• Title/Summary/Keyword: 근위대퇴골

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Pseudoaneurysm Originating from the Lateral Femoral Circumflex Artery after Retrograde Intramedullary Nailing of a Distal Femur Shaft Fracture (원위 대퇴골 골절에서 역행성 골수 정 시행 후 발생한 외측 대퇴 회선 동맥 기원의 가성동맥류)

  • Yu, Jeongseok;Lee, Beom-Seok;Kim, Han-Bit
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.535-539
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    • 2021
  • Vascular complications following a femoral fracture are rare but can result in serious issues. Several case studies have reported pseudoaneurysms occurring after direct trauma or the insertion of a proximal femoral nail in the case of a proximal femoral fracture. The authors encountered an 85-year-old patient treated with retrograde intramedullary nail fixation for a distal femur fracture and suffered a decrease in the hemoglobin level, swelling, and pain on the 9th day after surgery. The authors initially attributed the temporary hematoma and pain to ordinary postoperative processes. On the 16th day after surgery, a pseudoaneurysm originating from the descending branch of the lateral femoral convolutional artery was diagnosed and treated by percutaneous vascular embolization. After the procedure, the hemoglobin level increased, and the swelling and pain decreased.

Diagnostic Coincidence of Radiologic Measurement Methods of the Proximal Femur Anterior-posterior Projection for Assessment of Osteoporosis (근위대퇴부 정면 영상을 이용한 골다공증 평가 시 방사선적 계측의 진단일치도)

  • Kang, Yeong-Han;Cho, Kwang-Ho
    • The Journal of the Korea Contents Association
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    • v.12 no.6
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    • pp.353-360
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    • 2012
  • The purpose of this study was to determine whether there are relationships between radiologic parameters for osteoporosis by the proximal femur radiograhps and bone mineral density, as assessed by Dual Energy X-ray Absorptiometry(DEXA). Proximal femur anterior-posterior projection were taken from 112 individuals who undergoing DEXA. Radiographic parameters including canal-to-calcar ratio(CCR) and cortical thickness indices(CTI) were measured and compared with bone mineral density($g/cm^2$), T-score. The intramedullary femoral canal width(FW) and calcar width(CW) at osteoporosis group was significantly larger than that of control group. The CCR were correlated negatively with bone mineral density($g/cm^2$)(r=-0.340, p<0.01), and the CTI were correlated positively(r=0.624). The diagnostic accuracy of CCR for osteoporosis was 63.4%, and kappa value was 0.271. And the accuracy of CTI was 67.0%, and kappa value was the level of fair agreement(${\kappa}$=0.258). The proximal femur with large CCR and small CTI had lower T-scores. When evaluating proximal femur anterior-posterior radiographs, those patients with the thinnest femur diaphyseal cortices should be referred for further osteoporosis investigation.

Juvenile Hemangioma Occurred in Distal Femoral Epiphysis (소아의 대퇴골 원위부 골단에 발생한 혈관종)

  • Kim, Tai-Seung;Lee, Chang-Hoon;Park, Chan-Keum
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.37-41
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    • 2010
  • A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.

Radiographic Evaluation of Limb Bone Development in Miniature Porcine (미니돼지의 팔다리 뼈 성장에 대한 방사선학적 평가)

  • Chang, Jin-Hwa;Jung, Joo-Hyun;Choi, Min-Cheol
    • Journal of Life Science
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    • v.17 no.10
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    • pp.1315-1320
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    • 2007
  • Epiphyseal development in the long bones was studied radiographically in minipigs. Radiographs of the proximal and distal epiphyses of humerus, radius, ulna, femur and tibia were obtained at 4, 8, 12, 20, 40, 48, 96 and 144 weeks of age in total 58 minipigs. The assessment of maturity process was made in accordance with the criteria proposed by Owada and Sutow. The secondary ossification centers developed rapidly from 4 weeks of age to 40 weeks of age, and gradually thereafter until 96 weeks of age. The earliest epiphyseal fusion was apparent in the proximal radius, proximal and distal femur at 96 weeks of age. The complete fusion of the epiphyseal line in the long bones was evident on 144 weeks of age and was observed in most long bones such as the proximal humerus, the proximal and distal ulna and the distal radius, and the proximal tibia in minipigs.

Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur (대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술)

  • Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.7-13
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    • 2014
  • Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient (퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계)

  • Park, Sang Eun;Mun, Sang Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.100-104
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    • 2011
  • The purpose of this article is to examine correlation between femoral rotational angle and subjective satisfaction of high tibial osteotomy outcome of the range of motion of knee joint. The subjects were 15 patients (6 males, 9 females) with primary osteoarthritis undergoing high tibial osteotomy from June of 2004 to August of 2008. They were CT tested on the knee joint before and after high tibial osteotomy. TEA (Fig. 1) and Akagi's line (Fig. 2) are analyzed as percentages. The Kendall's and Spearman's nonparametric correlation coefficient were used for the statistical tests with 0.5 level of significance. The result reveals that femoral rotational angle correlates with not the range of motion of knee joint but subjective satisfaction of the patients. Therefore, this will enable patients and physicians to have better clinical outcome.

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Analysis on Femoral Neck Fractures Using Morphological Variations (파라메트릭 형상모델을 이용한 근위 대퇴골의 경부 골절 영향 해석)

  • Lee, Ho-Sang;Park, Byoung-Keon;Chae, Je-Wook;Kim, Jay-Jung
    • Journal of the Korean Society for Nondestructive Testing
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    • v.31 no.5
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    • pp.459-465
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    • 2011
  • It has been reported that the femoral morphology has a major correlation to femoral neck fractures(FNF). Previous studies to analyze these correlations have relied on mechanical testing and finite element methods. However, these methods have not been widely applied to various femur samples and models. It is because of the availability of the samples from both patients and cadavers, and also of the geometric limitations in changing the shape of the models. In this study we analyzed femoral neck fractures using a parameterized femoral model that could provide flexibility in changing the geometry of the model for the wide applications of FNF analysis. With the parameterization a variety of models could be generated by changing four major dimensions: femoral head diameter(FHD), femoral neck diameter(FND), femoral neck length(FNL), and neck-shaft angle(NSA). We have performed FEA on the models to compute the stress distributions and reaction forces, and compare them with the data previously generated from mechanical testing. The analysis results indicate that the FND is significantly related with the FNF and the FHD is not significantly related with the FNF.

Influence of Impact Angle on Deformation in Proximal Femur during Slide Falling (측방 낙상시의 충격 각도가 대퇴골 근위부의 변형에 미치는 영향)

  • 김병수;배태수;김정규;최귀원
    • Journal of Biomedical Engineering Research
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    • v.24 no.3
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    • pp.233-239
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    • 2003
  • Falling related injuries are categorized as the most serious and common medical problems experienced by the elderly, hip joint fracture, one of the most serious consequences of falling in the elderly, occurs in only about 1% of falling. Nevertheless, hip fracture accounts for a considerable part of the disability, death, and medical costs associated with falling. In this study, we considered the impact angle and displacement rate in falling as another factor affecting femoral strength. Using a fresh-frozen human femur, we developed system to simulate the falling condition and then conducted the experiments changing the impact angle (0$^{\circ}$, 15$^{\circ}$, 30$^{\circ}$) of proximal femur. Also, in order to analyze the relative risk due to falling to normal situation in proximal femur, we did the static test simulating the two-legged stance condition. The results showed that the change in impact angle affected the strain distribution in proximal femur, and that a large deformation in femoral neck than in other sites. Furthermore despite low impact velocity, a large deformation in proximal femur occurred in the impact test and different strain distribution was observed compare to the static case.

Reconstruction of Extensor Mechanism After Prosthetic Replacement of The Proximal Tibia (근위 경골에 발생한 악성종양 절제 후 슬관절 신전력 재건술 -증례 보고-)

  • Park, Jong-Hoon;Oh, Jung-Moon;Kim, Jin-Wook;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.120-123
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    • 2004
  • Benign and malignant bone tumors occur most commonly around the knee. The proximal tibia is the most technically demanding site for limb salvage surgery. The most difficult problem using an endoprothesis for proximal tibial resection has been reconstruction of the extensor mechanism. After excision of proximal tibia, we resected distal femur and made a composite with resected distal femur, low heat treated autogenous proximal tibia and endoprothesis. Patella was fixed into the resected down-loaded distal femur. This article shows the new technique and the results of reconstruction of extensor mechanism after prosthetic replacement of the proximal tibia.

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