• Title/Summary/Keyword: Calcaneus fracture

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Free Muscle Transplantation of the Chronic Lower Extremity Osteomyelitis (만성 하지 골수염에 시행한 유리 근 이식술)

  • Lee, Jun-Mo;Huh, Dal-Young
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.176-183
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    • 1999
  • Chronic osteomyelitis have been treated with wound dressing and antibiotics therapy often results in healing but foul odor pus discharges from the fibrotic soft tissues reactivates and requires appropriate control of the infection. Debridement of the wound, curettage and sequestrectomy, bone graft and immediate free flap transplantation is the curative protocol for the chronic osteomyelitis in the lower extremity. Authors have treated 7 cases of chronic osteomyelitis in the lower extremity with microsurgical free tissue transplantation at Department of Orthopedic Surgery, Chonbuk National University Hospital from December 1993 through February 1998. The results are as follows. 1. The chronic osteomyelitis occurred in tibial shaft in 4 cases, in calcaneus 2 cases and in femur 1 case. 2. Duration of the chronic osteomyelitis was at average 31.6 years. 3. Squamous cell carcinoma in the surrounding fibrotic tissue was biopsied in 1 case. 4. 4 cases had no trauma and occurred through hematogenous infection and 3 cases had fracture trauma. 5. Wound debridement and immediate free muscle transplantation had done in 5 cases and wound debridement, sequestrectomy and immediate free muscle transplantation in 2 cases. 6. Rectus abdominis muscle transplantation had peformed in 4 cases(57.1%), latissimus dorsi mucle 1 case(14.3%), latissimus dorsi myocutaneous 1 case(14.3%) and gracilis 1 case (14.3%). 6 cases of 7 were success(85.7%). 7. 1 case of failed latissimus dorsi musculocutaneous flap in thigh had done above knee amputation and 1 case of chronic posttraumatic osteoarthritis of the ankle joint had done below knee amputation at other hospital.

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The Operative Treatment using Mini-open Sinus Tarsi Approach for Displaced Intraarticular Calcaneal Fractures (전위성 관절내 종골 골절에서 최소 침습적 족근동 도달법 및 압박나사 내고정술을 이용한 수술적 치료)

  • Kim, Yong-Min;Cho, Byung-Ki;Shon, Hyun-Chul;Park, Ji-Kang;Jeong, Ho-Seung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.247-256
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    • 2012
  • Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using mini-open sinus tarsi approach for displaced intraarticular calcaneal fractures. Materials and Methods: We studied 18 cases (16 patients) of intraarticular calcaneal fractures who were treated with sinus tarsi approach by same surgeon. The mean age of patients was 44.8 years, and mean follow-up period was 17.2 months. The measurement of B$\ddot{o}$hler angle, Gissane angle, the degree of articular surface depression, and the period to union were performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: B$\ddot{o}$hler angle and Gissane angle had improved significantly from preoperative average $9.8^{\circ}$, $117.6^{\circ}$to average $22.4^{\circ}$, $113.4^{\circ}$ immediate postoperatively, and had maintained to average $21.8^{\circ}$and $114.2^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 5.2 mm to 1.2 mm at the last follow-up. All cases achieved bone union, and the period to union was average 10.5 weeks. AOFAS score was average 86.2 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the CNHF scale. Therefore, 16 cases (88.8%) achieved satisfactory results. Conclusion: The minimally invasive sinus tarsi approach using headless compression screw seems to be an effective surgical method for displaced intraarticular calcaneal fractures, because of the possibility of accurate restoration of articular surface and the low risk of postoperative soft tissue complications.

Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density (골다공증 진단을 위한 초음파 변수의 골밀도에 대한 의존성)

  • Hwang, Kyo Seung;Kim, Yoon Mi;Park, Jong Chan;Choi, Min Joo;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.502-508
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    • 2012
  • Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

Relation Between Nutritional Factors and Bone Status by Broadband Ultrasound Attenuation among College Students (대학생의 골초음파 상태에 영향을 미치는 영양요인 분석)

  • Kwon, Se-Mi;Lee, Byung-Kook;Kim, Hee-Seon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.11
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    • pp.1551-1558
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    • 2009
  • The management of skeletal health in the twenties is the number one priority for preventing fracture or osteoporosis occurrence in later life cycle. Therefore, the factors influencing bone mineral density were examined by anthropometric measurements, food intakes, bone mineral density and biochemical nutritional indexes in blood among college students. Among the students who received health examinations from May to December, 2007, 532 male and 507 female students who agreed to participate in the study were selected. Nutritional intakes were estimated with 3-day 24-hour recall method. Bone mineral density was measured by ultrasonic attenuation passing through right calcaneus bone and expressed as broadband ultrasound attenuation and t-score was calculated by WHO criteria. Red blood cell count, hemoglobin, hematocrit values were measured by whole blood analysis, and alkaline phosphatase, serum calcium and serum iron were used as indexes for biochemical nutritional status. Data analysis was conducted using SPSS 14.0 program, and protecting and risk factors on bone health status were analyzed by logistic regression analysis between normal bone health group (t-score$\underline{\geq}$ -1.0) and osteopenia group (t-score<-1.0). The results showed that more people belong to the normal bone health group probably because this study was conducted among those with their peak bone density. Biochemical nutritional status and nutrition intakes of both groups for normal and osteopenia did not show statistically significant difference except MCHC, animal protein and animal iron intakes in female. According to the results of logistic regression analyses, dietary intakes of animal protein, animal iron and zinc showed protecting effects against osteopenia. Therefore, dietary nutritional intakes of micronutrients, especially iron and zinc are important for bone health of young people.

Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures (Sanders 4형 종골 골절에 대한 관혈적 정복술 및 내고정술과 일차성 거골하 관절 유합술의 치료 결과 비교)

  • Woo, Seung Hun;Chung, Hyung-Jin;Bae, Su-Young;Kim, Sun-Kyu
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.49-58
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    • 2017
  • Purpose: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). Materials and Methods: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. Results: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. Conclusion: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.