Increase of AST and ALT is a common biochemical finding in patients with multiple trauma. So it is difficult to make a decision for appropriate operation timing and to predict prognosis with consideration of parenchymal liver disease. We studied patients with multiple trauma who admitted to orthopedic department with increased AST & ALT and patients who had hepatitis from Jan. 1993 to Dec. 1993. The patients were checked AST & ALT on admission day and followed by the 3rd, 5th, 9th day, second and third week. We checked the relation of changed level of these enzymes and severity of injury, combined abdominal trauma, head trauma and the presence of HBs Ag/Ab. We concluded as followed: 1) Traumatized patients had high AST than ALT during first 3 days but hepatitis patients had higher ALT than AST during throughout admission days. High ALT in hepatitis patients had statistically significance compare to traumatized patients. 2) Traumatized patients with high AST were decreased more rapidly than ALT and showed normalized enzymatic level by 3rd week. 3) The AST level was higher in severely injured patients and it was statistically significant within first 3 days. But ALT was not correlated with the severity of injury. 4) In patients with abdominal injury, AST was higher than ALT and AST had significance but ALT had none. 5) There is no specific correlation between these enzyme level in neurosurgical problem and the presence of HBsAg/Ab.
Abdominal Injuries ; Craniocerebral Trauma ; Hepatitis ; Humans ; Liver Diseases ; Multiple Trauma ; Orthopedics ; Prognosis

Computed tomography was used in the evaluation of intra-articular fractures of the calcaneus to develop and reasonable treatment program and predict prognosis. Twenty-four fractures of the calcaneus in the twenty-two patients were shown to involve the posterior facet and classified by the images of coronal CT scan; Type 1(non-displaced), Type 2(displaced) and Type 3(comminuted). There were one Type 1, fourteen Type 2, and nine type 3 fractures, all of which were treated with open reduction, internal fixation, with or without bone graft. The length of follow-up ranged from eighteen to thirty-six months(mean, 23 months). the results were fraded by a predetermined point system. The one Type 1 had an excellent result. Of the fourteen Type 2 fractures, four had and excellent result; seven good result; two fair; and one poor. Of the nine Type 3 fractures, two had good; three fair; and four poor result. On the basis of our study, we believed that open reduction and internal fixation was a good method of treatment for the displacce or mildly comminuted intra-articular fractures of the cal-caneus.
Calcaneus ; Classification ; Follow-Up Studies ; Humans ; Intra-Articular Fractures ; Methods ; Prognosis ; Tomography, X-Ray Computed ; Transplants

The symphysis pubis is a nonsynovial amphiarthrosis in which the bodies of the two pubic bones are united by a fibrocartilaginous disk. This forms subsidiary tie arches that augment femorsacral arch in the erect position, ischiosacral arch in the sitting position. In normal state the symphysis is strong enough not to be separated. We experienced 5 cases of separated symphysis pubis developed during labor at the Catholic Hospital from January 1987 to December 1988. The duration of follow-up was between 12 and 19 months without any residual symptom after conservative treatment.
Follow-Up Studies ; Pubic Bone

We treated 27 cases of the complete dislocation of the acromioclavicular joint with the modified Weaver and Dunn procedure described by Shoji et al, which is resection of the lateral end of the clavicle and bone block transfer of the coracoacromial ligament, from July 1987 to December 1989. Twenty-one patients were followed for an average of fourteen months and the brief summary of the observations are as follows: 1. The peak incidence was in 3rd and 4th decades and much more prevalent in male (76%). 2. The most common cause of the injury was traffic accident and followed by fall down. 3. In functional evaluation by the Weitzmann criteria, an excellent result was seen in fourteen cases; a good result, in five; a fair result, in two. 4. The comparision of the coracoclavicular interval ratio before surgery with that after surgery facilitated the evaluation of the effectiveness of the coracoclavicular ligament reconstruction. 5. There were no major complications that could affect to end result.
Accidents, Traffic ; Acromioclavicular Joint ; Clavicle ; Dislocations ; Humans ; Incidence ; Ligaments ; Male

