PURPOSE: Nonunion and metal failure as a complication may occur in femoral fractures, which are treated with plate and screw or intramedullary nail. The authors clinically reviewed metal failure patients from initial operation to rehabilitation program, and analyzed the cause of failure and attempted to establish more rational methods of management and prevention. MATERIALS AND METHODS: Seventeen patients of metal failure, treated at Kyungpook National University Hospital from 1989 to 1998, were included in this study. We studied the relationship between the initial site of fracture, type of fracture, time interval of metal failure, configuration of metal failure, probable cause of metal failure, and secondary reconstructive operation for metal failure. RESULTS: Dynamic compression plate was the most frequently (12cases) used implant. The most common site and type of fracture were proximal 1/3 of femoral shaft (8cases) and transverse fractures (11cases). As the configuration of metal failure, breakage of the plate or nail were more common at proximal or distal 1/3 of the shaft. There was no relationship between the time interval of metal failure and the initial site or type of fracture. The most probable cause of metal failure was improper rehabilitation in 6 cases (75%), other causes were another source of external force, inadequate bone support, improper choice of implant and infection. CONCLUSIONS: To prevent metal failure, we must preserve the periosteum and soft tissue, use bone-grafting at the time of treatment and employ cooperative rehabilitation therapy to implement gradual increasing non-weight bearing joint exercise, partial-and full-weight bearing excercise.
Femoral Fractures ; Femur* ; Gyeongsangbuk-do ; Humans ; Internal Fixators* ; Joints ; Periosteum ; Rehabilitation

PURPOSE: The purpose of this paper was to evaluate the treatment results according to bone union, union time, and complications, including infection of unreamed nailing of tibial fractures between closed and open fractures. MATERIALS AND METHODS: We reviewed 64 tibial shaft fractures that were treated with unreamed tibial nail. These included 42 closed fractures and 22 open fractures. RESULTS: Average union time of closed fractures was 19.8 weeks and that of open fractures was 20.2 weeks, nonunion rate were 4/42 and 3/22 in closed and open fractures. Average union time were 19.2, 20.4, 21.3 weeks in open grade I, II, llla fractures. According to the type of fractures, average union time were 18.5, 20.2, 24.6 weeks and nonunion rate were 2/29, 3/26, 2/9 in type A, B, C fractures. According to the level of fractures, average union time were 20.0, 20.3, 19.4 weeks and nonunion rate were 1/5, 4/37, 2/22 in proximal, middle, and distal fractures. There was no significant differences in average period of radiologic union, infection rate and nonunion rate between closed and open fracture group, but longer union time and higher nonunion rate in complex and comminuted fractures (P<0.05). CONCLUSIONS: We consider unreamed intramedullary nailing in the tibial shaft fractures as a good treatment modality for closed and open grade I, II, IIIa fractures
Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Tibial Fractures*

The hereditary multiple osteochondromatosis is a hereditary disorder characterized by gradual development of numerous osteocartilagenous masses from the metaphyseal region of long bones. The abnormality is transmitted as an autosomal dominant trait and its etiology is unknown but many theories of pathogenesis have been advanced. Four members of a family with hereditary multiple osteochondromatosis who are much shorter in height are presented with a brief review of literatures.
Exostoses, Multiple Hereditary ; Humans

The extensive traumatic wound has posed a serious problem to the surgeon. Various drugs and dressing methods have been used for this kind of wound but there has been no ideal method. The pigskin xenograft was used initially for the treatment of burn wound. The salutary effect of porcine xenograft are the stimulation of growth of healthy granulation tissue, as well as epithelial borders, inhibition of bacterial growth and pain relief. We have performed porcine xenograft in 20 cases having extensive traumatic wound with skin defect from January 1981 to February 1982. The results obtained are as follows: 1. Protect large open wound until autograft are available. 2. Alleviate pain in the wound. 3. Promote granulation tissue growth which is needed for early autograft. 4. Protect the exposed wound areas (bone and tendon) from infection. 5. The healing time of the wound depended upon the severity and the state of underlying tissue in the wound rather than wound size.
Autografts ; Bandages ; Burns ; Granulation Tissue ; Heterografts ; Methods ; Skin ; Wounds and Injuries

