• Title/Summary/Keyword: 대퇴골 골절

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Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.1-11
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    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

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Comparison of Subchondral Fracture on Radiographs with MR Images in Evaluation of Osteonecrosis in LCP Patients (LCP 환아에서 골괴사의 평가방법으로 연골하 골절선과 자기공명영상의 비교)

  • Kim, Jin-Won;Park, Mee-Jung;Choi, Ho-Chul;Cho, Jae-Min;Ryoo, Jae-Wook;Jeong, Seong-Hoon;Kim, Dong-Hee;Lee, Gyung-Kyu;Na, Jae-Boem
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.177-182
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    • 2009
  • Purpose : To compare the subchondral fracture on plain radiography and MR image as a method for assessing osteonecrosis in Legg-Calve-Perthes(LCP) pateients. Materials and methods: We retrospetively reviewed 15 hip joint MR images and plain radiography which visualized subchondral fracture. With basis of the Salter-Thompson classification, extent of necrosis was graded group A to B, as follows; Group A = < 50%, B = > 50%. On PACS workstation, necrotic area of each MR image was measured to calculate the volume of necrotic portion: volume = necrotic area $\times$ slice thickness. Necrotic areas on MR images were graded group A to B and results were compared with that measured in Salter-Thompson classification. On follow up, bone resorption was measured and the extent was compared with subchondral fracture representing necrotic area and that on MR volume method respectively. Results : In 9 joints of 15 hip joints (60%), the degree of necrosis in Salter-Thompson classification on plain radiographs was different from that on MR volume method. Based on plain radiographs by Salter-Thompson classification, the degree of necrosis was overestimated in 6(67%) joints, and underestimated in 3(33%) joints compared with MR volume method. On follow up study, bone resorption was not correlated with necrotic extent of subchondral fracture and MR volume method. Conclusion : The extent of femoral head necrosis measured by subchondral fracture was different from that measured by MR and was not correlated with bone resorption on follow up. Therefore, usefulness of subchondral fracture as a prognostic factor may be limited.

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Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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A Study on the Causes of Injury Codes by Case-Based Injury Code of External Causes Frequency Analysis (사례 중심의 손상코드 별 손상외인코드 빈도수 분석에 따른 손상코드 발생 원인에 관한 연구)

  • Eun-Mee Choi;Hye-Eun Jin;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.1
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    • pp.50-59
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    • 2023
  • The purpose of this study was to analyze the patients hospitalized with damage by injury code based on data for two years in 2020 and 2021 of A institution located in Gangneung, Gangwon-do. Analyzed the injury codes with a large number of occurrences per year, and analyzed the injury codes of external causes accordingly. The cause of the injury code was analyzed by analyzing the frequency of the injury code of external causes. Injury code S0650 had the highest frequency of injury code of external causes W189 and X5999, which was judged to be the cause of traumatic subdural hemorrhage without open intracranial wounds when falling in an unspecified place or toilet. Injury code S72120 had the highest frequency of injury code of external causes W010 and W180, and it was judged to be the cause of obstructive femoral intertrochanteric fracture that occurs when falling in the residence. The injury code S32090 had a high frequency of X5999, and it was analyzed that it caused the obstructive fracture of the lumbar region due to an accident caused by exposure in an unspecified place, and the injury code S72.090 had a high frequency of W010 and W180. It was confirmed that the cause of the obstructive fracture of the femoral neck was mainly caused by slipping or slipping in the residence, and the injury code S0220 had a high frequency of the injury code of external causes Y049, and it was confirmed that the fibula was fractured mainly by the force or fist. As such, the cause of the injury code was analyzed by analyzing the frequency of the injury code for each injury code of external causes.

