• Title/Summary/Keyword: 대퇴골 골절

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The Difference between Short and Long Intramedullary Nailing as the Treatment for Unstable Intertrochanteric Femoral Fracture (AO/OTA 31-A2) in Elderly Patients (고령환자에서 발생한 불안정성 대퇴골 전자간부 골절(AO/OTA 31-A2)의 치료 시 골수강내 금속정의 길이에 따른 추시 결과)

  • Shin, Won Chul;Lee, Eun Sung;Suh, Kuen Tak
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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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.

Correlations between Acoustic Properties and Bone Mineral Density in Bovine Femoral Trabecular Bone In Vitro (생체 외 조건의 소 대퇴골 해면질골에서 음향특성과 골밀도 사이의 상관관계)

  • Hwang, Kyo-Seung;Seo, Dong-Wan;Lee, Kang-Il
    • The Journal of the Acoustical Society of Korea
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    • v.31 no.4
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    • pp.244-252
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    • 2012
  • The purpose of the present study is to investigate the correlations between acoustic properties, such as speed of sound and normalized broadband ultrasound attenuation, and bone mineral density in femur with high fracture risk. The speed of sound and the normalized broadband ultrasound attenuation in 15 bovine femoral trabecular bone samples in vitro were measured by using a through-transmission method with two matched pairs of ultrasonic transducers with center frequencies of 0.5 and 1.0 MHz. The volumetric bone mineral density of the trabecular bone samples was measured by using micro-computed tomography. The bone mineral density exhibited strong correlations with both the speed of sound and the normalized broadband ultrasound attenuation measured by using the 0.5 and the 1.0 MHz transducers. The highest correlation was found between the bone mineral density and the normalized broadband ultrasound attenuation measured by using the 0.5 MHz ultrasonic transducers. The results suggest that the acoustic properties measured in the femur in vitro can be used as indices for the prediction of femoral bone mineral density.

Anterior Cruciate Ligament Reconstruction Using Autologous Bone-patellar Tendon-bone (자가 골-슬개건-골을 이용한 전방십자인대 재건술)

  • Kyung, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.88-91
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    • 2010
  • 전방십자인대 재건술시 자가건 선택에 대해서는 많은 논쟁의 소지가 존재하며 많은 보고들이 나오고 있으나, 현 시점에서 이식건으로써 자가 골-슬개건-골이 표준(gold standard)라는 주장은 이제 변화하고 있으며, 골-건 고정방법의 개선에 따른 조기 슬관절 안정성의 호전으로 자가 슬괵건의 사용이 점점 증가되고 있는 추세이다. 자가 골-슬개건-골은 이식건으로써 강한 물성, 튼튼한 고정, 장기 추시에서 높은 성공률 등으로 젊고, 강한 활동을 요하는 운동선수에서 종종 선택되고 있으며 조기에 강한 활동으로의 운동 복귀를 할 수 있다. 그러나 슬관절 전방 통증, 무릎을 꿇을 때의 통증, 슬개골골절, 슬개-대퇴 관절의 염발음 및 대퇴사두근력의 감소 등 이식물 채취로 인한 공여부 이환이 문제가 되었다. 그래서 자가 골-슬개건-골의 이식건으로서의 문제점 및 문헌상 고찰을 하여 논하고자 한다.

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Studies on the Comparative Analysis Between GE Prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool (골절의 절대위험도 평가방법에서 GE Prodigy와 FRAX Tool의 비교분석에 관한 고찰)

  • Lee, Hwa-Jin;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Mu-Seok;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.137-142
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    • 2009
  • Purpose: World Health Organization (WHO) have suggested that an individual's 10-year absolute fracture risk is more reliable than Bone Mineral Density (BMD) measurement as the predictor of osteoporotic fracture. In 2008, Fracture Risk Assessment Tool ($FRAX^{TM}$) was developed by WHO to evaluate fracture risk of patients based on individual's clinical risk factors. The purpose of this study is to offer the comparative analysis of the existing GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Materials and Methods: 201 women ($55{\pm}3.5$ years) underwent femoral neck BMD measurement using GE Prodigy. The 10-year probability (%) of hip fracture (or a major osteoporosis-related fracture) was estimated using T-scores of GE prodigy and $FRAX^{TM}$. We made a comparative analysis of these data using SPSS (Ver.12). Results: There was a significant difference statistically between T-score ($-0.52{\pm}0.97$) of GE prodigy and T-score ($-1.45{\pm}0.81$) of $FRAX^{TM}$ (r=0.977, p=0.000). Also, there was a significant difference statistically between a major osteoporosis- related fracture ($9.15{\pm}3.71$) of GE prodigy and a major osteoporosis-related fracture ($4.87{\pm}1.51$) of $FRAX^{TM}$ (r=0.909, p=0.000). Moreover, a statistically significant difference was found in the 10-year probability of hip fracture of GE prodigy ($1.56{\pm}1.48$) and of hip fracture ($0.53{\pm}0.61$) of $FRAX^{TM}$ (r=0.905, p=0.000). Conclusions: There was a significant difference statistically between GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Especially, T-score, a major osteoporosis-related fracture and the 10-year probability of hip fracture that were estimated using GE prodigy tended to show the higher results than one evaluated by $FRAX^{TM}$ Tool. In conclusion, $FRAX^{TM}$ Tool may provide a better tool. The application of $FRAX^{TM}$ Tool as a fracture predictor remains to be clarified.

