This study was performed to establish a radiological indication and contraindication of indirect decompression in the thoracolumbar burst fracture as well as to clarify an acceptable degree of the canal constriction to enhance neurologic recovery and to prevent the spinal stenosis. The canal diameter ratio (CDR) of the constricted level was determined using pre-and post-operative CAT images of 31 thoracolumbar burst fractures, decompressed indirectly. The acceptable CDR was decided by the lower limit of the 95% confidence interval of the post-operative CDR in cases without neurologic deficit associated with the canal constriction. A radiological indication and contraindication of indirect decompression was establish based on the calculation of the discriminant equation and linear regression equation respectively. The results were as followings. 1. The acceptable CDR was 46% at the cauda equina level and 37% at the conus medullaris level. 2. According to the result of calculation of the regression equation, the radiological contraindication of indirect decompression was the pre-operative CDR of 13% or less at the cauda equina level and 27% or less at the conus medullaris level. In conclusion, the radiological indication of indirect decompression was the pre-operative CDR of 34% at the cauda eqbina level and 42% at the conus medullaris.
Animals ; Cats ; Cauda Equina ; Constriction ; Conus Snail ; Decompression* ; Linear Models ; Neurologic Manifestations ; Spinal Stenosis

As a decompression means, the fasciotomy has been of good evaluation in many diseases such as impending V.I.C., ischemic myositis due to CO poisoning, snake bite, burn, anterior tibial compartment syndrome, carpal tunnel syndrome and gas gangrene, etc. From 1966 to 1973, 7 cases of snake bites and 5 cases of the ischemic myositis due to CO poisoning were treated at the Orthopedic Department of Seoul National University Hospital and the results were as follows; 1. All cases of the snake bites had got good results without any complication after the fasciotomy, while the fasciotomy performed in the ischemic myositis due to CO poisoning were not effective. 2. The time elapsed from the snake bite to the fasciotomy had a close relation to the prognosis. 3. In the 4 of 5 cases of the ischemic myositis due to CO poisoning, infections were superimposed on the fasciotomy sites. 4. The inappropriately continuous use of the tourniquet for hours after the snake bites caused worse prognosis.
Burns ; Carpal Tunnel Syndrome ; Compartment Syndromes ; Decompression ; Extremities ; Gas Gangrene ; Myositis ; Orthopedics ; Poisoning ; Prognosis ; Seoul ; Snake Bites ; Tourniquets

We present at least a one-year follow up of the 19 patients(twenty-two hands) of a open release of carpal ligament and external neurolysis in surgery for carpal tunnel syndrome. The transverse carpal ligament is exposed through a three centimeter paJmar incision in line with the axis of the third finger, started at the mid-point of the distal wrist crease and then straightly advanced. We analysed clinical manifestations and the following results were obtained; The average follow-up period was 27 months (12 - 120months). 1. According to the patients satisfaction of results(Cseuz criteria), the large majority of patients(91%) obtained good results. In 9% of the case (two hands) symptoms were siightly improved followed the operation but pain, numbness and paresthesia remained troublesome. 2. The mean grip and pinch strength of the fifteen hands were 23.4kg and 5.97kg respectively. 3. Thirteen(87%) of the fifteen hands that had thenar atrophy regained normal muscle bulk. 4. Six(50%) of the twelve hands that had denervation findings such as fibrillation or sharp wave were disappeared. 5. Twenty(91%) of the twenty-two hands that had increased values for two-point discrimination had normal values at follow-up.
Atrophy ; Axis, Cervical Vertebra ; Carpal Tunnel Syndrome* ; Denervation ; Discrimination (Psychology) ; Fingers ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Hypesthesia ; Ligaments* ; Paresthesia ; Pinch Strength ; Reference Values ; Wrist

Adrenal cyst is a rare pathologic lesion in all patients which can pose difficult problems in terms of diagnosis and treatment. Most are small and found incidentally on autopsy. We report one case of a large adrenal cyst in a 54-year- old female with review of the literature.
Autopsy ; Diagnosis ; Female ; Humans

A clinical study of the Tibial Shaft fracture was made on 128 patients, who had been treated at the Department of Orthopedic Surgery, College of Medicine Kyung Hee Universlty from the October, 1971 to May, 1979. The results were as follows: 1. The rate of fracture union was accelerated under the age of 20 years but it was slow in aged group. 2. The poor prognosis of fracture union was shown in junction between middle and distal 1/3 than others. 3. The better prognosis of the fracture type was shown in oblique and spiral fracture than in the comminuted and segmental. 4. There was prolonged rate of union in case of associated fibula fracture. 5. The frequency of delayed and nonunion were more prevalent in open fracture. 6. Among the open comminuted tibial shaft fracture with skin and soft tissue loss, the good results was obtained by the Hoffmanns external skeletal fixation method.
Classification ; Clinical Study ; Fibula ; Fracture Fixation ; Fractures, Open ; Humans ; Methods ; Orthopedics ; Prognosis ; Skin