Prevalence of Osteoporosis among Male Adults with Apparently Radiolucent Lumbar Vertebral Bodies on the Plain Radiographs (단순 영상에서 요추체의 음영이 감소된 성인 남성에서의 골다공증 유병률)

  • Kim, Kook Jong;Lim, Sung Joon;Kim, Yong Min;Lee, Hyung Ki;Kim, Geon Jung
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.491-497
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    • 2021
  • Purpose: To investigate the prevalence of osteoporosis or osteopenia via dual-energy X-ray absorptiometry bone mineral density (DEXA BMD) in adult males who showed radiolucent lumbar vertebra on the plain radiographs. Materials and Methods: The DEXA BMD values of 98 adult males, who showed radiolucent vertebrae on plain X-rays, were compared with those of the control group (n=168) and osteoporosis-related fracture group (n=113) by statistical analysis. The World Health Organization (WHO) method (lower value between the mean lumbar and femur neck) and the Hansen's method (lowest lumbar vertebra) were used to determine osteoporosis. Results: The mean and standard deviation of the BMD value of each group was -1.4 (±1.2) in the suspicious group, -0.8 (±1.1) in the control group, and -2.4 (±1.0) in the fracture group, respectively; the difference was statistically significant. Using the WHO method, the prevalence ratio of osteoporosis was 17.3% in the suspicious group, 8.3% in the control group, and 45.1% in the fracture group, respectively. Osteopenia was observed in 40.8% of the suspicious group. Hansen's method (lowest lumbar vertebra) revealed the prevalence of osteoporosis in 30.6% of the suspicious group, 17.9% of the control group, and 62.0% of the fracture group. Conclusion: Approximately 17.3% of the suspicious group was diagnosed with osteoporosis, and 40.8% were osteopenic by a confirmative BMD study (WHO criteria) among the adult males showing apparent radiolucency on plain X-rays. The control group also showed an 8% prevalence of osteoporosis. These results suggest that males also are vulnerable to osteoporosis. Therefore, a BMD study should also be used for males, especially for the people showing lumbar vertebrae with radiolucent features.

The Use of Special Washers in Bone Plates for Improved Impact-Absorbing Characteristics (충격흡수 특성의 향상을 위하 내고정용 특수 와셔에 관한 연구)

  • 김윤영;김장수
    • Journal of Biomedical Engineering Research
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    • v.16 no.4
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    • pp.457-462
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    • 1995
  • Unlike the usual bone plate and screw fracture fixation, an improved plate fixation method, which can transfer gradually physiological load to bones, is described. The key feature of the present method is to use washers between the plate and the screw. Bio-absorbable materials or non-ferrous materials with good damping characteristics are used to manufacture the washers. The purpose of this paper is to discuss potential advantages of the proposed method, and to show experimentally its improved impact-absorbing characteristics. Vibration experiments are carried out for pig femurs and cow tibias with and without the proposed washers. This experiments show that the washers can drop the first peak value suite substantially in the FRF plots. Although in-vivo experiments have not been conducted, the present fixation method appears to be a simple and effective alternative to the presently used method.

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Study of Deformity by the Involvement of the Femoral Head of the Proximal Femur in Polyostotic Fibrous Dysplasia (다발성 섬유성 이형성증에서 근위 대퇴골두 침범 여부에 따른 변형 정도)

  • Na, Bo Ram;Jung, Sung Taek;Cho, Yong Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.519-527
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    • 2019
  • Purpose: To evaluate the treatment result in polyostotic fibrous dysplasia classified according to the involvement of the femoral head. Materials and Methods: Twenty-three patients from March 1987 to March 2014 were reviewed retrospectively. Patients with no involvement of the physeal scar in the femoral head were classified as Type I, and those with involvement of the physeal scar were classified as Type II. A plain radiograph was used to measure the femoral neck shaft angle, articulo-trochanteric distance (ATD), and anterior bowing through the lateral view. A teleoroentgenogram of the lower limb was used to measure the leg length discrepancy and lower extremity mechanical axis. The pre- and postoperative femoral neck-shaft angle and ATD were compared to assess the degree of correction of the deformity. Results: Among a total of 46 cases (23 patients), 28 cases (23 patients) had lesions in the proximal femur. Type I were 16/28 cases (15/23 patients) and Type II were 12/28 cases (9/23 patients). The preoperative proximal femoral neck-shaft angle was 116.8° in Type I and 95.3° in Type II. The ATD was 12.08 mm in Type I and -5.54 mm in Type II. The deformity correction showed significant improvement immediately after surgery, the deformity correction was lost in Type II (neck shaft angle Type I: 133.8°-130.8°, Type II: 128.6°-116.9°, and ATD Type I: 17.66-15.72 mm, Type II: 7.44-4.16 mm). The extent of anterior bowing was 12.74° in Type I and 20.19° in Type II. The mean differences of 12 mm between the 9 patients who showed a leg length discrepancy and the lower extremity mechanical axis showed 4 cases of lateral deviation and 7 cases of medial deviation. Conclusion: In polyostotic fibrous dysplasia, when the femur head is involved, the femur neck shaft angle, ATD, and anterior bowing of the femur had more deformity, and the postoperative correction of deformity was lost, suggesting that the involvement of the femoral head was an important factor in the prognosis of the disease.

