No abstract available.

No abstract available.
Esophageal Fistula* ; Tuberculosis, Spinal*

No abstract available.

No abstract available.
Animals ; Lordosis* ; Spine*

The transpedicular screw fixation is known to be capable of providing more secure correctional, force and rigid fixation to the spine. But it is often accompanied by various complications, including stress shield effects, loosening in osteoporotic spine, pseudoarthrosis, hardware problems and long-term change in motion behaviors at the adjacent motion segment and etc. The purpose of this study is to compare the flexible and rigid rods system in terms of complications and problems for various degenerative lumbar diseases. From September 1991 to November 1994, 41 patients were operated with the flexible rods system (group A) and 39 patients with the rigid rods system (group B). They were followed up for more than 4 years. The flexible rods system was composed of 41 cases of Wiltse system and the rigid rods system was composed of 29 cases of Diapason, 8 cases of TSRH and 2 cases of CD instrument. The resuits of the study were as follows: 1. By standard Cobb lateral measurement, 7 cases in group A and 10 cases in group B showed significant loss of sagittal angle (>4), post-operatively. 2. Hardware failure was noted in 7 cases in group A and 10 cases in group B. In group A, rod bending was seen in 4 cases, rod breakage in 2 and screw loosening in one. In group B, screw loosening was observed in 5 and screw-rod locking mechanism failure in 5 cases. 3. In spondylolisthesis patients, 10 cases in group A and 14 in group B, there was no statistically significant differences between the two groups in the reduction rate immediately after surgery and loss of reduction at the last follow up. 4. Clinical results were good to excellent in 85.4% of patients in group A and 82.1% of group B. No statistically significant differences between the two groups were found, 5. No statistically significant differences between the two groups were found with respect to degenerative changes at the adjacent motion segment to the fused level and pseudoarthrosis.
Follow-Up Studies ; Humans ; Pseudarthrosis ; Spine* ; Spondylolisthesis

Cysts of the meniscus are rare lesion of the knee. They may present as a local tumor or mimic signs of an internal derangement of the knee. So it is difficult to diagnose and apt to overlook in physical examination. Also they almost always have combined pathology of the involved meniscus, such as, meniscal tear or discoid meniscus. The pathologic basis of the meniscal cyst is controversial, but rece 2. Most of the patients had tear of the involved meniscus, but the patients with discoid meniscus did not have gross tears or previous trauma history. nt works suggest the etiology is infiltration of joint fluid through micro and macro tears in the meniscus. In the past, complete excision of the meniscus as well as cyst was thought to be the treatment of choice to prevent recurrences. But nowadays, the trend is changed as preserving the involved meniscus, when no tear of the meniscus is found to prevent enevitable degenerative changes after total meniscectomy. We experienced 6 cases of meniscal cyst during recent 2 years and obtained following results. 1. Precise joint line evaluation is much more important in the diagnosis of the meniscal cyst before making special study. 2. Most of the patients had tears of the involved meniscus, but the patients with discoid meniscus did not have gross tears or previous trauma history. 3. When the cyst is located anteriorly in the joint line, it is prominent in flexed position of the knee; and when located posteriorly, prominent in extended position of the knee. 4. Excision of the cyst and reattachment of the meniscus were thought to be good method when the cyst was located in the parameinscal area without gross tear of the involved meniscus.
Diagnosis ; Humans ; Joints ; Knee ; Methods ; Pathology ; Physical Examination ; Recurrence ; Tears

The most frequent complication of the open arthrotomy for the cruciate reconstruction are quadriceps weakness and flexion contracture of the knee. Besides complications such as chondromalacia, patellar maltracking, saphenous neuralgia and patellar crepitus are not infrequent in wide open arthrotomy. We adopted an open method with smaller incision like arthroscopic maneuver to reduce these complications. The pre-requisite of this mini-incision are arranging a proper instrument and graft material. We advocate Achilles autograft which is longer and more flexible than other autografts and by taking advantage of these characteristics, we could performed reconstruction with relatively small incision. The advantages of mini-incision technique are early recovery of quadriceps function and little complication. We applied this method in ACL, PCL and simultaneous ACL & PCL reconstruction, with the result of early recovery of qudriceps function.
Autografts ; Cartilage Diseases ; Contracture ; Knee ; Methods ; Neuralgia ; Transplants

It is not infrequent to observe the reeurrence of the Bakers cyst. Recurrence of the cystic lesions are more frequent in wide based type than in pedicle type due to difficult ,identification and inadequate eradication of the cyst wall. We injected methylene blue into the cyst after aspiration of the fluid. Blue stained wall enables the surgeons to idendify the whole inner surface of the cyst, and lessens the chance of missing a portion of it. We could reduce the recurrence rate near to zero percent after adopting this technique upto now. Broad based type is more prone to recurr and the whole recurred five cases were belong to this type.
Arthroscopy ; Humans ; Knee ; Methylene Blue ; Popliteal Cyst ; Recurrence ; Surgeons

In traumatic knee dislocation, vascular injury is one of the most serious complication. After pertinent management of acute vascular problems, we should take care of the ligamentous injury involving both the ACL and PCL which are the main causes of knee instability, and consequent traumatic degenerative changes. No standard technique of reconstruction has been reported concerning these ligamentous injuries up to now as far as we know. Authors tried a new management which reconstruction was done simultaneously on both the ACL and PCL injuries. Bone-Achilles tendon autograft was used as PCL substitute in all the cases, and which turned out to be a very efficient one for the control of anterior-posterior displasement as well as rotary instability. Bone-patellar tendon-bone autograft or bone-Achilles tendon autograft was good for the reconstruction of the ACL bone-patellar tendon-bone in two cases, bone-Achilles tendon in two cases, and semitendinosus tendon also in two cases. After 6 months of operation, all the patient returned to the previous level of walking without crutches. This management showed outstanding results in terms of knee stability and subjective symptoms.
Achilles Tendon ; Autografts ; Crutches ; Dislocations ; Humans ; Knee Dislocation ; Knee Joint ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Tendons ; Vascular System Injuries ; Walking

In the treatment of elderly hip fracture, early mobilization as a means of reducing early postoperative morbiyt and morbidity is mandatory. Even though Ender nailing have many advantages, most serious problems with use of Ender nailing method are distal migration of nails, subsequent loss of fixation and limited knee joint motion. To prevent these difficult problems, we have used distal wiring technique with Ender nailing since 1988. In operation, we performed Ender nailing as usual manner under image intensifier and for the prevention of the nail migration, we performed circumferential wiring through the each Ender nail eye and above the adducter tubercle of the distal femur. Forty six cases were available with minimum follow-up of six months which were healed radiologically and clinically (Mean follow up: 21 months). The mean age was 74 years (Range: 52 years-88 years)and showed 26 cases of famale and 20 cases of male. The radiological morphometry using Singh index showed poor bone quality: 36 cases were below Grade III and the fracture type was classified by Tronzo criteria. In results, patients who had Ender nailing with distal wiring showed no distal migration, however one case of proximal migration was observed at the beginning stage of this technique. So, in elderly trochanteric fracture, to reduce the complication of the Ender nailing, especially nail migration, the authors recommend the Ender Nailing with distal wiring technique.
Aged ; Early Ambulation ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip ; Humans ; Knee Joint ; Male ; Methods