Baker's cyst is commonly associated with intraarticular pathology such as degenerative arthritis. Few cases of neural compression by a Baker's cyst in the popliteal fossa have been reported with intraarticular pathology. We report a case of peroneal nerve compression by an atypical Baker's cyst in a child without intraarticular pathology. A 10-year-old boy had 6-month history of the left foot drop without a known trauma. There was no swelling or pain in the knee. The electrodiagnostic study demonstrated a profound lesion of the deep peroneal nerve and a mild denervation of the superfical peroneal nerve. Magnetic resonance images displayed an atypical Baker's cyst originating from the popliteal fossa and extending to the posterolateral side of the fibular head. Clinical and electrophysiological findings improved after aspiration of the cyst.
Child* ; Denervation ; Foot ; Head ; Humans ; Knee ; Male ; Osteoarthritis ; Pathology ; Peroneal Nerve* ; Popliteal Cyst*

After bone damage of the fetal rat femurs induced by administrating cyclophosphamide(CP),(1/8 LD50) to the pregnant rat on 13th day of gestation, the effects of serum and ascorbic acid on the repair process of the bone during organ culture were studied, histologically and scanning electron microscopically. CP-damaged fetal femurs harvested at 20 days of gestation were cultured fro 2, 5 and 7 days in the waymouth media(WM) with or without fetal bovine serum(FBS) and ascorbic acid, and were observed with light microscope and JSM-35C scanning electron microscope. The results were as follows:1. CP-damaged bone tissue cultured in WM with 10% FBS showed relatively enhanced activities in the differentiation of chondrocytes and ossificstion as compared to that cultured in WM. 2. CP-damaged bone tissue cultured in WM with 10% FBS and 100µg/ml ascorbic acid, showed increase in the length of the bone marrow cavity, and active formation of new osteoid and collagen bundles. 3. The bone tissues cultured in WM with 10% FBS and 400µg/ml ascorbic acid revealed active deposition of bone matrix, thickening of periosteum and marked elongation of the bone marrow cavity. 4. Bone trabeculae of CP-damaged femurs cultured for 2 days in WM showed poor cell proliferation and insignificant bone matix formation. 5. The number of new cells and the amount of the collagen fibrils increased on the bone trabeculae of the bone cultured in WM with 10% FBS as compared to that cultured in WM and this increase was enhanced as the culture time progressed. 6. A remarkable increase was noted in the number of cells and collagen fibrils in the bone tissues cultured in WM with 10% FBS and ascorbic acid than in those cultured in WM with 10% FBS. 7. The number of the spherules formed by cellular component with collagen fibrils is more numerous than that formed by calcospherites associated with collagen fibrils.
Animals ; Ascorbic Acid ; Bone and Bones ; Bone Marrow ; Bone Matrix ; Cell Proliferation ; Chondrocytes ; Collagen ; Cyclophosphamide ; Femur ; In Vitro Techniques ; Organ Culture Techniques ; Periosteum ; Pregnancy ; Rats

The recent trend in method of long bone fracture had been toward bracing or closed medullary nailing except for certain fractures that fall within well-established surigcal criteria. Functional bracing is gaining widespread acceptance in management of tibial, femoral, and forearm fractures and is well suited to humeral shaft fractures. Twenty four cases of humeral shaft fractures were treated with functional brace and early mobiliza tion from October 19S2 to June 1984 at Busan National University Hospital and the results were as follows. 1. The fracture sites were composed of middle third in 15 cases, distal third in 6 cases, and proximal third in 3 cases and the fracture shapes were transverse in 10 cases, oblique and spiral in 5 cases respectively, and comminuted in 4 cases. 2. The average time from injury to functional bracing was 13.0 days and to discontinuance of the functional brace was 9.0 weeks. 3. Nonunions have not been encountered in all cases. The residual angulation was under 20degrees in all but one and the most common deformity was varus in 20 cases. Minimum limitation of motion, mostly a loss of the last few degrees of external rotation, was detected after follow-up of 2 months but did not present any clinical problem. 4. The achievement of rapid and uninterrupted osteogenesis without undesirable functional or cos- metic deficit could be listed as the advantage.
Braces ; Busan ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Fractures, Bone ; Humerus ; Methods ; Osteogenesis