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Influence of Cortical Endplates on Ultrasonic Properties of Trabecular Bone (피질골판이 해면질골의 초음파 특성에 미치는 영향)

  • Kim, Yoon Mi;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.35 no.2
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    • pp.103-111
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    • 2015
  • The present study investigated the influence of thick cortical endplates on the ultrasonic properties of trabecular bone in a femur with a high fracture risk. Twelve trabecular bone samples were prepared from bovine femurs, and acrylic plates with thicknesses of 1.25, 1.80, and 2.75 mm were manufactured to simulate the cortical endplates using acrylic with a density and a sound speed similar to cortical bone. Although the thickness of the acrylic plates attached to the two sides of the trabecular bone increased, high correlations were observed between the speed of sound and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.80-0.86. High correlations were also observed between the attenuation coefficient at 0.5 MHz and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.84-0.91. These results suggest that the speed of sound and attenuation coefficient at a specific frequency measured in a femur with relatively thick cortical endplates compared to the calcaneus could be used as indices for predicting the bone mineral density of the femur.

The Clinical Study of the Supracondylar Fracture of the Femur (대퇴골 과상부 골절 및 치료에 대한 임상적 고찰)

  • Ahn, Jong-Chul;Kim, Se-Dong;Ahn, Myun-Whan;Seo, Jae-Sung;Lee, Dong-Chul;Lee, Young-Joo
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.197-211
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    • 1993
  • 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 complications 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 $C_2$&$C_3$). 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 conservative 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.

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Medical Application of the Nondestructive Ultrasonic Tests: Diagnosis of Micro Bone Fractures using Ultrasonic C Scan Images (비파괴 초음파 검사법의 의학적 활용: 초음파 C 스캔 영상을 이용한 미세 골절의 진단)

  • Choi, Min-Joo
    • Journal of the Korean Society for Nondestructive Testing
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    • v.22 no.4
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    • pp.377-385
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    • 2002
  • Ultrasonic tests employing non-ionizing radiation are preferred in nondestructive examinations since they are safe and simple in use. The same principles of the techniques have been taken as valuable tools in medical area for the diagnoses of diseases, in other words, defects of the human body. The paper overviews the principles of the medical diagnosis based on nondestructive ultrasonic tests, and then evaluates experimentally the clinical potential of C scan images not popular in medicine, for detecting the micro fractures of the cortical bone. In the experiment the micro bone fractures were created on the femurs of porks by loading three point bending forces (2-4kN) with the speed of 1 mm/min. As the extent of the fracture was altered, not only X ray images but also ultrasonic C scan images using a focused ultrasonic probe resonated at 25 MHz were obtained. The results showed that ultrasonic C scan images were capable of detecting the micro bone fractures which were not possible to identify by conventional X ray images.

Malignant Transformation of Fibrous Dysplasiainto Osteosarcoma - A Case Report - (골육종으로 악성 전환된 섬유성 골 이형성증 - 1예 보고 -)

  • Kim, Tai-Seung;Lee, Jin-Kyu
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.87-91
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    • 2009
  • Fibrous dysplasia is a developmental benign disorder in which normal bone is replaced by fibrous tissue. Malignant transformation of fibrous dysplasia is a rare complication and more commonly occur in the polyostotic form than monostotic form. We report a case in which osteosarcoma developed in area of fibrous dysplasia of proximal femur after treating with curettage, wedge osteotomy, internal fixation, and bone graft. A review of the literature is presented.

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Surgical Treatment of Metastatic Pathologic or Impending Pathologic Fractures (전이성 병적 골절 또는 병적 임박 골절의 수술적 치료)

  • Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.44-51
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    • 2009
  • Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

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A Study on the Main Diagnostic Code according to the Analysis of the Frequency of Fall Patients by Case-Centered Damage External Code (사례 중심의 손상외인코드 별 낙상환자 빈도수 분석에 따른 주진단코드 연구)

  • Eun-Mee Choi;Ye-Ji Park;So-Hyeon Bang;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.6
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    • pp.533-539
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    • 2023
  • This study aimed to analyze patients hospitalized for injuries who fell using the data from 2020 to 2021 at institution A located in Gangneung-si, Gangwon-do, using codes for causes of injury. After classifying 20 codes from W00 to W19, which are external cause codes for fall patients, the most frequently occurring W18, W01, W10, and W13 were analyzed. The external cause of injury code W18 was other falls on the same plane, with the highest frequency of S72 and Z47, S72 being a fracture of the femur, and Z47 being orthopedic follow-up treatment. The external injury code W01 was determined to be a fall on the same plane due to slipping, tripping, and tripping, and like W18, S72, a fracture of the femur, and Z47, orthopedic follow-up treatment, were frequently reported. In W10, intracranial injuries such as concussion and epidural hemorrhage due to a fall on the stairs, S06, were common. Lastly, in W13, 91% of cases occurred in people in their 40s to 70s due to falls from buildings or structures, confirming that they occur frequently in middle-aged people, Z47 had the most frequent orthopedic follow-up treatment, and S72 had a fracture of the femur. It was found to be the second most common. In this way, the frequency of falling patients was analyzed, and the age and main diagnosis code at which most falls occurred were analyzed.