Intramedullary rodding has been the treatment of choice for long bone shaft fracture when operative fixation is necessary. The present technology on rodding has been the use of a single, rigid intramedullary rod. However, an undesirable consequence of the use of such a rigid rodding is the post-union osteopenia along the rod, which is believed to be secondary to the over-protection of the surrounding bone from normal stresses, the so called “stress bypass effect”. Another disadvantage of the rodding procedure is interruption of intramedullary vascularity by reaming which may contribute to non-union. To evalvate these parameters, experiments were performed on mature dogs, using flexible multiple rods which can be inserted without reaming. The fracture healing was studied biomechanically by measuring the nondestructive bending and torsion stiffness, maximum torque and energy absorption to failure. Using two expermental dogs a zero time test of the osteotomized femur in which one bone was fixed with multiple rods and the contralateral bone fixed with a Kiintscher rod, showed that the bending stiffness was higher in the Kuntscher rod than in the multiple rods fixed bone. This fact means the flexible multiple rods fixation gives more elastic fixation than Kiintscher rod. The bending and torsion stiffness of the femur as expressed by repair per control percentage showed the multiple rods were significantly higher than Kuntscher rod at 6 weeks study but not in 9 weeks study. In the six month study, the repaired femur of the multiple-rods had significantly high bending and torsion stiff-ness, maximum torque and energy. Through these results, it was found that there was some advantage to the multiple rods in terms of early fracture healing at the 6 weeks study but no significant difference between two rod systems at the 9 weeks study. And there was significant advantage in the late remodelling phase of fracture healing in flexible rod.
Absorption ; Animals ; Bone Diseases, Metabolic ; Dogs ; Femur ; Fracture Healing ; Torque

Kyphosis and scoliosis develops from various causes, Tuberculosis is the main cause of kyphosis and spinal deformity in Korea. Such spinal deformities are frequently accompanied by cardiac and respiratory changes. In 1969, Westgate and Moe reported that, when a kyphoscoliotic patient dies, he dies because of cardio-respiratory failure and not because of skeletal abnormality, and, in 1968, Nilsonne and Lundgren reported that the mortality in patients with severe spinal deformity was twice as high as in normal persons, and that heart or lung disease was the main cause of death. One must consider the cardiopulmonary status when treating patients with severe spinal deformities. While there are numerous reports on pulmonary dysfunction due to scoliosis or kyphoscoliosis, studies on pulmonary function of patients with tuberculous kyphosis are surprisingly few. The authors investigated the correlation of the degrees of curvature and pulmonary function on 17 cases of adults with tuberculous kyphosis and compared the results with those of the children reported in 1972 by Moon and Lee. The results of this study are as follows: 1. The over-all mean degree of kyphosis was 92.6 (Salters angle). Vital capacity was 63.1% and maximum breathing capacity 61.7% of the predicted normal value. 2. Vital capacity showed a negative correlation with the degree of kyphotic curvature; i. e. the greater the spinal curvature, the less the vital capacity and vice versa, R=0.45, P=<0.1, but there was no correlation between maximum breathing capacity and the degree of curvature. 3. Vital capacity showed a relatively significant positive correlation with maximum breathing capacity as kyphosis increased. 4. The over-all mean tidal volume increased 9.3% of the normal predicted value. 5. When comparing with the pulmonary function of the children with same level and same degree of kyphosis, the adults had significant decrease in vital capacity and maximum breathing capacity, but had increased tidal volume. Such disparity was more prominent in the thoracic spine than in the lumbar spine and when the kyphotic curvature was greater than when less. 6. Timed vital capacity was within normal limits in spite of kyphotic changes of the spine.
Adult ; Cause of Death ; Child ; Congenital Abnormalities ; Forced Expiratory Volume ; Heart ; Humans ; Korea ; Kyphosis ; Lung Diseases ; Moon ; Mortality ; Reference Values ; Respiration ; Scoliosis ; Spinal Curvatures ; Spine ; Tidal Volume ; Tuberculosis ; Vital Capacity

