To evaluate the neurologic and functional improvement of anterior decompression and fusion in patients with cervical spin injury, the clinical records and x-rays of 17 patients who were treated at Gyeong-Sang National University Hospital between January 1989 and December 1993 were analyzed. The results were as follows 1. There were complete injuries of the cord in six cases, incomplete injuries in nine and nerve root injuries in two. All the patients were treated using anterior decompression and autogenous iliac bone graft with cervical plate fixation within 7 days after trauma. 2. The average time lapse from the operation to radiological union was 9.2 weeks(range;7–14 weeks). 3. The prognosis for neurologic recovery mainly depends on the severity of the initial neurologic status. The recoveries of neurologic deficit were complete in four cases, partial in ten and none in three. The motor index improved from 45.6 to 64.6 and the modified Barthel index was 71.2 points at the last follow-up. 4. The clinical results were excellent in nine cases, good in three, fair in two and poor in three. In conclusion, anterior decompression and fusion with bone graft and cervical plate provided early mobilization and rehabilitation, and improved neurological function in a considerable portion of the patient who had neurologic deficits after cervical spine injuries.
Decompression ; Early Ambulation ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Prognosis ; Rehabilitation ; Spine ; Transplants

PURPOSE: We compared the clinical manifestations of patients with tsutsugamushi disease between children and adults. METHODS: From January 2003 to December 2012, 768 patients diagnosed with tsutsugamushi disease were retrospectively reviewed, and the clinical characteristics, laboratory findings, and complications were compared between children and adults. RESULTS: No patterns of annual increases in the number of patients were noted in both children and adults. The higher incidences occurred in October and November respectively. By gender, male outnumbered female in children, but the opposite trend was seen in adults. By residential area, the urban distribution of children was higher than that of adults. Rashes (P=0.001) and eschar (P=0.004) were more common in children, while myalgia was more common in adults. Children had a high prevalence of anemia (P=0.041), and low incidence rates of thrombocytopenia, abnormal liver and renal function. Children yielded better results in the duration of their hospital stay and the incidence of complications (P<0.001). A comparison of the therapeutic effects of doxycycline and macrolide antibiotics, which was performed only on the children, did not reveal any significant differences. CONCLUSION: Compared to adults, children had higher incidence rates of male patients and more often suffered from rashes and eschar. Children yielded better results in the laboratory findings and duration of the hospital stay and complications. Therefore, when children are suspected to have tsutsugamushi disease, especially during its peak occurrence period, detailed physical examination and serological test should be performed to ensure a prompt diagnosis, and the use of macrolide antibiotics, which have fewer side effects, is expected to yield the same therapeutic effects.
Adult* ; Anemia ; Anti-Bacterial Agents ; Child* ; Diagnosis ; Doxycycline ; Exanthema ; Female ; Humans ; Incidence ; Length of Stay ; Liver ; Male ; Myalgia ; Physical Examination ; Prevalence ; Retrospective Studies ; Scrub Typhus* ; Serologic Tests ; Thrombocytopenia

Soft tissue defect on dorsum of hand requires immediate soft tissue cover to achieve early wound closure and to minimize wound infection and scarring. If the tendon or bone was exposed and the deep structures were absent, flap was required to provide adequate protection and allow proper function of the underlying structures. Small size in skin loss can easily be covered with local flaps but major defects involving the dorsal aspect of the hand should be coverd with distant flaps, free flaps or radial forearm flaps. Techniques in distant flaps require staged procedures and free flap transfer to obtain soft tissue cover in a single stage require microsurgical techniques. The reverse radial forearm flap is a fasciocutaneous flap based on the radial artery which together with its two venae comitantes lies invested in a condensation of the deep fascia known as the lateral intermuscular septum. The authors had treated 5 cases of distally based reverse forearm flap for soft tissue reconstruction on 2 patients of crushing injury with soft tissue defect on hand, a patient with Marjolin's ulcer on dorsum of hand due to previous burn scar and a patient with soft tissue necrosis on dorsum of both hands due to extravasation of adriamycin during chemotherapy. It has proved to be one of the saftest, simple and effective one-stage method of soft tissue reconstruction in hand without long term immobilization. The results of these operation in cover of soft tissue defect have been satisfactory.
Burns ; Cicatrix ; Doxorubicin ; Drug Therapy ; Fascia ; Forearm ; Free Tissue Flaps ; Hand ; Humans ; Immobilization ; Methods ; Necrosis ; Radial Artery ; Skin ; Tendons ; Ulcer ; Wound Infection ; Wounds and Injuries

The tibia is the most commonly fractured bone of all the long bones. In this age of vehicular accidents, the tibia is frequently subjected to high energy trauma. Anatomically the tibia has poor soft tissue coverage and poor blood supply. Therefore severe injury on the tibia can lead to severe complication and major disability. 41 adult patients with comminuted fracture of the tibial shaft were treated by OR/IF with D.C.P. and bone graft at the Department of Orthopedic Surgery, Kyungpook University Hospital from January 1978 to June 1986. These were analysed according to mechanism of injury, degree of comminution, timing of operation, soft tissue injury and operation time. Bone union and end results of treatment were reviewed. The results were as follows Of 41 cases, causes of injury were vehicular accident in 32 cases. 34 cases had associated injury on other part of body and average injury per case was 1.7 injuries. Based on the classification of Johner and Wruhs, the B group with butterfly fragment was 27 cases and C group was 14 cases. Among the B group, B2 was most common as 14 cases. Average union time was 18 weeks and delayed union and nonunion were 6 cases. Degree of comminution of fracture might be important fractor to bone union. According to the end result of Johner and Wruhs, excellent and good were 31, fair and poor were 10. Of the 41 cases, 10 cases had permanent disability. 4 cases had angular and rotational deformity alone and 1 case had shortening of tibia more than 1 cm, 1 case had both of them. Limited R.O.M. of ankle joint (>50%) occured in 4 cases. The post-operative infection occured in 6 cases, 3 were superficial infection but 3 cases were osteomyelitis. OR/IF with D.C.P. on comminuted tibial shaft fracture was a risk operation. Therefore proper method of treatment should be selected according to degree of comminution, timing of operation, presence or abscence of open wound and associated injury.
Adult ; Ankle Joint ; Butterflies ; Classification ; Clinical Study ; Congenital Abnormalities ; Fractures, Comminuted ; Gyeongsangbuk-do ; Humans ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Injuries ; Tibia ; Transplants ; Wounds and Injuries

