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

Extraosseous tuberculosis of the extremities is relatively rare even in the wide spread incidence of bone and joint tuberculosis. And few reports about extraosseous tuberculosis of the extremities have been published in the literatures. Eight cases of the extraosseous tuberculosis of the extremities were experienced at the Department of Orthopaedic Surgery, National Medical Center, from 1975 to Sep. 1979. Five out of 8 extraosseous tuberculosis were tenosynovitis and the others were bursitis in location. All cases were surgically excised and combined with antituberculous chemotherapy, and primarily cured.
Bursitis ; Drug Therapy ; Extremities ; Incidence ; Tenosynovitis ; Tuberculosis ; Tuberculosis, Osteoarticular

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

An erectiometer for the measurement of sleep erections is described. Clinical data using the erectiometer indicates that it processes a significant potential for valid measurement of the circumfernetial increase that may occur during sleep. Because of its reliability, simplicity, reproducible data and low cost the erectiometer is proposed as a screening procedure or as a diagnostic alternative when sleep laboratory facilities are not feasible practically.
Mass Screening

Neurilemmoma is a neoplasm arising from Schwann cells. It is usually solitary and may be benign or malignant, solid or cystic, encapsulated or diffuse. It rarely occurs in the retroperitoneum. We report one case of retroperitoneal neurilemmoma with review of the literatures.
Neurilemmoma* ; Schwann Cells

A giant hydronephrosis caused by ureteropelvic junction stricture in a 16-month-old male infant was presented. After the size and volume of giant hydronephrosis were estimated by retrograde pyelography, nephrectomy was performed. We report this case with review of literatures.
Constriction, Pathologic ; Humans ; Hydronephrosis* ; Infant ; Male ; Nephrectomy ; Urography

The Halo-pelvic traction has been considered as a powerful and strong method for correction of the severely deformed rigid spine whether it is kyphotic or scoliotic. It also affords firm stabilization during the operation and postoperative management with immobilization for a long time. Ambulation with this instrument enhances the usefulness. We have succeeded in treating and correcting 6 cases of Tuberculous Kyphosis, and 3 of which accompanied paraplegia. Especially one case of severe kyphosis, 78 was corrected to 20 and anterior strut graft was accomplished with vascuiarized free fibular graft with aid of microvascular technique. The correction rate was 38% in average. No significant complications have developed except osteoporosis of the spine.
Congenital Abnormalities ; Immobilization ; Kyphosis ; Methods ; Osteoporosis ; Paraplegia ; Spine ; Spondylitis ; Traction ; Transplants ; Walking

The displaced femoral neck fracture continues to be a difficult problems such as high percentage of avascular necrosis and non-union. Compression hip screw was designed to aliow firm impaction at the time of operation and secondarily, for continued impaction if resorption occurs at the fracture line during healing. 22 cases of femoral neck fracture treated by compression hip screw in the department of orthopaedic surgery at National Medical Center were analyzed, and results were as follow. 1. The average of patient was fifty-three years, and man was predominant. 2. Average 8.9 days was elapsed from initial injury to hospital, and good results were observed in the cases of operation within 3 days. 3. The end results were good when the fragment was reduced within 165°–180° of Garden's angle in A-P film and 20° of anterior and posterior angulation in lateral film. 4. The good results were observed in the position of the screw center and low in A-P film, and center and posterior in lateral film. 5. The positive findings of the intraosseous-venogram was observed in 6 weeks from operation and apparent in all cases done after 6 months. 6. Bony union was obtained within 5.9 months, and avascular necrosis was established in 29 months. 7. Developed 3 avascular necrosis, 1 non-union, and 2 degenerative arthritis of 22 cases.
Femoral Neck Fractures ; Femur ; Hip ; Humans ; Neck ; Necrosis ; Osteoarthritis

The non-surgical treatment for the fresh humeral shaft fracture would appeared to be not sufficient in respect of immobilization and maintenance of the contact surface of the fracture ends, which have had stimulated surgeons to perform internal fixation. This might be one of the reasons to produce non-union of humeral shaft fracture, supplemented by increasing incidence of fractures due to car and machinary accident. Authors have experienced 18 cases of non-union of humeral shaft fracture and accomplished solid union in all cases by osteosynthesis accompanied by autogenous bone graft. In detail: 1. Non-union was prevalent in the agr group of 20 to 40 and mostly in male. Site of non-union was found mostly at the lower 2/3. 2. The cause of the fracture was mainly due to the car and machinary accident. Initial treatments were surgical in 14 out of 18 cases, and 12 cases of this surgically treated group were treated within 2 days after the injury. 3. On retrospective analysis of medical records and X-ray films, probable cause of the non-union were supposed to be too early performed inadequate internal fixation and post-operative infection in the operated cases, whereas distraction of fracture ends due to poor external fixation and infection in the cases treated conservatively. 4. 16 cases of established non-union were treated by authors with rigid internal fixation and additional bone graft, and 1 case with bone graft only. 5. Authors have utilized shoulder spica or long arm cast post-operatively for 1 to 4 months. 6. Union was obtained in all cases. Developed transient radial nerve palsy in 4 cases; and neighbouring joints contracture in 2 cases, which required considerable time of physical therapy.
Arm ; Contracture ; Humans ; Immobilization ; Incidence ; Joints ; Male ; Medical Records ; Paralysis ; Radial Nerve ; Retrospective Studies ; Shoulder ; Surgeons ; Transplants ; X-Ray Film