- Physeal Remodeling after Internal Fixation of Slipped Capital Femoral Epiphysis.
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Se Dong Kim, Byung Won Park
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Yeungnam Univ J Med. 2003;20(1):28-35. Published online June 30, 2003
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DOI: https://doi.org/10.12701/yujm.2003.20.1.28
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- PURPOSE: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. MATERIALS AND METHODS: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal- shaft angle. RESULTS: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, 7.8degree), in 2 patients (3 hips) at group II (mean, 10.7degree). CONCLUSION: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.
- The Effect of Long Chain N-3 Polyunsaturated Fatty Acids on Development of Collagen-induced Arthritis in Rats.
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Kyung Ho Shin, Se Dong Kim, Hwan Jin Jeon, Eung Chan Jang, Suck Kang Lee
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Yeungnam Univ J Med. 2002;19(1):39-48. Published online June 30, 2002
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DOI: https://doi.org/10.12701/yujm.2002.19.1.39
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- BACKGROUND
The treatment of rheumatoid arthritis still depend on conserve therapy in major. Recent studies report that n-3 polyunsaturated fatty acids(PUFA) could modulate the incidence and progress of arthritis. The purpose of this study was to investigate the effects of n-3 PUFA on the development of collagen-induced arthritis in rats. MATERIALS AND METHODS: Female Louvain rats were used for this experiment. Rats were randomly assigned into either normal(n=8) or collagen-immunized groups, and collagen immunized groups were divided into control(n=8, normal diet) and n-3 PUFA(n=8, 5% n-3 PUFA in diet) groups. One week after feeding n-3 PUFA to rats, they were immunized with type II collagen emulsified in incomplete Freund's adjuvant into tail and back. Development of arthritis was confirmed by x-ray and microscopic examination. RESULTS: Incidence of arthritis at the 5th week after immunization was 38% in control and 0% in n-3 PUFA. Rats with arthritis showed edema in hind paws and inflammation in synovial membrane of the knee joint. Plasma glucose and insulin were not changed by both of immunization and diet. Plasma triglycerides and cholesterol concentrations were decreased by n-3 PUFA. CONCLUSION: n-3 PUFA may prevent or treat collagen-induced arthritis in rats. Further studies are needed for action mechanism of it.
- Non-traumatic Avascular Necrosis of the Femoral Head.
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Se Dong Kim
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Yeungnam Univ J Med. 1999;16(1):1-9. Published online June 30, 1999
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DOI: https://doi.org/10.12701/yujm.1999.16.1.1
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- Avascular necrosis of the femoral head is a debilitating disease that leads to destruction of the hip joint in patients who are in the third, fourth, or fifth decade of life. The total societal cost is so high because these patients are generally young, hold jobs, and have a considerable life expectancy. Therefore, we have to delay or eliminate the need for total hip replacement as possible as we can. The purpose of this review id to provide a current perspective of avascular necrosis of the femoral head.
- Arthrographic Evaluation in Developmental Dislocation of the Hip: Comparison Between Hip Arthrogram and Operative Findings.
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Se Dong Kim, Yun Seok Lee
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Yeungnam Univ J Med. 1998;15(2):263-274. Published online December 31, 1998
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DOI: https://doi.org/10.12701/yujm.1998.15.2.263
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- One of the main purposes in the treatment of developmental dislocation of the hip is to achieve and maintain concentric, congruent, and stable reduction. The arthrogram perform an important role in the diagnosis and treatment of developmental dislocation of the hip. The arthrogram provides much information about the soft tissue status of the hip joint. Limbus and ligamentum teres is exactly evaluated so we can plan the reduction and treatment before operation. 18 preoperative hip arthrograms of 17 children treated for developmental dislocation of the hip from 1992 to 1998 were reviewed. The limbus, ligamentum teres and transverse acetabular ligament were compared with the pathoanatomy seen at the time of open reduction. Arthrography proved reliable in identifying the limbus and ligamentum teres. So we recommend that arthrography must be performed before closed or open reduction. Also, we recorded the radiographic parameters: acetabular index, acetabular floor thickness, center edge(CE) angle of Wiberg, and Y-coordinate. The center edge(CE) angle of Wiberg obtained from arthrography was measured more accurately than from simple roentgenograms because the ossification of the femoral head was frequently located eccentrically in the developmental dislocation of the hip.
