• Journal of the Korean Orthopaedic Association
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• 제52권1호
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• pp.25-32
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• 2017

Purpose: The purpose of this study was to analyze the radiological and clinical outcomes in elderly patients with unstable intertrochanteric femur fractures in accordance with the length of intramedullary nail. Materials and Methods: Between August 2009 and December 2014, a total of 139 patients-older than 65 years of age with AO/OTA classification of 31-A2 unstable intertrochanteric femur fracture-who has been followed-up for at least 1 year after the treatment with internal fixation by using an intramedullary nail were enrolled for this retrospective control study. The subjects were classified into two groups according to the length of intramedullary nail: 106 patients in the short group (group I) and 33 patients in the long group (group II). For radiological assessments, the reduction state, time to union, and implant related complications were examined. The clinical outcomes were assessed by preoperative hemoglobin, operating time, intraoperative bleeding amount, blood transfusion rate, hospitalization period, and Charnley hip pain scoring system at the final follow-up. Results: The postoperative radiographs showed good or acceptable reduction in all cases. The mean time of radiologic bone union was 4.8 months, and there was no difference between the two groups. With respect to surgical time, the group II was found to take longer (57.87 minutes) than the group I (45.65 minutes) (p=0.003). The bleeding amount during surgery of the group II was greater (288.78 ml) than that of the group I (209.90 ml) (p=0.046). The clinical results at the final follow-up were found to be satisfactory in both groups. Conclusion: In cases of good reduction of the fracture from the treatment of unstable intertrochanteric femur fracture accompanying the posteromedial fragment in elderly patients, both groups-long and short intramedullary nails-showed satisfactory radiological and clinical outcomes.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.17-22
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• 1988

Fractures of the femoral neck in children are rare and usually the result of severe trauma. The femoral necks in children, in contrast to those of adults, have many anatomic and physiologic differences. Among the late complications encountered are avascular necrosis, coxa vara, premature closure of the proximal capital femoral epiphysis and nonunion. In spite of careful management, significant complication rate often results. Nine cases of fractures of the femoral neck in children which were treated at Yeungnam University Hospital from June 1984 to August 1987 were reviewed. The results obtained are as follows: 1. The main causes of fractures were traffic accidents(5 cases). 2. Among 9 patients, 6 were girls and 3 were boys. 3. According to the classification of Delbet and Colonna, the transcervical fracture(6 cases) was the commonest type. 4. 4 cases were treated by closed reduction and internal fixation, 3 cases were treated by open reduction and internal fixation. 2 cases were treated by skin traction and cast. 5. The results were analyzed according to Ratliff's assessment. 6 cases showed good results, and 3 cases showed poor results. 6. Early diagnosis and good fixation method seemed to be vital to prognosis.

• The Journal of the Korean bone and joint tumor society
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• 제20권1호
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• pp.36-40
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• 2014

Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.

• Transactions of the Korean Society of Mechanical Engineers A
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• 제24권2호
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• pp.329-337
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• 2000

An investigation has been performed to develop an analysis tool based on a nonlinear beam theory, which can be used to predict the long-term behavior of an artificial hip joint. The nonlinear behav ior of the femur arise from the coupled dependence of the bone density and the mechanical properties on each other. The beam theory together with its numerical algorithm is developed to take into account the nonlinear bone remodeling process of the femur that is long enough to be assumed as a beam. A piecewise linear curve for the bone remodeling rate is used in the bone remodeling theory and the surface area density of bone is modeled as the third order polynomial function of bone density. At each section of the beam, a constant curvature is assumed and the longitudinal strains are also assumed to vary linearly across the section. The Newton-Rhapson iteration method is used to solve the nonlinear equations for each cross section of the bone and a backward method is used to march along the time. The density and the remodeling signal ar, calculated along with time for the various time steps, and the developed beam theory has been verified by comparing with the results of finite element analysis of a remodeling bone with an artificial hip joint of titanium prosthesis subjected to uni-axial loads and pure bending moment. It is concluded that the developed beam theory can be used to predict the long-term behavior of the femur and thus to design the artificial hip prosthesis.

• The Journal of the Korean bone and joint tumor society
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• 제12권2호
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• pp.126-130
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• 2006

Liposclerosing myxofibrous tumor (LSMFT) is a fibro-osseous lesion of the bone with a marked predilection for the intertrochanteric region of the proximal femur. It is characterized by a complex mixture of histological elements including fibrous dysplasia-like features, myxofibrous tissue, lipomatous area, ischemic ossification, xanthoma cells and pseudo-Paget's bone. Though some consider LSMFT as a variant of the fibrous dysplasia, intraosseous lipoma, or other benign osseous lesions, recently LSMFT is emerged as a genuine clinicopathologic entity. We experienced a 48-year female patient with typical histologic and radiologic findings of LSMFT. It was located at the intertrochanteric area of the femur. Radiologically, the lesion was radiolucent and ground-glass appearance with sclerotic rim in the plain film and magnetic resonance imaging. Histologically, myxofibrous tissue, lipomatous area and fibrous dysplasia-like features were predominant findings.