No abstract in English.
Congenital Abnormalities ; Tibia

Tuberculosis of the spine is still prevalent in many parts of the world and still remains as an important orthopaedic problem in Korea. Moreover, spinal tuberculosis is the most common and dangerous form of skeletal tuberculosis. With the availability of very effective antituberculous drugs two divergent controversy in the management of tuberculosis of the spine have been reported. A large group of surgeons has advocated the radical excision of the tuberculous focus and replacement of the defect with autogenous bone grafts under cover of chemo-therapy, and another practise is typified by regimen of Friedman, Konstam, Kaplan, and Stevenson and Manning, who treated a large number of patients with spinal tuberculosis using antiuberculous drugs alone. Even now, because of the shortage of hospital beds and ancillary help, private poor economy and patients general condition, some group of patient with tuberclous spine have been treated conservatively using effective antituberculous drugs. In this study authors clinically analysed the 75 patients who had conservative treatment with triple drug therapy for 18 months at the department of Orthopaedics, Catholic Medical College and Center during the past 10 years, and the results were as follows: 1. There were two prevalent age groups. One is the first decade (30.6%) and the other is the third decade(30.7%). The age prevalence in children was 6 to 10 years of age. 2. The lesions were common in the lumbar spine(56.0%) and the most commonly involved vertebra was L3. The average initial number of involved vertebral body was 1.9 vertebrae and it was changed to 2.3 vertebrae at the end of treatment(18 months). 3. Active pulmonary foci was associated in 17.4%(6.7% of tuberculous pleurisy included). 4. Out of 75 cases twenty-six(34.7%) had new involvement at the adjacent vertebra within 18 months after treatment. 5. The radiographic activity was assessed as active in all cases initially, but at 18 months after treatment 83% of the cases were in quiescent condition, and this percentage was increased to 78.7% at 36 months. 6. Spontaneous fusion rate of involved vertebral bodies was 24% at 18 months and 36% at 36 months after treatment, respectively. 7. Radiologically observed deep seated abscess shadow disappeared slowly over 3 to 20 months, but this disappearance was observed mainly within 8 months after treatment. 8. Mean increment of the kyphosis was average 7.5 degree (9.3° in children and 6.6° in adults) at the end of the treatment(18 months), and average 8.6 degree(10.9° in children and 7.3° in adults) at 36 months, by. internal gibbus angle. 9. Almost in all the adult patients, kyphosis developed during the active phase of the disease, while in children kyphosis progressed even after the healing of the disease. Children who had multiple vertebral involvement at the dorsal area had a tendency to develop more severe kyphosis. 10. Decrement of the kyphosis angle which located at the lumbar area after the end of the treatment was considered to be an effect of narmal lordotic curvature. 11. Generally representation of the changes seen in children was almost osteolytic change without sequestrum in comparison to adults who had more sequestrum formation. 12. In 95% of cases a favourable results were obtained.
Abscess ; Adult ; Child ; Drug Therapy ; Humans ; Korea ; Kyphosis ; Prevalence ; Spine ; Surgeons ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Spinal

Tibial plateau fractures are a common injury which often produce major disability. The extent of actural damage is always greater than that suggested by X-ray, a situation which, if not appreciated, can easily lead to a complacent surgical attitude. Although recent studies suggest that early knee motion and perhaps better surgical technique have improved clinical end-results, still recent series show unaccepatble results in 20-40 percent of cases. The authors analyzed the 37 cases of the tibial plateau fractures treated at the Department of Orthopaedics, Catholic University Medical College, Kang-Nam St. Mary's Hospital and following results were obtained. 1. The highest incidence was in the 5th decade and the next was 4th, and most frequent cases of trauma was pedestrian car accident(83%). 2. The most common fracture type was type VI by Schatzker classification and next was type II. 3. Among 37 cases, 27 were treated by open reduction and internal fixation and 14 out of those 27 cases meeded bone graft for the elevation of the tibial articular surface. 4. According to Blokker's criteria(1984), 32(86.6%) out of 37 cases had satisfactory result. Among 5 cases of unsatisfactory results 3 cases developed varus tilting of the tibial plateau more than 10 during the early stage (6–12 weeks post operation) of follow-up and those 3 were Schatzker's type VI fracture. 5. It is thought that open anatomical reduction of articular surface bone graft, internal fixation and early joint motion are the best way for the treatment of depressed or displaced fracture. 6. It is found tha Schatzker's type VI fracture has a tendency to develop varus tilting through the proximal tibial fracture before it unites completely.
Classification ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Tibial Fractures ; Transplants