- Slipped Capital Femoral Epiphysis(SCFE).
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Jin Myoung Dan, Se Dong Kim
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Yeungnam Univ J Med. 1997;14(1):245-261. Published online June 30, 1997
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DOI: https://doi.org/10.12701/yujm.1997.14.1.245
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- Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. the association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to reatore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.
- Treatment of Developmental Dislocation of the Hip in Walking Age.
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Se Dong Kim, Jae Hyuk Jang, Dong Chul Lee, Duk Seop Shin
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Yeungnam Univ J Med. 1996;13(2):211-224. Published online December 31, 1996
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DOI: https://doi.org/10.12701/yujm.1996.13.2.211
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- The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative -patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better
- Percutaneous K-wire fixation of supracondylar fracture of humerus in children.
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Duk Seop Shin, Jong Chul Ahn, Se Dong Kim, Dong Woo Lee
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Yeungnam Univ J Med. 1993;10(2):400-408. Published online December 31, 1993
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DOI: https://doi.org/10.12701/yujm.1993.10.2.400
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- During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result,, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safty, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an exellent reduction.
- Treatment of tibial fractures by interlocking intramedullary nailing.
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Kwang Yeoung Jung, Dong Chul Lee, Jae Sung Suh, Se Dong Kim
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Yeungnam Univ J Med. 1993;10(2):388-399. Published online December 31, 1993
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DOI: https://doi.org/10.12701/yujm.1993.10.2.388
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- The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993. 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft. fractures. 3. The Im erlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open-with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major-complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of . fracture and then made early joint motion exercise and ambulation.
- The clinical study of the supracondylar fracture of the femur.
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Jong Chul Ahn, Se Dong Kim, Jae Sung Seo, Dong Chul Lee, Young Joo Lee
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Yeungnam Univ J Med. 1993;10(1):197-211. Published online June 30, 1993
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DOI: https://doi.org/10.12701/yujm.1993.10.1.197
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- Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So compliactions of the supracondyle fractures 'including joint.. stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed. 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989. Dec. To 1992. Jan. The results were as follows 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification, 4 cases were type A, 4 in type B, 12 in type C (10 in type C2&C3). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in consevative treatment and 67 in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
- Clinical observation and treatment of fracture-dislocation of talus.
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Dong Chul Lee, Se Dong Kim, Hae Hoon Jung
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Yeungnam Univ J Med. 1992;9(2):302-311. Published online December 31, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.2.302
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- Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)
- Erythrocyte sedimentation rate and C-reactive protein values in patients with hip arthroplasty.
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Se Dong Kim, Dong Chul Lee, Dong Gu Park
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Yeungnam Univ J Med. 1992;9(2):218-223. Published online December 31, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.2.218
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- Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.
- Treatment of the tibia shaft fractures with ender nails.
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In Ki Kim, Dong Chul Lee, Jae Sung Seo, Myun Whan Ahn, Se Dong Kim, Jong Chul Ahn
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Yeungnam Univ J Med. 1992;9(1):130-136. Published online June 30, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.1.130
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- Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their numerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fracture and the remaining 11 were open. The comminuted and segmental fractures were 18 (57.7%) in number and the most common fracture site was the middle one third (53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
- Fracture-separation of the distal humeral epiphysis in children.
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Ja Woong Koo, Se Dong Kim, Jong Chul Ahn
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Yeungnam Univ J Med. 1991;8(2):121-127. Published online December 31, 1991
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DOI: https://doi.org/10.12701/yujm.1991.8.2.121
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- We have reviewed seven cases of fracture-separation of the distal humeral epiphysis, one of which was initially misdiagnosed as a fracture of the lateral condyle. There were difficulties in making the diagnosis. The injury must be distinguished from an elbow dislocation and a fracture of the lateral humeral condyle. All seven patients revealed posteromedial displacement of the distal humeral epiphysis on initial x-rays. Three patients were treated by closed reduction and cast immobilization, and four patients by open reduction and internal fixation. All three patients with conservative treatment had slight cubitus varus (under 5 degrees). Two patients with operative treatment had significant deformities of the elbow, one 25 degrees of valgus and one 20 degrees of varus. In treatment of these injuries, accurate evaluation of the state of reduction is most important. We got acceptable results with a conservative treatment.
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