Fifty-seven cases of non-union examined and treated at Department of Orthopedic Surgery, Seoul National University Hospital during the period of 1968 to 1979 were observed and analysed. The results were summarized as follows: 1. Of the 57 cases,there were 43 male and 14 female patients. This result showed marked predominence of male over female patients. 2. Non-unions most commonly occured between 21 and 40 of age. 3. The causes of the fractures consisted of 22 traffic accidents, 20 fallings, 7 machinery injuries, 6 direct blows, and 2 chronic osteomyelitis. 4. Of the 57 cases, there were 20 open fractures and 37 closed fractures. 5. The sites of nonunion were lower extremities in 41 cases and upper extremities in 16 cases. The femur, 31 cases, was most commonly involved. 6. The mean duration from fracture to diagnosis of non-union was 14.8 months. 7. Prior to admission to this hospital, one received no treatment at all, 23 were treated conservatively, and the remaining 33 treated operatively. 8. Probable causes of the nonunions were unsatisfactory immobilization in 26 cases, operative complications in-24, infections in 3, interpositions of the soft tissues in 3, and separations of fragments in 1. 9. All patients received surgical operations, which were successful in 87.7%.
Accidents, Traffic ; Diagnosis ; Female ; Femur ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Lower Extremity ; Male ; Orthopedics ; Osteomyelitis ; Seoul ; Upper Extremity

It has been emphasized that treatment of hemoral neck fracture is early anatomical reduction and rigid internal fixation to reduce severe complications such as avascular necrosis or non-union.Operative treatment were developed recently with development of radiological technique. This study reviewed twenty-nine patients of femoral neck fracture treated by internal fixation between December 1973 and December 1979. There are eleven casesof Garden's stage I or II fracture with multiple Knowles pinning and eighteen cases (All Gardens stage) treated with compression hip screw, and followed for a minimum of nine months with an average eighteen months. The results were as follows; 1. Eleven cases with minimal displaced fracture (Garden's stage I or II) treated by multiple Knowles pinning were revealed good results. 2. In total eighteen cases treated by compression hip screw, nine cases (Garden's stage I or II) were revealed good results and other nine cases (Garden's stage I or II) were revealed fair or poor results. 3. Eleven cases of mlutiple Knowles pinning and nine case of compressian hip screw used for undisplaced fracture (Garden's stage I or II) were revealed good results without regard to internal fixation devices. 4. Avascular necrosis were four cases in nine cases(44%) of displaced fracture. 5. Non-union were not found in this aeries.
Agriculture ; Femoral Neck Fractures ; Femur Neck ; Hip ; Humans ; Internal Fixators ; Neck ; Necrosis

The utility of computerized tomogaphy in the study of the anatomy, and pathology of the musculoskeletal system has been the subject of considerable interest since the introduction of CT scanning. It provides an accurate and detailed cross-sectional image of normal anatomical structures and shows the relation of masses to these structures. In order to assess the utility of computed tomography, we analyzed the 92 clinical cases. We divided our experience into three major categories: spinal lesios, pelvic (including hip) lesions, and lesions of extremities. The advent of a new prototype scanning device has made it possible to exam a variety of abonormalities in the orthopedic diseases in a manner not previously possible.
Extremities ; Musculoskeletal System ; Orthopedics ; Pathology ; Tomography, X-Ray Computed

Experimental osteoarthritis has been studied by various methods such as local compression of the joint, immobilization of the joint, relief of the contact and incision of the meniscus. The instability caused by the ligament injuries of the knee joints of the rabbits induced degenerative changes of the articular cartilages. After excision of the medial collateral ligament, medial meniscus and both cruciate ligament, the articular cartilages were observed serially after 1, 2, 3, 4, 6, 8, 10 and 12 weeks, grossly and microscopically. The results obtained are as follows; 1. Loss of transluscency and luster was observed even in the early group of the first week, and was followed by erosion and fissure on the articular cartilage in the groups of the third and later weeks grossly. 2. Microscopically, cluster formation of the chondrocytes on the articular cartilage was observed in the group of the first week and there was tendency of increase in its numbers and extents in the subsquent groups. Fibrillation and cleft formation was also observed in these groups. 3. Loss of metachromasia was observed in the groups of the second and subsquent weeks, but it was most prominant in the groups of the sixth and eighth weeks. 4. The tendancy of cluster formation was more prominent, compared with those of fibrillation or erosion.
Cartilage, Articular ; Chondrocytes ; Collateral Ligaments ; Immobilization ; Joints ; Knee Joint ; Knee ; Ligaments ; Menisci, Tibial ; Osteoarthritis ; Rabbits

No abstract available.
Tuberous Sclerosis*