• Title/Summary/Keyword: Femoral fractures

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Fracture analysis of wild mammals in South Korea

  • Jang, Hyunkyu;Park, Jong-Moon;Ahmed, Sohail;Seok, Seong-Hoon;Kim, Ho-Su;Yeon, Seong-Chan
    • Korean Journal of Veterinary Research
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    • v.59 no.4
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    • pp.175-180
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    • 2019
  • This study was conducted to evaluate and analyze fractures types in wild mammals in Korea. Wild mammals treated at 3 wildlife centers in Korea were included. Of the 63 cases included in this study, water deer was the most common species encountered with fractures. We determined 85 different fracture sites, with maximum lumber vertebral fractures followed by femoral, tibial and pelvic fractures. External skeletal fixator (ESF)-intramedullary (IM) pin (IM+ESF tie-in fixation) was the most common method applied for the surgical treatment of mammals. Lumbar vertebrae and femur were the most common bones involved. The findings of this study are expected to provide information for veterinarians regarding the frequency and characteristics of fractures in wild mammals and serve as a basic database for the types and outcomes of fractures in wild mammals.

Predict of Fracture Risk Rate According to Morphological Measuring of Proximal Femoral Part Using Dual Energy X-ray Absoptiometry (이중에너지 X선 흡수계측법을 이용한 대퇴골 근위부의 형태학적 측정에 따른 골절 위험도의 예측)

  • Yoon, Han-Sik
    • Journal of radiological science and technology
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    • v.25 no.1
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    • pp.49-53
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    • 2002
  • The femoral fracture is the most serious problem of old ages haying osteoporotic fractures. First of all, prevention to reduce the incidence of hip fracture and to identify the risk factor is essential subject. The purpose of this study is to investigate which geometric parameters of proximal femur are related to the hip fracture risk in old ages. Author analyzed the bone density and bone content of over 60 years old women who had suffered hip fracture (n=60) and non fracture groups (n=60). Author concluded that geometric measurements of proximal femoral part made on dual energy x-ray absorptiometry can predict hip fracture independently of bone mineral density.

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Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Successful repair of coracoid and femur fractures in a Eurasian eagle owl (Bubo bubo) and its post-release survival

  • Hee-Jong Kim;Kyoo-Tae Kim
    • Journal of Veterinary Science
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    • v.24 no.1
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    • pp.17.1-17.9
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    • 2023
  • To our knowledge, this is the first case of concurrent diaphyseal left coracoid and left femoral fractures in a Eurasian eagle owl and its post-release survival in Korea. The femur was surgically repaired using an external skeletal fixator-intramedullary (IM) pin tie-in method, and the coracoid was repaired solely with an IM pin on day 6 after femur surgery. The eagle owl underwent a gradual rehabilitation process. The bird was successfully rehabilitated and released 101 d after initial presentation. The bird was monitored using a wildlife tracking device and was confirmed to have survived for over 5 mon in the wild.

Factors Affecting the Period of Bone Union When Treating Femoral Fractures with a Retrograde Intramedullary Nail (역행성 골수강 내 금속정을 이용한 대퇴골절의 치료 시 골유합 기간에 영향 미치는 인자)

  • Kim, Bum-Soo;Kim, Seong-Tae;Shin, Seungyup;Jeon, Seong Man
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.326-333
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    • 2021
  • Purpose: A retrograde intramedullary nail is commonly used to treat femoral shaft and distal femur fractures. The authors analyzed the treatment results and the factors affecting the period of bone union for thirty-five patients treated with a retrograde intramedullary nail. Materials and Methods: Thirty-five patients who could be followed up for more than twelve months after the treatment with retrograde intramedullary nailing were analyzed retrospectively. The treatment results and the relationship between the period of bone union and the patient's age, sex, comminution of fracture, presence of open fracture, location of the fracture, and accompanying fractures were evaluated. Results: The average bone union time was 4.50 months. The period of bone union was unaffected by the age, sex, location, and presence of open fractures but was affected by the presence of comminution and accompanying fractures. Conclusion: Retrograde intramedullary nailing is effective for distal and shaft of fractures of the femur. The period of bone union is affected by the presence of comminution and accompanying fractures.

