• Title/Summary/Keyword: 하지골절

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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.

The Effect of Negative electric field using charged PTFE membrane on Bone Healing of Rabbit Long Bone (Charged membrane에 의한 negative electric field가 토끼 장골의 골 치유에 미치는 영향)

  • Kwon, Yong-Su;Park, Jin-Woo;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.34 no.3
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    • pp.551-562
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    • 2004
  • The purpose of this study was to evaluate the effects of negatively electric field on bone healing in rabbit segmental long bone defects using negatively charged PTFE membrane. Ten millimeter segmental defects in the rabbit radius were used as the experimental model. After membranes were then charge injected using a corona-charging apparatus, the left defects were covered with non charged PTFE membranes as control groups, whereas the right defect was covered with negatively charged PTFE membranes as test group. The animals were divided into 4 groups of 2 rabbits each, and sacrificed at 2, 4, 6, and 8 weeks. Histomorphometric analysis showed a more newly formed bone in negatively charged membrane at early healing period. At 2 weeks, the proportion of new bone formation to total defect area was 0.32% in control group, 1.10% in experimental group. At 4 weeks, the proportion of new bone formation to total defect area was 6.86% in control, and 13.75% in experimental. At 6 and 8 weeks, no obvious difference was found between the two groups but newly formed bone in test groups were slightly more than that in control groups. In conclusion, negatively charged membranes showed more newly bone tissue than noncharged membranes at an early healing period. Although the number of samples was small, this study showed that the combination of negatively electrical stimulation and P1FE membrane may be of value in long bone healing.

Reconstruction of the Lower Extremities with the Gracilis Muscle Flap (박근 유리조직을 이용한 하지 재건술)

  • Lee, Jun-Mo;Lee, Ju-Hong
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.62-67
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    • 1998
  • The gracilis muscle is well suited to small and medium-sized soft tissue defects that cannot be adequately handled by simple rotational flaps and it will conform well to irregular contours, can be split longitudinally at both ends to allow cavities and awkwardly shaped spaces and can be transferred in part or in whole. The gracilis muscle used as a free muscle or musculocutaneous flap is small with a long, narrow contour and its vascular pedicle is a terminal branch of the medial femoral circumflex artery and vein. The aims of soft tissue reconstruction are to cover soft tissue defects, to clear up infection and to prepare for further surgical procedures. Authors have performed 12 gracilis muscle flaps in the lower extremities at Chonbuk National University Hospital from June 1994 through March 1998. The results were as follows. 1. 11 cases of 12(91.7%) were sustained from the crushing injury and secondary complications from the traffic accident. 2. The microsurgical anastomosis of one artery and two veins have performed in 6 cases(50%) of 12 and 11(91.7%) cases of 12 were successful at the third postoperative week and in the final result. 3. Gracilis muscle flap is the infetion-resistant and aesthetically acceptable performed in the lower leg 1/3 and the foot.

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Analysis of the In-Patients Who were Admitted due to Bicycle Related Injuries (자전거 사고로 입원한 환자에 대한 분석)

  • Lee, Dong-Hoon;Kim, Byung-Kuk;Yoon, Hyung-Ku;Shin, Dong-Eun;Lee, In-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.58-64
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    • 2010
  • Purpose: Bicycle riding is an increasingly popular sports and leisure activity in Korea. The aim of this study was to identify injury patterns of admitted patients who were injured from bicycle riding. Materials and Methods: This study examined 71 patients from Jan. 2008 to May 2009. There were 54 male and 17 female patients. We investigated the injured body parts, mechanisms of injury, location of injury, types of bicycles, purpose of bicycle riding, any concomitant luggage or passenger on rear seat, injury seasons and the helmet use. We analyzed the data using Injury Severity Score(ISS). Results: There were 11 cases of ISS 1, 41 cases of ISS 4, 2 cases of ISS 5, 13 cases of ISS 9, one case of ISS 13, two cases of ISS 16 and one case of ISS 29 among the 71 patients. 36 patients(50.7%) underwent surgery for upper and lower extremity injuries, two patients for vertebral body fractures, 8 patients for facial bone injuries and one patient for abdominal organ injury. There were 10 head injuries among whom three patients received treatment in ICU(4.2%). Conclusion: Bicycle riding can cause severe injuries with subsequent admission and major surgeries. Several measures including constructing more bicycle road, public campaign and wearing protective gears should be instituted.