Twenty-six cases of fracture of the femur and tibia on the same leg in twenty-five patients were treated at the Dept. of Orthopedic Surgery, Kyungpook National University Hospital during the period of 1973 to 1979. Twenty-two patients were sustained by the motor vehicle accident. Open fractures of the femur and tibia were ten cases, and closed femur fracture and open tibia fracture were twelve cases. Concomitant Injuries were brain Injury in eight patients and hemorrhagic shock In seven patients. Eight patients were treated by internal fixation (Kuntschernall or Compression plate) on femur and by conservative treatment on tibia. Conservative treatment was done in eleven patients on both femur and tibia fracture. Five patients were amputated. Average healing time of fracture was: twenty-two weeks in femur and twenty-seven weeks in tibia. Functional end results were assessed and rated with satisfactory results In six patients and fair and poor in elght patients respectively.
Brain Injuries ; Clinical Study ; Femur ; Fractures, Open ; Gyeongsangbuk-do ; Humans ; Leg ; Motor Vehicles ; Orthopedics ; Shock, Hemorrhagic ; Tibia

In the past 13 years period, authors experienced 14 cases of giant cell tumor, 3 of which were treated by bone cementing after curettage. The results of various methods of treatment applied were compared and literatures surveyed. The followings were noted: 1. The most efficient method of treatment for giant cell tumor is en bloc resection. 2. The method of bone graft after curettage has such disadvantages as high recurrence rate and sequelae due to long periods of immoblization, especially for the large lesion with severe bone destruction. 3. Bone cementing after curettage seemed to be a choice in the methods of primary treatment of long bone giant cell tumor, especially useful for the tumors near the knee joint; the main advantages over other methods of treatment were considered to be technical simplicity and lack of complications.
Curettage ; Giant Cell Tumors ; Giant Cells ; Knee Joint ; Methods ; Recurrence ; Transplants

Authors have treated a case of glomus tumor which was occurred in the tip of the right thumb, 34 years old female. The patient has complained of pain, tenderness, and cold sensitivity on the lateral side of the tip of the right thumb for 10 years. Reddish purple discolorarion was noticed under the nail bed. On X-ray, erosion of the lateral cortex of the distal phalanx and increased soft tissue density around the erosion was noted. Grossly, the tumor was purple in color, more deeply colored than the surrounding tissue and tumor tissue will shell out of the surrounding bone and soft tissue. Glomus tumor was confirmed by the excisional biopsy.
Biopsy ; Female ; Glomus Tumor ; Humans ; Thumb

Authors had analyzed 35 patients of traumatic posterior dislocation of the hip which was treated at Kyungpook National University Hospital during the period of 7 years from 1972 to 1978. 21 of the 35 dislocation of the hip had sustained the injury by automobile accidents. 33 patients were reduced by closed reduction under general anesthesia. Within one week following closed reduction, intra-articular bony fragments were removed in 4 patients and posterior fragments of acetabular fractures were reduced and fixed with screws in 8 patients. 17 of the 35 patients were followed for eight months to 91 months, average 38 months. The results were rated according to criteris of the Stewart and Milford. Satisfactory results were obtained in 11 patients and those of 9 patients were reduced within 12 hours after injury. As the complication, avascular necrosis, myositis ossificans and osteroarthritis were developed in two patients, four patients, and seven patients respectively.
Acetabulum ; Anesthesia, General ; Automobiles ; Dislocations ; Gyeongsangbuk-do ; Hip ; Humans ; Myositis Ossificans ; Necrosis

Belt injury is an increasingly serious injury and one that frequently results in undesirable disabilities. We reviewed 20 cases of belt injury which had been treated in Kyungpook National University Hospital during the five and a half year period from Auguat, 1972 to January, 1978. 1. This injury is more prevalent in males (M:F = 4:1) with the peak incidence between the second and fourth decades (85%). 2. Upper extremities are involved in almost all cases (95%). 3. Some injury patterns were more frequently seen and were classified arbitarily as follows: Type I
Clinical Study ; Forearm ; Fractures, Bone ; Gyeongsangbuk-do ; Humans ; Humerus ; Incidence ; Male ; Paralysis ; Prognosis ; Upper Extremity

Tuberculous tenosynovitis affecting flexor tendon sheaths of the hand is a rare condition and quite disabling to the patient like tuberculosis elsewhere. It should be attacked by operation and antituberculous chemotherapy, but has a tendency to recur after surgery. The authors have encountered a case of tuberculous tenosynovitis affecting flexor tendon sheaths in the palmar area of the left hand, and treated the case with surgery and anti-tuberculous chemotherapy.
Drug Therapy ; Hand ; Humans ; Tendons ; Tenosynovitis ; Tuberculosis