The growth plate is responsible for longitudinal bone growth and is involved in 6–15% of children's fracture. Of these injuries, 25–35% have been reported to result in some shortening or deformity, but in only 10% are the deformities sufficiently severe to lead to functional problems. The problem of repair of a demaged growth plate in children has never been adequately solved. The purpose of this study is to clarify that allograft of cultured chondrocytes can survive in the growth plate defect and can prevent the angular deformity by avoiding the formation of bone bridge. The chondrocytes were obtained from the rib cartilage of rabbit weighing 500g. The chondrocytes were cultured by socalled micromass culture method. The rabbits were divided two groups; the group I in which medial proximal tibial growth plate was destroyed, and the group II in which the cultured chondrocytes were transplanted into the right medial proximal tibial physeal defect. Each group has 10 rabbits. The tibial growth was observed grossly, radiologically and histologically until 16 weeks after graft. The angular deformity was observed from 3 weeks after operation and histologically the fusion of growth plate was observed in all of group I. In group II, there were no angular deformity and no fusion of growth plate in 7 out of 10 rabbits. Allografted cultured chondrocytes survived and produced matrix in the physeal defects. Through this study it was inferred that allograft transplantation of cultued chondrocytes in the iatrogenical physeal defect is a useful method to keep the physeal growth without cessation. However, further studies will be necessary to prove that the longitudinal growth potential resides in the transplanted chondrocytes as growth plate cartilage.
Allografts ; Bone Development ; Cartilage ; Child ; Chondrocytes ; Congenital Abnormalities ; Growth Plate ; Humans ; Methods ; Rabbits ; Ribs ; Transplants

No abstract available in English.
Animals ; Dogs ; Spine

The results in thrity-six adolescent idiopathic scoliosis patients(thirty-nine curves) who have been treated with the Boston brace are reported. The average follow-up was two years and three months(range, one year to four years ten months). Before treatment, all the patients had a curve that measured 20 to 35 degrees; 26 patients were in Risser sign of zero or 1, 10 patients in Risser sign 2 to 4. Although the magnitude of the curve was generally reduced about 40 percent by the initial application of the brace, a gradual loss of this initial correction was observed both during active treatment and after the wearing of the brace. Although eleven(28.2 percent) of the curves had progressed more than 5 degrees at follow up. Sixty-seven percent of the thoracic curve, 33.3 percent of the thoracolumbar, 27.8 percent of the lumbar curve had progression of more than 5 degrees. Twelve patients wore the brace for sixteen hours a day, 19 patients wore for 16 to 20 hours a day and 5 patients wore more than 20 hours a day. 41.7 percent of sixteen hours bracing, 15,8 percent of 16 to 20 hours bracing and 60 percent of 20 hours bracing had progression of more than 5 degrees. Our finding indicates that the Boston brace prevents deterioration in certain cases but does not convert major deformity into minor ones, and part time bracing can prevent progression of the curve and can even afford some correction.
Adolescent ; Braces ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Scoliosis

Twenty nine patients who had fracture of tibial shaft were treated with closed Rush nailing and early weight bearing. 1. The average age was 37.8 years (range from 20 to 65), and 21 were men and 8 women. Eighteen cases were open fractures and 11 closed. 2. The time for clinical union was averaging 15.4 weeks. In some cases callus appeared as early as 3 weeks after nailing and in most cases appeared at 8 weeks. 3. Mild angular and rotational deformity of the fractured shaft were developed as complication but did not present any clinical problems. No deep wound infection and pulmonary embolism were encountered. 4. The nails allowed a certain dynamic controlled motion at the fracture site which was probably beneficial to early callus formation. 5. This type of closed nailing method required no medullary reaming, further periosteal stripping and muscle detachment. The allowance of early knee and ankle movements and early weight bearing after surgery could be listed as the advantage.
Ankle ; Bony Callus ; Congenital Abnormalities ; Female ; Fractures, Open ; Humans ; Knee ; Male ; Methods ; Pulmonary Embolism ; Tibia ; Weight-Bearing ; Wound Infection