Implementation of curved type a metallic plate system at the Bone contact (골 접촉 곡선형 금속 고정 시스템 구현)

  • Kim, Jeong-Lae
    • Journal of the Korea Society of Computer and Information
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    • v.12 no.5
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    • pp.285-292
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    • 2007
  • This study was developed the metallic plate for fixation in the femur fracture for the orthopedic region and rigid fixation with plates has a firm place in fracture treatment. Most plates can be used for rigid as well as biological and dynamical fracture fixation. The device's designation and sizing has a specific with bending structural stiffness and strength, known meaning that is reliable regardless of the plate by the short type and long type. Short plate have a wrapping of femur and long plate have to preserve a pole of femur. The bending strength of the curved metallic long plate has to evaluate a 11,000N and The bending strength of the curved metallic short plate has to evaluate a 6,525N. The tensile stress through to press a plate is $1573N/m^2\;and\;1539N/m^2$. The device can be used to support Revision case of Hip Implant and to use a case of Hip screw compression of Hip Neck Fracture.

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Arthroscopic Assisted Reduction and Internal Fixation of Lateral Femoral Epiphyseal Injury in Old Adolescent Soccer Player - Report of 1 Case - (청소년기 축구선수에서 원위 대퇴외과 성장판 손상의 관절경하 정복 및 내고정 - 1례 보고-)

  • Lee, Yong-Seuk;Jung, Jae-Kyoung;Kong, Chae-Kwan;Shin, Yoon-Chang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.66-69
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    • 2007
  • Sports-related knee injuries frequently occur in adolescent period and fractures are more common than ligamentous Injuries in this age group because of physiologic characteristics. We operated an adolescent soccer player with lateral femoral epiphyseal injury using arthroscopic assisted reduction and infernal fixation. In $2^{nd}$ look arthroscopy and metal removal at postoperative 2 years, articular cartilage was healed with good congruity and lower extremity entire long film showed normal axial alignment without residual deformity.

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A Case of Atypical Bone Growth after Femur Neck Fracture in the Paraplegic Patient with Trochanteric Sore (대전자부 압박궤양을 가지고 있는 하지마비 환자에서 대퇴골 골절부위에 발생한 비정상적 골증식의 치험례)

  • Yang, Jeong Yeol;Cheon, Ji Seon
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.92-95
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    • 2008
  • Purpose: Heterotopic ossification in pressure sore patients is reported to rarely develop, but once it occurs, it frequently causes joint stiffness and mobilization restriction. The aim of this article is to report our experience of atypical bone growing at femur neck fracture site with chronic, extensive pressure sore in patient with paraplegia secondary to spinal injury. Methods: A 28-year-old male patient presented with atypical bone growth at femur neck fracture site with pressure sore. He had undergone atypical growth bone removal and separation of united iliac bone and femur, and then pressure sore was covered by advanced rotation flap. Results: The patient mobilized hip joint and rode in a wheelchair. Complications such as dehiscence, infection, hematoma and flap necrosis did not occur. Conclusion: We experienced successful correction of atypical bone growth removal and recovery of pressure sore. We report our experience of atypical bone growth of fracture site and the related literature was reviewed.