No abstract available.
Animal Experimentation ; Animals ; Legg-Calve-Perthes Disease ; Rabbits

PURPOSE: The purpose of this study was to evaluate the long term results of performing femoral varus osteotomy (FVO) for the treatment of Legg-Calve-Perthes disease (LCPD). MATERIALS AND METHODS: We selected 35 LCPD patients who received FVO and they were followed up to the time their skeletons' matured. The inclusion criteria were patients in a fragmentation stage, the patients were in Catterall group III or IV, and the patients underwent a teleoroentgenographic examination at the time of full skeletal maturity. RESULTS: The radiological outcome at the time of skeletal maturity was assessed using Stulberg's classification. The final results were 4 hips in class I, 17 hips in class II, 13 hips in class III, one hip in class IV and none in class V. The satisfactory results (good+fair hips) were 34 hips (97%). Significant shortening (>10 mm) was observed in 12 hips (34%). In 35 patients, 5 (14%) had same leg length (less than 2 mm difference), 27 (77%) had shortening of 2 mm or more, and 3 had lengthening of 2 mm or more in the operated limb. Of these 12 patients with significant shortening, only 3 patients (9%) showed shortening of 21 mm or more. CONCLUSION: FVO is a reliable method for managing LCPD in patients who are in Catterall group III or IV and who are in the fragmentation stage of disease.
Extremities ; Hip ; Humans ; Leg ; Legg-Calve-Perthes Disease ; Osteotomy

Purpose: Genu valgum in Legg-Calve-Perthes disease (LCPD) is not a known complication. We investigated whether this valgus tendency is a complication of femoral varus osteotomy (FVO) or the sequela of the disease process itself, and what are the related factors. Materials and Methods: 35 patients treated by FVO and 38 by abduction orthosis (AO) were selected for this study. Only those patients with unilateral involvement, fragmentation stage, Catterall Group III or IV, and who were followed-up to full skeletal maturity were included in the study. We measured mechanical axis deviation percentage and hip-knee-ankle angle for femorotibial alignment, and mechanical lateral distal femoral angle and medial proximal tibial angle (mMPTA) for knee orientation on teleoroentgenograms and compared the affected and normal limbs. Results: All measurements, excluding the mMPTA, demonstrated a tendency of relative genu valgum versus the opposite normal limbs. This tendency was observed in both groups. There was no statistically significant difference between the two groups. Conclusion: Genu valgum occurred in 66% to 70% of the LCPD patients. Four factors were found to be significantly correlated with valgus shift: increased medial bowing of the femoral neck, decreased acetabulum head index, coxa magna, and limb shortening. Multivariate regression analysis identified limb shortening as the factor most responsible for valgus shift.
Acetabulum ; Axis, Cervical Vertebra ; Extremities* ; Femur Neck ; Genu Valgum* ; Head ; Hip ; Humans ; Knee ; Legg-Calve-Perthes Disease* ; Orthotic Devices ; Osteotomy

PURPOSE: The serial radiographs of 64 children with unilateral developmental dislocation of the hip (DDH) were reviewed in order to follow the natural hip development with age after a concentric reduction. MATERIALS AND METHODS: All patients were treated with a closed (22 patients) or open reduction (42 patients) and were followed up to the age of skeletal maturity. The radiographic measurements including the acetabular angle (AA), Sharp angle (SA), center-edge angle (CEA), acetabulum-head index (AHI) and neck-shaft angle (NSA) were obtained in 6 age groups; 0-2 years, 2-4, 4-8, 8-12, 12-16, 16 and over. RESULTS: The rate of acetabular development evaluated by both the AA and SA, was greatest before 4 years of age and continued to a lesser extent until skeletal maturity. The neck-shaft angle also continuously and gradually improved after the concentric reduction until skeletal maturity. Acetabular coverage of the femoral head, which was evaluated by the CEA and AHI, reached the normal level in the 8-12 year age group and was maintained a normal level through to skeletal maturity. CONCLUSION: The hip dysplasia continued to improve until skeletal maturity. Therefore, it is recommended that secondary surgery should not be performed if the X-ray shows continuous improvement and a concentric reduction is maintained.
Acetabulum ; Child ; Dislocations* ; Follow-Up Studies* ; Head ; Hip Dislocation ; Hip* ; Humans