A supracondylar fracture of the humerus is the most common fracture of the elbow in children, and it may also be one of the most difficult fracture to treat. To obtain a good result after a supracondylar fracture of the humerus, an accurate reduction is needed. This region of humerus is very thin, and even if reduction is obtained it may be unstable. 104 children with 104 supracondylar fractures of the humerus were managed at the Department of Orthopedic Surgery, Busan National University Hospital from Jan. 1979 to Dec. 1983. Of 104 patients, 48 cases which fixed internally were reviewed and following results were obtained. 1. The average age was 7.6 years, ranged from 18 months to 15 years, and 68.8% were bodys. The left humerus was affected in 58.3%. 2. In type of fracture, extension type was 95. 8%. Type II was 12 cases (26.1%), Type III 22( 47.8 and Type IV 12 (26.1%). Posteromedial displacement was 75% (35 cases). 3. Average loss of motion was 11.9°, and change of carrying angle was 5.1° In change of range of motion by the final follow-up date, during 3 to 6 months that was relatively high by 37.5°, and then the change was improved. During 2 to 5 years the change was 5. 6°, and 1 to 2 years that was similiar to the whole average by 11.7°. 4. By the modified Mitchell & Adams criteria for grading results, excellent were obtained in 30.4%, good in 45.3% fair in 10.0% and poor in 6.3%. Namely, satisfactory was 93.7% and unsatisfactory was 6.3%.
Busan ; Child ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Orthopedics ; Range of Motion, Articular

Although antibiotics have greatly improved the results of treatment of hematogenous osteomyelitis, hematogenous osteomyelitis in children is still complex and difficult disease by which severe deformity and disability may result. A retrospective clinical study of 44 cases of hematogenous osteomyelitis in children was done at Department of Orthopaedic Surgery, Busan National University Hospital from January 1980 to February 1985. The results were as follows: 1. The ratio between males and females was 2.1: 1, and the prevalent age gmup was from 11 to 15 years. 2. The common sites of involvement were femur and tibia in orders. 3. At initial surgical treatment, fenestration in acute stage and saucerization in chronic stage were commonly performed. And at surgical wound management, primary closure with closed continuous irrigation was most frequently performed. 4. Children with acute clinical presentations tended to have more unsatisfactory results, probably because of delay of diagnosis and treatment, simple soft tissue drainage at initial surgical treatment, secondary closure at surgical wound management and inadequate parenteral antibiotic therapy.
Anti-Bacterial Agents ; Busan ; Child ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Drainage ; Female ; Femur ; Humans ; Male ; Osteomyelitis ; Retrospective Studies ; Tibia ; Wounds and Injuries

Entrapment of the posterior interosseous nerve is an uncommon syndrome characterized by an inability to extend the fingers and thumb. This entity bas become recognized increasingly since reported in 1966 by Capener and Muholland et al. The pathogenesis could be explained as an anatomical basis. And various cases were reported that trauma, local swelling, inflammation, postural and iatrogenic factors were concerned with the causes. In recent 4 cases of posterior interosseous nerve syndrome were experienced at Busan National University Hospital and following result were obtained.1l. Arcade of Frohse, fibrous band, recurrent radial artery are important compressive factors. 2. Surgical decompression led to an effective cure. 3. Tendon transfer is indicated after severe degenerative change.
Busan ; Decompression, Surgical ; Fingers ; Inflammation ; Radial Artery ; Tendon Transfer ; Thumb

The authors investigated LD activity and isoenzyme of total serum and joint fiuid in 18 cases of rheumatoid arthritis, 11 cases of degenerative arthritis, 6 cases of traumatic arthritis, and 10 cases of healthy control. The samples of serum examined were obtained from the anterior cubital vein and joint fluid from the knee joint except 2 cases of the rheumatoid arthritis, which were obtained from the wrist joint, in Busan National University Hospital from the April to July 1981. Total serum LD activity was measured by method of Caboud-Wroblewski and isoenzyme fractions were analysed by cellulose acetate electrophoresis. The results obtained were as follows: l. In the patients with joint diseases, total serum LD activity was significantly increased than that of healthy control. 2. The LD1 isoenzyme of joint fiuid was increased in degenerative arthritis than that in rheumatoid arthritis, and LD3 and LD5 isoenzymes were significantly increased in rheumatoid arthritis than that in degenerative arthritis. 3. In correlation between total LD and LD isoenzymes activities in joint fluid, total LD activity of rheumatoid arthritis was correlated with decrease of LD1 isoenzyme and increase of LD5 isoenzyme activity, and total LD activity of the degenerative arthritis was correlated with increase of LD1 isoenzyme activity. 4. In correlation between isoenzyme activity and gamma globulin of joint fluid, LD3 and LD5 isoenzyme activity in rheumatoid arthritis and LD4 in degenerative arthritis was correlated with increase of gamma globulin.
Arthritis ; Arthritis, Rheumatoid ; Busan ; Electrophoresis, Cellulose Acetate ; gamma-Globulins ; Humans ; Isoenzymes ; Joint Diseases ; Joints ; Knee Joint ; Methods ; Osteoarthritis ; Synovial Fluid ; Veins ; Wrist Joint