60 cases of fractures of the femoral shaft were treated at the department of orthpaedic surgry, Pusan National Uriversity Hospital from Junuary, 1967 to August, 1970 The results were as follows; 1) The age group between 20 and 40 years occupied 51.6% in this series, and preponderance of male to female (3:1) was noted. 2) There were 39 cases (65%) being traffic accident, 20 being industrial injury and 1 case (1.7%) being other cause. 3) 30 cases involved the middle one third, 20 cases the lower one third and 10 cases the upper one third of femur shaft. 25 cases (41.6%) were on the left side and 32 cases (53.3%) were on the right side. 4) there were 35 cases of transverse, 25 cases of oblique and 10 cases (16.6%) of communited fractures, and 50 cases (83.3%) of closed fractures. 5) By using the adequate size intra-medullary nail, the complications, which could be resulted by the using the inadequate intra-medullary nail, could be prevented. 6) By using of the heavy intra-medullary nail, the rotation of the nail, could be prevented and so, the knee joint stiffness could be prevented so as to encourage early excercise. 7) By using the heavy intra-medullary nail, the duration of hospitalization could be shortened and the financial burden could be decreased.
Accidents, Traffic ; Adult ; Busan ; Female ; Femur ; Fractures, Closed ; Hospitalization ; Humans ; Knee Joint ; Male

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

Fifty seven consecutive trochanteric hip fracture treated with Smith-Petersen nail and Thornton plate who were treated at the Department of Orthopedic Surgery, St. Marys Hospital Catholic Medical College, during the period of January 1969 to September 1975 were reviewed. This covered a period of six years and nine months. Of the fifty seven cases treated with this method, only thirty four cases were able to be analysed completely. Of these thirty four cases, in two cases the nail penetrated to the hip joint, four cases showed a loosening bolt of the S-P nail, one case involved a delayed union and three cases resulted in malunion, showing a total failure rate of 29.4%. In addition, four cases of intertrochanteric hip fractures of children were reviewed. 1) The sex ratio was 2.1:1 (male to female). Those in their fifth decade showed the highest incidence at 26.3%, next came those in their third decade. 2) The most common cause of the trochanteric hip fractures was traffic accidents (57.9%), other cause were slipping or falling down, direct trauma and pathological fractures. 3) The ratio of left trochanteric hip fractures to right was 7:6. 4) In the group which received external immobilization with Buck's extension skin traction and delayed weight bearing method, the results were better than that group to which external immobilization was not applied and early weight bearing was allowed. 5) The group which received the external immobilization and delayed weight bearing method showed a total failure rate of 21.8% 6) The group to which external immobilization was not applied and early weight bearing was allowed a total failure rate of 64%.
Accidental Falls ; Accidents, Traffic ; Child ; Clinical Study ; Femur ; Fractures, Spontaneous ; Hip ; Hip Fractures ; Hip Joint ; Humans ; Immobilization ; Incidence ; Methods ; Orthopedics ; Sex Ratio ; Skin ; Traction ; Weight-Bearing

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

Methods of treatment of Legg-Calve-Perthes' disease, (L.C.P.D.) are at present generally defined, and the individual approach is now more precise than before. But it is still controversial, particularly in older age groups. We analized the result of intertrochanteric varus osteotomy in 44 hips and innominate osteotomy in 23 hips of L.C.P.D., and compared the former with the later. To find out the influence of the both osteotomies on the femoral head (coxa magna), the relations between the stage and degree of involvement at operation and reult, and the postoperative progression of disease, the cases were analyzed and classified by Elizabethtown's stage and Catterall group. And also the duration of fragmentation stage after osteotomy was observed. Results were as follows: l. At the time of operation 45 hips were in avascular stage, 18 hips in fragmentation stage, and 4 hips in healing stage. 20 hips(29.8%) were classified as group II, 29(43. 3%) group III, and 18(23.1%) group IV. 2. After the osteotmy in case of avasculsr necrosis stage, average duration of fragmentation stage was 6.3 months after femoral osteotomy and 1 year 6 months after innominate osteotomy. 12 among 20 hips were skipped the fragmentation stage, and got into healing stage in case of femoral osteotomy. 3. After the osteotomy at the fragmentation stage, average duration of the fragmentation stage was 9.8 months after femoral osteotomy and 1 year 3 months in case of innominate osteotomy. 4. Regardless of the type of osteotomy, coxa magna was observed more frequently in the case who had surgery at the late stage and severely involoved head at the time of osteotomy. 5. In the case of femoral osteotomy, average preoperative neck shaft angle was 138.5°, and postoperative one was 113.5°. During the follow-up study, 12.0° of revalgarisation took place. 6. The result obtained by femoral osteotomy gave better results than those by innominate osteotomy. Regardless of the type of osteotomy, good results were obtained in case who had surgery at the early stage such as avascular stage, and had mild involvement as such group II.
Follow-Up Studies ; Head ; Hip ; Humans ; Neck ; Necrosis ; Osteotomy