• Journal of Korean Orthopaedic Sports Medicine
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• 제10권1호
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• pp.27-34
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• 2011

Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.

• The Journal of Korean Society for Radiation Therapy
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• 제15권1호
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• pp.67-77
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• 2003

I. Purpose Uniform dose distribution of the whole body is essential factor for the total body irradiation(TBI). In order to achieved this goal, we used to compensation filter to compensate body contour irregularity and thickness differences. But we can not compensate components of body, namely lung or bone. The purpose of this study is evaluation of dose attenuation in bone tissue when TBI using diode detectors and TLD system. II. Materials and Methods The object of this study were 5 patients who undergo TBI at our hospital. Dosimetry system were diode detectors and TLD system. Treatment method was bilateral and delivered 10MV X-ray from linear accelerator. Measurement points were head, neck, pelvis, knees and ankles. TLD used two patients and diode detectors used three patients. III. Results Results are as followed. All measured dose value were normalized skin dose. TLD dosimetry : Measured skin dose of head, neck, pelvis, knees and ankles were $92.78{\pm}3.3,\;104.34{\pm}2.3,\;98.03{\pm}1.4,\;99.9{\pm}2.53,\;98.17{\pm}0.56$ respectably. Measured mid-depth dose of pelvis, knees and ankles were $86{\pm}1.82,\;93.24{\pm}2.53,\;91.50{\pm}2.84$ respectably. There were $6.67\%{\sim}11.65\%$ dose attenuation at mid-depth in pelvis, knees and ankles. Diode detector : Measured skin dose of head, neck, pelvis, knees and ankles were $95.23{\pm}1.18,\;98.33{\pm}0.6,\;93.5{\pm}1.5,\;87.3{\pm}1.5,\;86.90{\pm}1.16$ respectably. There were $4.53\%{\sim}12.6\%$ dose attenuation at mid-depth in pelvis, knees and ankles. IV. Conclusion We concluded that dose measurement with TLD or diode detector was inevitable when TBI treatment. Considered dose attenuation in bone tissue, We must have adequately deduction of compensator thickness that body portion involved bone tissue.

• Investigative Magnetic Resonance Imaging
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• 제11권1호
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• pp.49-53
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• 2007

Fibrous dysplasia is a skeletal developmental anomaly of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a nonhereditary disorder of unknown cause. In fibrous dysplasia, the medullary bone is replaced by fibrous tissue, which appears various imaging findings. It is usually an incidental finding, generally not requiring further investigation. However, fibrous dysplasia may be complicated by pathologic fracture, and rarely by malignant degeneration. We present the image findings of a 44-year-old man who had a chondroblastic osteosarcoma arising from polyostotic fibrous dysplasia in the femur. Evidence of cortical destruction on plain radiography and soft tissue mass in the lesion on MR images suggested a tumor of malignant transformation.

• Composites Research
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• 제25권1호
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• pp.9-13
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• 2012

In this research, biomechanical characteristics of the bone tissue are experimentally investigated. By using specimens of the bovine bone, the mechanical properties are obtained through tension and shear tests. In experiments, non-homogeneous and anisotropic properties with respect to longitudinal and transversal directions are observed. Moreover, the viscoelastic behavior in which modulus and strength properties are dependent on strain rates is analyzed. It is expected that a numerical damage model of the bone be efficiently established based on the results.

• Journal of the Korean Society of Radiology
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• 제7권5호
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• pp.313-320
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• 2013

For some patients with joint illnesses such as rheumarthritis or varus deformity, the total knee arthroplasty (TKA) procedures are performed. However, when inserting metal cutting guide for the procedures, due to the femoral shaft bowing, complications such as the cortex of the femoral shaft damages or secondary fractures can be caused. If the central coordinate value of the femoral shaft is known, the metal cutting guide could be inserted into the anatomical center, so such complications can be prevented. In this study, CT images of femoral shafts of 10 individuals in the experiment group who are in need of receiving the total knee arthroplasty procedures and those of 10 individuals in the control group without illness in the femoral shaft have been utilized to locate the 3-dimensional coordinate values. Then, Matlab was utilized to identify the central coordinate value in order to obtain a graph reflecting the anatomical shapes as well as to acquire the 3-dimensional radial curvature values by section. As a result, the average curvature range and standard deviation of femoral shafts of the experiment group was determined to be $758.15{\pm}206.3mm$ whereas the that of the control group was determined to be $1672.97{\pm}395.6mm$. The statistical significance of the measured results was verified through f-distribution analysis. Based on these results, it was verified that the level of curvature of the femoral shaft of the experiment group was higher. If the anatomical central points are located and analyzed using this methodology, it would be helpful in performing orthopedic operations such as the total knee arthroplasty.