We clinically reviewed and analysed 19 patients treated as Girdlestone operation with or without Batchelor osteotomy at the Department of Orthopedic Surgery, Busan National University Hospital from April 1979 to June 1981. The results were as follows: 1. The underlying disease were infected pinning and nailing of 8 cases, pyogenic hip of 4 cases, failed total hip arthroplasty of 4 cases, tuberculous hip of 2 cases and femur neck fracture of 1 case. 2. Satisfactory results were obtained in 7 or 8 cases treated as secondary Girdlestone operation over 50 years of age. 3. Postoperative shortening ogleg length was 3.2cm in average (from 1.7cm to 5.0cm), which was average 2.5cm at 12 weeks traction and average 3.7cm at 6 weeks traction. 4. Postoperative average range of motion was; flexion to 80 degrees and abduction to 30 degrees. There was statistical significancy in activity of daily living of hip function at 12 weeks traction in postoperative score. 5. 6 cases out of 11 cases without pain in postoperative condition showed severe bony contacts and ir- regularities of proximal portion of the operated femur radiologically.
Arthroplasty, Replacement, Hip ; Busan ; Femoral Neck Fractures ; Femur ; Hip ; Humans ; Orthopedics ; Osteotomy ; Range of Motion, Articular ; Traction

The twelve cases of metallic failure after compression plate fixation which were observed and treated at Department of Orthopedic Surgery, Busan National University Hospital were clinically analysed. The results were summerized as follows; 1. Age and sex of the patients was male in his active age in life. 2. The causes of fracture were traffic accidents and industrial accidents. The sites of fracture were femur in 11 cases and tibia 1 case. 3. The types of fracture were comminuted in 11 cases and short oblique in 1 case. 4. The 6 patients were not cooperative and began walking at their will after postoperative 4 weeks despite doctors order of nonweight bearing. Average duration of immobilization was 6 weeks. 5. Metallic failure occurred as screw failure in 1 case, plate failures through empty hole in 4 cases and plate failures through hole filled with screw nearest to the sites of fracture in 7 cases. 6. Interval between operation and metallic failure was 6.25 months average. The 75% of the metallic failure occurred between 4 to 7 months. 7. Treatments of metallic failures were cast immobilization with bone grafting in 1 case at tibia, intramedullary nailing with bone grafting in 1 case at femur and compression plate fixation with bone grafting in 10 cases at femur. 8. Causes of failure after internal fixation 1). Insufficient bone support Inadequate inter-fragmentary compression 9 cases Absence of cancellous bone graft 8 cases Empty plate hole 4 cases Remaining defects 3 cases 2). Inadequate postoperative treatment 6 cases.
Accidents, Occupational ; Accidents, Traffic ; Bone Transplantation ; Busan ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Male ; Orthopedics ; Tibia ; Transplants ; Walking

A recurrent shoulder joint dislocation was performed on fourteen cases who were treated by modified Bristow operation from June, 1978 to April, 1981. and following results were obtained. 1. The age of initial dislocation varied from 13 years to 23 years of age with the average of 18. 6 years. 2. The age at operation varied from 20 years to 28 years of age with the average of 23 years. 3. The duration of recurrent dislocaticn varied from 2 years to 8 years with the average of 4.4 years. 4. The times of dislocation varied from 6 to 50 times with the average of 17.1 times. 5. The roentgenograms showed the Hill-Sachs' Iesion in 10cases (71.4%), subluxation in 4 cases (28.6%), and glenoid rim abnormality in 2 cases. 6. The operative findings were Bankart's lesion in II cases(78.6%), glenoid rim erosion in 2 case, and subscapularis laxity in 2 case. 7. The complication and recurrence were not observed in this period. 8. The average limitation of abduction and external rotation were 5. 7 and 12. 2 degree respectively.
Dislocations ; Recurrence ; Shoulder Dislocation ; Shoulder Joint ; Shoulder