• Title/Summary/Keyword: 골절위험

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Analysis of Risk Factors for Complication after Hip Fracture Surgery in the Elderly According to Geriatric Interdisciplinary Team Care and Orthopedic Care (노년내과와 정형외과의 협진 여부에 따른 노인의 고관절 골절수술 후 합병증 발생 위험 요인분석)

  • Park, Eun Young;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.18 no.4
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    • pp.193-202
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    • 2016
  • Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.

A CASE REPORT OF SURGICAL CORRECTION OF NASOMAXILLARY HYPOPLASIA DUE TO CONGENITAL SYPHILIS BY LE FORT II OSTEOTOMY WITH CORONAL APPROACH (선천성 매독에의한 비상악골 부전증환자의 관상두피 접근법에 의한 Le Fort II 골절단술을 이용한 치험례)

  • Um, In-Woong;Kim, Chang-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.88-94
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    • 1991
  • Maxillofacial deformities are not considered to be a trouble in social life but function. So many maxillofacial plastc surgeons has made efforts to overcome these troubles and bring out more positive life. The proper proportion and shape decide esthetic quality. Lower third of face was consist with lip, cheek, mandibular lower border and mandibular angle. Widening lower third of face give a impression with muscular and recklessness. And lower and wide mandibular angle makes face square shape. Unilateral involvement cause asymmestric face. These face is considered unfavorable, especially in Korea or Japan. We prevent a number of with mandibular angle Bulging which was corrected with mandibular osteotomy or masseter myotomy.

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Study on Injury Risk Factors of the Elderly for Safety·Security Design (안전·안심디자인을 위한 고령자의 손상 위험요인에 관한 연구)

  • Kim, Mi-Young
    • The Journal of the Korea Contents Association
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    • v.17 no.2
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    • pp.105-112
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    • 2017
  • This study recognizes it as a social problem that can be prevented by basic research on safety security design for the elderly, and aims to clearly analyze risk factors for injury. For this study, raw data from the 6th Korean National Health and Nutrition Survey were employed and analyzed. Their social characteristics were classified with standards including gender, education, EuroQoL(human locomotion, normal activity and pain uncomfortableness), the quality of life(PHQ-(1)(2)(4)), recognition on stress, activity restriction status and associated causes(bone fracture and joint injury). Their epidemiological traits were chronic diseases, 'diabetes and hip-joint pain', and health-behavioral traits were 'smoking, breakfast frequency and high-level physical activity status.' In conclusion, it can be found that damage risk of elderly rose in case of female, lower education, inconvenience or limitation, pain or discomfort in locomotion and daily activities, higher recognition of stress, lower interest in work, feeling of depression, despair, and weariness, restriction in activity caused by bone fracture and joint injury, having diabetes and hip-joint pain, smoking, low frequency in having breakfast and high-level physical activities. Based on this study, we envision that an effective solution for injury risk factors caused by the organic relation can be reached in the near future.

Arthroscopic Treatment of an Anterior Cruciate Ligament Avulsion Fracture: Physeal-Sparing, All-Inside Suture Bridge Repair (전방십자인대 견열 골절의 관절경적 치료: 성장판을 보존한 All-Inside 교량형 봉합술)

  • Park, Byeong-Mun;Lee, Seung-Hwan;Yang, Bong-Seok;Kim, Ji-Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.444-449
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    • 2020
  • An anterior cruciate ligament (ACL) avulsion fracture is an uncommon injury that occurs predominantly in the pediatric and adolescent population. Accurate reduction and fixation of an avulsed fragment are necessary to restore and maintain the length of the ACL and normal knee biomechanics. Several techniques are available to repair an ACL avulsion fracture. On the other hand, treatment is controversial in skeletally immature patients due to risk of physeal injury. This paper reports a case of an ACL avulsed fracture in a skeletally immature patient treated with arthroscopic all-inside suture bridge repair, in which an excellent result and firm stability were obtained without physeal injury.

Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery (대퇴부골절 후 수술환자의 섬망과 임상예후와의 관계)

  • Shim, Jae-Lan;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.649-656
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    • 2016
  • This study was a retrospective examination to identify the association of postoperative delirium of the prognosis on following femur fracture surgery in elderly patients. Data was collected from the medical records of elderly patients (aged 65 years or older), who underwent femur fracture surgery from July 2010 to January 2014, following on 3-years in one university hospital. A total of 68 patients were involved. There were 31 cases (45.6%) with delirium and 37 cases (54.4%) without delirium. The participant's average age was 80.8 (patients with delirium), and 81.8 (delirium without patients) years of age, respectively, and most of them were female. There was no significant difference between the two groups. Taking five or more medications, serum creatinine level, and the total medical costs were significantly different in the delirium group and non-delirium group. In addition, the proportional hazard model of Cox to determine the predictors for the major clinical outcome occurring after surgery revealed delirium, five or more multi-drug use, and an experience of transfusion to be significant predictors. In conclusion, postoperative delirium in the elderly undergoing femur fracture surgery can have a negative clinical outcome in patients and caregivers. Therefore, a preoperative evaluation and management of the risk factors will be necessary.

Management of Patients with Rib Fractures: Analysis of the Risk Factors Affecting the Outcome (늑골골절 환자 치료: 결과에 영향을 주는 위험인자 분석)

  • Kim, Han-Yong;Kim, Myoung-Young
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.285-291
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    • 2010
  • Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

평면연삭에서 숫돌의 종류와 연삭조건에 따른 표면거칠기 및 연삭숫돌의 파괴

  • 오동석;이종훈;이병곤
    • Proceedings of the Korean Institute of Industrial Safety Conference
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    • 2000.06a
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    • pp.31-36
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    • 2000
  • 평면연삭은 기계부품의 후가공 공정에 사용되며, 기계부품의 다듬질면은 내마멸성, 피로강도 및 내식성등 품질에 큰 영향을 미친다. 연삭작업중 가장 큰 위험 요소는 고속작업중 연삭숫돌의 파손이다. 연삭숫돌의 파괴되는 주요 원인은 고속 회전중 최고사용 원주속도를 넘어 지나치게 빠를 때 원심력이 결합력보다 커지는 경우와, 숫돌에 균열(crack)이 있을 때이다. 연삭숫돌이 파괴되어 숫돌 파편이 작업자의 머리, 안면등을 강타하여 사망이나 골절등 중대재해가 발생된다. (중략)

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