It has been known that osseous stability of the hip is dependent upon the inclination, anteversion and depth of acetabulum and also upon neck-shaft angle and anteversion of femur. Acetabulum enlarges from two different growth centers; one from the concave articular surface cartilage and the other from the triradiate cartilage. The former contributes primarily to the thickness of acetabular wall, where as, the latter to the central enlargement of the acetabular socket. Additionally the shape of acetabulum can be changed by deformity of the femoral head and neck, which can be explained by Wolff's and Hueter-Volkmann's laws. Yet there are still many factors to be clarified by clinical researchers in the future Authors in this experiment tried to clarify the role of triradiate cartilage and greater trochanteric growth plate upon the development of acetabulum. The material used for this study consiated of 30 rabbits of both sexes, aged 8 weeks. Animals were divided into 3 groups, and each group consisted of 10 rabbits In group I. hip was not injured and used as a Control: in group II, right greater trochanter with its growth plate was destructed completely; in group III, triradiate cartilage of right side was destructed. Subsequent to injury of Y cartilage ot greater trochanter with its growth plate, radiographs of the pelvis including hips were obtained weekly on each rabbit over 6 weeks period. and to evaluate the effect of injury upon the hip development acetatular angle, C-E angle, and acetabular depth and width were measured. The following results were obtained; 1. The shape of acetabulum of rabbits have showe remarable developmental changes until the 10 weeks of age after birth, but the changes became less remarkable by age of the 14 weeks. Thereafter it remained unchanged. 2. In group II, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle showed an increase of 1.9 degrees, and the center dege angle and acetabular depth showed a decrease of 3.21 degrees and 0.43mm respectirely. 3. In group III, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle increased by 18.9 degress while the center-edge angle decreased by 22.8 degrees. The acetabular depth showed a decrease of 1.81mm and the acetabular width showed an increase of 0.73mm. These observations suggest that the development of acetabulum depends largely upon the growth of triradiate cartilage, and also is affected secondarily by valgalization of femoral neck which is resulted by destruction of greater trochanteric growth cartilage.
Acetabulum ; Animals ; Cartilage ; Congenital Abnormalities ; Femur Neck ; Femur ; Growth Plate ; Head ; Hip ; Jurisprudence ; Neck ; Parturition ; Pelvis ; Rabbits

No abstract available.
Dislocations ; Spine

No abstract available in English.
Orthopedics ; Suction ; Wounds and Injuries

The intra-articular osteochondroma arising from soft tissue is very rare and has been reported less than a dozen cases in the English literature. This tumor is the result of extrasynovial metaplasia of the fibrous capsule or of the adjacent connective tissue of a joint. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 37 year-old man which arised from the medial meniscus. Histology as well as gross findings were consistent with osteochondroma. Excision of the mass with attached meniscus relieved symptoms. No recurrence, or malignant change was identified up to 1 year after excision.
Connective Tissue ; Joints ; Knee ; Menisci, Tibial ; Metaplasia ; Osteochondroma ; Recurrence

Rickets is a syndrome, characterized pathophysiologically by a failure of normal mineralization of bone and epiphyseal cartilage and clinically by skeletal deformity in growing children. The five principal causes of rickets are vitamin D deficiency, absorptive defects, renal tubular insufficiency, chronic renal insufficiency and hypophosphatasia. In addition to these causes of rickets a defective reabsorption mechanism of the proximal renal tubule is currently believed to be a factor in the development of hypophosphatemic vitamine D resistant rickets. Simple type of hypophosphatemic vitamine D resistant rickets is the most common of all the cases of rickets due to tubular insufficiency. It has a familiar incidence and is a sex-linked dominant disease. There is hypophos-phatemia and an elevated alkaline phosphatase but usually no glomerular disease or uremia. All the clinical manifestations are those of advanced rickets of the ordinary type and usually begin early. We experienced four cases of hypophosphatemic vitamine D resistant rickets which developed in a family.
Alkaline Phosphatase ; Child ; Congenital Abnormalities ; Growth Plate ; Humans ; Hypophosphatasia ; Incidence ; Kidney Tubules, Proximal ; Miners ; Renal Insufficiency, Chronic ; Rickets ; Uremia ; Vitamin D Deficiency ; Vitamins