; Incidence ; Stents* ; Thrombosis

This study was conducted to assess the prognostic value of tumor angiogenesis and Cathepsin-D in breast carcinoma, by correlating them with other clinicopathologic prognostic factors. In order to estimate microvessels within the tumor, an immunohistochemical method using monoclonal antibodies for factor VIII-related antigens (DAKO-vWf, F8/86) was used, and they were counted (perx200 field) in the most active areas of neovascularization. For the expression of Cathepsin-D, an immunohistochemical method using monoclonal antibodies (Novocastra, NCL-CDm) was performed. The microvessel count ranged from 8 to 346 per x200 field and the mean (+/-SD) was 72.46+/-54.96. The microvessel count was correlated with the estrogen receptor status, and it was also correlated with the tumor size when it was graded into four groups (1-33, 34-67, 68-100, >100), but was not correlated with other clinicopathologic parameters. Cathepsin-D was expressed in 40% (46/115) of the cases, but it was statistically correlated with the tumor size only. In conclusion, the expression of Cathepsin D and the degree of angiogenesis in breast cancer showed a correlation with the tumor size only. Therefore, they do not appear to be good prognostic parameters, according to the present study.
Antibodies, Monoclonal ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cathepsin D ; Estrogens ; Microvessels ; Prognosis ; von Willebrand Factor