We clinically analyzed 53 patients of fresh femoral neck fractures who were treated in Daegu Catholic Hospital from Aug. 1980 to Apr. 1987: The end results of the surgical methods, i.e. internal fixation, endoprosthesis and total hip replacement, were compared in the 45 patients who were followed for more than 2 years. The results were as follows. 1. The most frequent age occurrence was different in sexes ; male was in the 8th decade (29%) and female was in the 6th decade(31%). 2. The most frequent cause of fracture was “fell from height” in male(43%) and slip down in female(47%).3. Mid cervical fracture was the most frequent in anatomical classification(49%) and 83% of fractures were displaced(Garden stage III & IV). 4. The results were evaluated by the modified Lunceford criteria which included the degree of patient's own satisfaction. The combined result of “excellent” and “good” were obtained in 75% of 20 internal fixation cases, 80% of 15 endoprosthesis cases and 71% of total hip replacement cases. It was concluded that we could get similar results by 3 surgical methods if reasonable criteria of indication were applied for each method: rehabilitation of patient can more important than osteosynthesis itself in the determination of indication of operative methods.
Arthroplasty, Replacement, Hip ; Daegu ; Female ; Femoral Neck Fractures ; Femur Neck ; Humans ; Male ; Methods ; Rehabilitation

The Inyo nail is a new intramedullary device for the treatment of the lateral malleolus. fracture of the ankle with the advantage of rigid fixation. The authors have experieced 16 cases of the Inyo nailing for the ankle fracture and fallowed more than 1 year in the 11 of them. Two groups of patients were evaluated; Group I was treated with the Inyo nail and Group II was treated by conventional technique. The following results were obtained; 1. The Inyo nail was suitable for treatment of type A & B fractures of the ankle. 2. Group I patients resumed their preinjury ROM of the ankles and activity earlier than Group II. 3. The results in the radiographic rating and fuctional criteria were excellent in those cases of Group I than those of Group II.
Ankle Fractures ; Ankle ; Humans

Combined injury of peroneus brevis rupture and bimalleolar fracture is very rare. The avulsion of peroneus brevis tendon from insertion maybe neglected and may prevent anatomic reduction of lateral malleolar fracture. We have treated open bimalleolar fracture with avulsion of peroneus brevis tendon from its insertion.
Ankle Fractures ; Rupture ; Tendons

Six. patients with clavicular nonunion were treated at the Daegu Catholic Hospital from Aug. 1980 to Jun, 1986. Five patients were male and one was female, and their ages ranged from 35 to 52 years. There were hypertrophic nonunion in four patients and atrophic nonunion in two patients; all six patients had symptoms due to nonunion. Factors that might have influenced the development of nonunion in our cases seem to be inadequate operative treatment, severe trauma and inadequate external fixation due to combined injuries. Five patients were treated with semitubular plating and iliac graft, and one was treated with intramedullary K-wire fixation and iliac graft. All patients achieved good union by average 10 weeks postoperatively and symptoms disappeared. It was concluded that symptomatic nonunion of the mid-clavicle could be treated by operation, and the procedure of choice seemed to be rigid internal fixation with plating applied in compression and bone graft.
Clavicle ; Clinical Study ; Daegu ; Female ; Humans ; Male ; Transplants

In 38 patients with femorsl neck fracture trested at Cstholic Hospital from Aug. 1980 to Jun. 1985, 24 patients were followed for more thsn 2 years. Preoperative bone scanning with 99m Tc MDP was performed in those 24 patients and postoperative follow-up bone scan assesment of the femorsl vascularity was done in 9 patients of them. Following results were obtained. 1 . Tc 99m methylenediphosphonate bone scanning was effective in assesing the femoral head vascularity in the femoral neck fracture patients. 2. The femoral head activity could be changed in the postoperative scanning : there could be further injury to the blood supply during operation or femoral head revascularization after operation 3. Some information about the possibility of future avascular necrosis could be obtained by comparing preoperative and postoperative bone scan in order that early preventive measures might be applied against the late head collapse. 4. It was conculuded that internal fixation should be considered first in the treatment of fresh femoral neck fracture : the indication of head replaement surgery could not be rnade by preoperative bone scan only.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Neck ; Necrosis ; Prognosis

The treatment of acute osteomyelitis has been much improved with the development of better antibiotics, but still a number of problems have remained unsolved. To find out possible problems in our method of management and to help resolve these problems, a clinical study was done of 34 cases of acute childhood osteomyelitis treated from August 1980 to January 1985. The results were as follows: 1. Bone scan helps diagnosis and localization of this disease; blood culture is significant in the selection of relevant antibiotics by sensitivity test. 2. All the causative organisms cultured were staphylococcus aureus which showed 100% sensitivity to cephalosporin and 100% resistant to penicillin: methicillin was not much effective compared with other reports. 3. 22 cases were trcated with decompression operation and 12 cases with conservative method: surgery is considered to be better method of treatment in the viewpoints of clinical process and complications.
Anti-Bacterial Agents ; Child ; Clinical Study ; Decompression ; Diagnosis ; Humans ; Methicillin ; Methods ; Osteomyelitis ; Penicillins ; Staphylococcus aureus