PURPOSE: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. MATERIALS AND METHODS: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. RESULTS: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. CONCLUSION: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.
Adult* ; Female ; Foot ; Humans ; Incidence ; Joints ; Male ; Metatarsophalangeal Joint ; Orthopedics ; Toes ; Volunteers

PURPOSE: To determine the radiographic changes in forefoot geometry with weight-bearing. MATERIALS AND METHODS: The forefoot radiographs of 100 normal Korean adults, 50 male and 50 female volunteers, were evaluated both in nonweight-bearing and weight-bearing. The mean age was 27 years with range of 21-39 years. Those with normal feet were selected from volunteers having no history of foot problems or other musculoskeletal diseases. RESULTS: The changes of measured angle between phalanges and metatarsals with weight-bearing were as follows; Hallux valgus angle was noted to increase in 20% of the feet, decrease in 59%, and remained unchange in 21%. Intermetatarsal angle 1~2 was noted to increase in 76% of the feet, decrease in 3%, and remained unchange in 21%. Intermetatarsal angle 1~5 was noted to increase in 95% and remained unchange in 5%. Shift in medial sesamoid on weight-bearing was also not consistent. Lateral shift was noted in 27%, no shift in 66%, medial shift in 7%. CONCLUSION: The generalized concept that the angles between bones and shift of medial sesamoid in the forefoot will change consistently with weightbearing was not found.
Adult ; Female ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Male ; Metatarsal Bones ; Musculoskeletal Diseases ; Volunteers ; Weight-Bearing*

PURPOSE: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. MATERIALS AND METHODS: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. RESULTS: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. CONCLUSION: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.
Adult ; Female ; Hallux Valgus ; Head ; Humans ; Male ; Metatarsal Bones ; Volunteers

PURPOSE: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. MATERIALS AND METHODS: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. RESULTS: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. CONCLUSION: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.
Adult* ; Female ; Foot ; Humans ; Incidence ; Joints ; Male ; Metatarsophalangeal Joint ; Orthopedics ; Toes ; Volunteers

PURPOSE: To determine the radiographic changes in forefoot geometry with weight-bearing. MATERIALS AND METHODS: The forefoot radiographs of 100 normal Korean adults, 50 male and 50 female volunteers, were evaluated both in nonweight-bearing and weight-bearing. The mean age was 27 years with range of 21-39 years. Those with normal feet were selected from volunteers having no history of foot problems or other musculoskeletal diseases. RESULTS: The changes of measured angle between phalanges and metatarsals with weight-bearing were as follows; Hallux valgus angle was noted to increase in 20% of the feet, decrease in 59%, and remained unchange in 21%. Intermetatarsal angle 1~2 was noted to increase in 76% of the feet, decrease in 3%, and remained unchange in 21%. Intermetatarsal angle 1~5 was noted to increase in 95% and remained unchange in 5%. Shift in medial sesamoid on weight-bearing was also not consistent. Lateral shift was noted in 27%, no shift in 66%, medial shift in 7%. CONCLUSION: The generalized concept that the angles between bones and shift of medial sesamoid in the forefoot will change consistently with weightbearing was not found.
Adult ; Female ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Male ; Metatarsal Bones ; Musculoskeletal Diseases ; Volunteers ; Weight-Bearing*

PURPOSE: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. MATERIALS AND METHODS: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. RESULTS: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. CONCLUSION: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.
Adult ; Female ; Hallux Valgus ; Head ; Humans ; Male ; Metatarsal Bones ; Volunteers