Midterm Results of Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femoral Fractures Using a Type 3C Cementless Stem (불안정성 대퇴골 전자간 골절에 3C형 무시멘트 대퇴 스템을 이용한 고관절 반치환술의 중기 결과)

  • Chung, Woochull;Cho, Hong Man;Kim, Sun do;Park, Jiyeon;Kwon, Kihyun;Lee, Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.503-510
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    • 2020
  • Purpose: Bipolar hemiarthroplasty is used as an alternative to open reduction and internal fixation for unstable intertrochanteric fractures in elderly patients. Recent advances in medical systems and technologies have resulted in increased survival rates after intertrochanteric fractures of the femur, requiring selection of the appropriate femoral stems considering the mid- to long-term duration of survival. Hemiarthroplasty was performed for unstable intertrochanteric fractures using a double tapered quadrilateral femoral stem (C2 stem), and the clinical and radiological results were evaluated as a five-year follow-up post-surgery. Materials and Methods: From January 2004 to December 2013, 43 patients (43 hips) who underwent hemiarthroplasty with a C2 stem were enrolled in this study. Their mean age was 78.6 years (range, 70-84 years), and the mean follow-up period was 85.4 months (range, 60-96 months). During the follow-up period, clinical parameters, such as the changes in pain, walking ability, and functional status, were examined. Radiologically, changes in the proximal femur, such as osteoporosis and bone resorption of cortical bone, were noted. Complications that occurred during the follow-up period, such as dislocation and prosthetic features, were also reviewed. Results: Initially, the pain was relieved postoperatively, but it increased four years after surgery. The walking ability was reduced by two steps in nine patients after 60 months, and the Harris hip score was reduced significantly postoperatively after two to three years. Radiologically, cortical osteoporosis occurred in 14 patients. Five patients developed cortical bone resorption. Four of them showed nonunion of the trochanteric fracture fragments, and three of them suffered reverse oblique fractures. Conclusion: Careful selection considering the general health condition and remaining lifespan of the patient would be necessary for primary hip hemiarthroplasty using a 3C type cementless femoral stem for unstable intertrochanteric fractures in elderly patients with osteoporosis.

Long Bone Fractures in Raptors: 28 cases (2004-2007)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.215-217
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    • 2008
  • Medical records from the Veterinary Medical Teaching Hospital of the University of Missouri-Columbia from 2004 to 2007 were available for 28 raptors that underwent long bone fracture repair. There were 14 owls, 10 hawks, 2 vultures, 1 eagle, and 1 falcon. Mean body weight was 780 g (ranged from 150 to 1400 g) for 14 owls; 650 g (ranged from 150 to 1270 g) for 10 hawks; 1760 g (ranged from 1520 to 2000 g) for 2 vultures; 5000 g for 1 eagle; and 130 g for 1 falcon. Of all 28 fracture cases, 11 cases (39%) and 1 case (3%) were related to hit-by-car and shooting respectively. Physical examination revealed dehydration in 18 raptors (64%) and lethargy in 12 raptors (42%). Forty one long bone fractures were included in 28 cases. The radiographs revealed 13 ulnar fractures (32%), 12 humeral fractures (30%), 10 radial fractures (25%), 4 tibiotarsal fractures (9%), 1 femoral fracture (2%), and 1 fibular fracture (2%). External skeletal fixation using polymethylmethacrylate (PMMA) combined with intramedullary fixation was used in 19 long bone fractures (46%). Intramedullary fixation using intramedullary Kirschner pin was used in 16 long bone fractures (39%). No surgical treatment was performed in 6 long bone fractures (15%). This study reported that many of raptors presented dehydration and lethargy when admitted for treatment. Therefore, proper hydration and nutrition are critical pre-surgical requirements. In addition, combination of internal fixation and external skeletal fixation using PMMA might be better option to treat raptors with comminuted fracture that results from mostly trauma of hit-by-car.

Usefulness of Bone SPECT/CT for Predicting Avascular Necrosis of the Femoral Head in Children with Slipped Capital Femoral Epiphysis or Femoral Neck Fracture