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Proposal of Modified Velpeau View as an Alternative Test Method of Velpeau View and the Visual Comparison (Velpeau view의 대체 검사법으로서 modified velpeau view의 제안 및 영상 비교평가)

  • Lee, Jae-Hyun;Kim, Sang-Tae
    • The Journal of the Korea Contents Association
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    • v.10 no.6
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    • pp.323-328
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    • 2010
  • If a patient wearing arm sliding due to shoulder dislocation or fracture is impossible with abduction, the velpeau view is performed instead of superior-inferior axial projection view. However, it aggravates the patient's pain because it is difficult for the patient with dislocation or fracture to pull back the shoulders. Therefore, I suggest a new method of the 'modified velpeau view' that allows patients to lower their heads at examination. In order to investigate the easiness of fixing posture at examination and clinical utility, I conducted a study comparing the bone structures at the velpeau view and those at the modified velpeau view depending on wall-bucky and the patients' leaning forward angle ($30^{\circ},\;45^{\circ},\;60^{\circ}\;and\;75^{\circ}$), with the subjects of 20 velpeau view-prescribed patients amongst who had come to my hospital suspected of dislocation of shoulder or fracture and 30 healthy people from October of 2009 to January of 2010. Department of radiologists and orthopedics specialists evaluated the pictures for scales 0 to 5(best grade) under the given criteria. As a result of comparison in bone structures depending on wall-bucky and the leaning-forward angle in the group of healthy people, the velpeau view and the modified velpeau showed a similar diagnostic utility at $45^{\circ}$ and $60^{\circ}$. The picture evaluation result for proving diagnostic value showed that the anterior and posterior of shoulder heads and the anterior and posterior of glenoid fossa could be observed in the velpeau view; on the other hand, besides these areas acromioclavicular joint and coracoid process could be viewed in the modified velpeau view. This result verified that the modified velpeau view could replace the velpeau view for its diagnostic value as an examination method. This result, moreover, suggests that the modified velpeau view needs to be studied and improved from a variety of perspectives not only for an alternative for patients having troubles with the velpeau view position but also for clinical application of new test method for diagnosis of shoulder disorders other than dislocation of shoulder or fracture.

Analysis of Factors for Cartilage Regeneration in Patients Who Underwent High Tibial Osteotomy Combined with Microfracture (근위 경골 절골술과 미세 골절술을 함께 시행 받은 환자 군에서 연골 재생에 영향을 미치는 요인에 대한 분석)

  • Lee, Young Min;Song, Eun-Kyoo;Oh, Ho-Seok;Kim, Yu-Seok;Seon, Jong-Keun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.404-412
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    • 2021
  • Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm2) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.

A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture (쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 수술 비교)

  • Yoo, Seong-Ho;Kang, Suk-Woong;Kim, Bu-Hwan;Song, Moo-Ho;Kim, Yeong-Joon;Park, Gyu-Taek;Kwack, Chang-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.1-6
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    • 2017
  • Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

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.

Clinical Case Report on the Gait disturbance Patient with Osteoporosis and Lower Limb Fracture Surgery Treated by Chuna Therapy (골다공증을 동반한 하지부골절 수술 후 보행불리 환자 재활에 단순추나요법을 적용한 치험 1례)

  • Lee, Yun-Jin;Park, Na-Ri;Yang, Doo-Hwa;Ahn, Hee-Duk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.77-88
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    • 2019
  • Objectives : The purpose of this study was to show the effectiveness of Chuna Manual Therapy applied to a osteoporosis patient with gait disturbance due to lower limb fracture surgery. Method : We focused on Chuna therapy accompanied with acupuncture, herbal medicine, moxibustion, cupping treatment and rehabilitation exercise. This case was assessed using the Visual Analogue Scale (VAS), Pain Free Walking Distance (PFWD), Berg Balance Scale (BBS), and Modified Barthel Index (MBI). Result : This patient showed improvement on the VAS from 6 to 3, PFWD from 0 m to 2000 m using a walker and 50 m by self-walking, BBS from 2 to 28, and MBI from 56 to 89. Moreover the walking state improved from gait disturbance to self-walking. Conclusion : This study suggests that Chuna therapy could be used to improve gait disturbance in patients with osteoporosis and lower limb fracture surgery.

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.