PURPOSE: This study was aimed to analyze the incidence and the anatomical distributions of HME (Hereditary Multiple Exostoses) on upper limbs and its related change in alignment of the upper limbs in HME patients. MATERIALS AND METHODS: Thirty eight patients who had been diagnosed HME between 2001 and 2009, were categorized into two groups; (1) group A (1-2 involvements); (2) group B (> or =3 involvements). We checked the carrying angle, VAS (Visual Analogue Scale), limitations in daily activities, cosmetic satisfaction according to the number of exostoses invasion. RESULTS: Among the 38 patients, 23 patients (43 cases) had exostoses in the upper limbs. The locations of exostoses in the upper limbs were proximal humerus in 33 cases (30%), distal ulna in 31 cases (28.2%), and distal radius in 24 cases (21.8%). The carrying angle of group A and B was 10.7degrees, 13.8degrees, VAS was 1.3, 3.5, and the limitations in daily activities was 7.3, 6.6 of 8 points. The cosmetic satisfactory cases were 13 and 10 cases, respectively. CONCLUSION: The deformity in upper limbs was observed in 65% of the HME patients. As the number of invasion increases, carrying angle and VAS were increased but limitations in daily activities and cosmetic satisfaction were decreased.
Congenital Abnormalities ; Cosmetics ; Exostoses ; Exostoses, Multiple Hereditary ; Humans ; Humerus ; Incidence ; Lifting ; Radius ; Ulna ; Upper Extremity

Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

Since the first successful replantation of incompletely amputated digit was performed by Kleinert in 1962, Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. Nowadays, further improvements in instrumentation and surgical skill are accomplished and replantation of digit has been popularized widely. But sometimes the functional results of replanted digits are not excellent expected and there is a place for discussing gain between the result and efforts to replantation. We have been analyzed 28 cases of finger replantation in 17 patients from June, 1982 through June, 1984 at the Department of Orthopedic Surgery, Kyungpook National University Hospital. The results were as follows: 1, Male were 12 and female were 5, and average age was 20.5 years old. 2. The most common injury was done by cutting machine. 3. The number of amputated fingers were as follows: thumb, 6 cases; index finger, 11 cases; middle finger 7 cases; ring finger, 3 cases; The level of amputation was as follows: Zone II, 6 cases; Zone III, 15 cases; Zone IV, 7 cases; 4. The maximum ischemic times for successful results of finger replantation were 19 hours. 5. The total ratio of successful replantation of digits in our cases was 82.1%. 6. The functional results of replantation including joint motion, sensory recovery, two point discrimination, pinch power, sweating were relatively satisfactory. (Normal 8, Fair 11, Poor 3, Protective 1 case) 7. The main cause of replantation failure was thrombosis of the vein.
Amputation ; Clinical Study ; Discrimination (Psychology) ; Female ; Fingers ; Gyeongsangbuk-do ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sweat ; Sweating ; Thrombosis ; Thumb ; Veins

In the workshops where the rorating belts are used belt, injuries frequently occur for lack of a safety device. Those injuries have several characteristics compared with other long bone fractures. Those are mostly multiple open fractures with considerable soft tissue damages, forearm both bones and humerus fractures by bending force and rotational distraction as mechanism of the injury, and sometimes particularly segmental fracture of the radius. From Aug. 1972 to Jan. 1985, we have traced 47patients of multiple fractures of forearm and humerus by belt injuries except 17 patients of solitary fractures of forearm and humerus. 1. This injury is more prevalent in males(M:F=4:1) with the peak incidence between the third and fourth deades(59%). 2. Multiple fractures of forearm and humerus by belt injuries were classified by fracture numbers and mechanism of injury as follows: Type I Fractures of Forearm Both Bones(53.2%). Type II Fractures of Forearm Both Bones and Humerus(27.7%). Type IU Segmental Fracture of Radius and Ulna(10.6%). Type IV Segmental Fracture of Radius, Ulna and Humerus(8.5%). 3. Most were open fractures with soft tissue damages(74%). 4. Nerve paralysis was the most frequent associated injury(27%). 5. All but 7 cases were treated by open reduction. Implants used for internal fixation were compression plates in 20 cases as elective surgery and Rush pins in 15 cases of forearm open fractures as emergency surgery. 6. By Anderson's critcria, satisfactory result(excellent or good) was obtained in 55% of cases.
Education ; Emergencies ; Forearm ; Fractures, Bone ; Fractures, Multiple ; Fractures, Open ; Humans ; Humerus ; Incidence ; Paralysis ; Protective Devices ; Radius ; Ulna

No abstract available in English.
Clinical Study ; Tibial Fractures

No abstract available in English.
Adult ; Clinical Study ; Humans