  • Yoo Sung Song;Won Woo Lee;Moon Seok Park;Nak Tscheol Kim;Ki Hyuk Sung
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.264-270
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    • 2022
  • Objective: This study aimed to investigate the usefulness of bone single-positron emission tomography/computed tomography (SPECT/CT) of the hip in predicting the later occurrence of avascular necrosis (AVN) after slipped capital femoral epiphysis (SCFE) or femoral neck fracture in pediatric patients. The quantitative parameters of SPECT/CT useful in predicting AVN were identified. Materials and Methods: Twenty-one (male:female, 10:11) consecutive patients aged < 18 years (mean age ± standard deviation [SD], 11.0 ± 2.7 years) who underwent surgery for SCFE or femoral neck fracture and postoperative bone SPECT/CT were included. The maximum standardized uptake value (SUV), mean SUV, and minimum SUV of the femoral head were measured. The ratios of the maximum SUV, mean SUV, and minimum SUV of the affected femoral head to the contralateral side were determined. Patients were followed up for > 1 year after the surgery. The SPECT/CT parameters were compared between patients who developed AVN and those who did not. The accuracy of SPECT/CT parameters for predicting AVN was assessed. Results: Six patients developed AVN. There was a significant difference in the ratio of the mean SUV among patients who developed AVN (mean ± SD, 0.8 ± 0.3) and those who did not (1.1 ± 0.2, p = 0.018). However, there were no significant differences in the ratios of the maximum and minimum SUV between the groups (all p = 0.205). For the maximum, mean, and minimum SUVs, no significant differences were observed between the groups (p = 0.519, 0.733, and 0.470, respectively). The cutoff mean SUV ratio of 0.87 yielded a 66.7% sensitivity and 93.2% specificity for predicting AVN. Conclusion: Quantitative bone SPECT/CT is useful for evaluating femoral head viability in pediatric patients with SCFE or femoral neck fractures. Clinicians should consider the high possibility of later AVN development in patients with a decreased mean SUV ratio.

A Case Report of Femoral Neck Fracture in an Elderly Patient Managed by Non-operative Korean Medical Treatment : 42 Months Follow-up

  • Kim, Ju-ran;Gong, Han Mi;Jun, Seungah;Lee, Jung Hee;Lee, Bong Hyo;Lee, Hyun-Jong;Kim, Jae Soo
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.252-258
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    • 2018
  • This report showed the clinical outcome of an elderly patient with a femoral neck fracture who was treated non-operatively with Korean medical treatment. The patient had acupuncture, herbal medication, moxibustion, and participated in physical rehabilitation for 3 months. The effects of Korean medical treatment were measured every 2 weeks using the numeric rating scale (NRS) and the Harris hip score (HHS). After treatments, the NRS score for hip pain decreased from 8 to 2, and the HHS increased from 0 to 43. A 42-month follow-up showed the patient's NRS score was 0 and the HHS was 61. Furthermore, an X-ray showed complete union of the femoral neck fracture with no suspicion of avascular necrosis. These results suggest that Korean medical treatment can effectively reduce pain and aid rehabilitation in patient with femoral neck fractures with no surgery, resulting in complete union of the fracture.

Results of Revascularization in Ischemic Lower Extremities (하지동맥 폐쇄질환의 외과적 고찰)

  • 이두연
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.58-67
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    • 1986
  • Aggressive revascularization of the ischemic lower extremities in atherosclerotic, occlusive diseases or acute embolic arterial occlusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by some authors. We have performed 68 first time vascular operations, including thromboembolectomies on RR patients with ischemic lower extremities, within an 11-year-and-6-month period, from January 1974 to June 1984. We have reviewed and analyzed our vascular operative procedures and post operative results. The patients upon whom thromboembolectomies were performed were 42 males and 13 females ranging from 5 to 72 years of age. The major arterial occlusive sites were common iliac artery in 20 cases, femoral artery in 21 cases, popliteal artery in 8 cases, common iliac artery and femoral artery in 4 cases, and femoral artery and popliteal artery in 3 cases. The underlying causes of arterial occlusive disease were atherosclerosis obliterans in 34 cases; Buerger`s disease in 3 cases; emboli due to cardiac valvular disease in 13 cases; and vascular trauma in 4 cases, including cardiac catheterization in I of those cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 31 cases. Amputations were done on 2 patients carrying out any more vascular operative procedures would have been of no benefit to them. Our bypass operations for ischemic lower extremities were classified as follows: those done between the abdominal aorta and the femoral artery in 17 cases, including those done between the aorta and the bifemoral arteries with a Y graft in four of those cases and long ones done from the axillary to the femoral artery in 4 cases. Five patients died in the hospital following vascular surgery for ischemic lower extremities, the causes of death were not directly related to the vascular reconstructive operative procedures. The leading causes of death were respiratory failure due to metastatic lung carcinoma: renal failure due to complications from atherosclerosis obliterans; sepsis from open, contaminated fractures of the tibia and fibula; and myocardial failures due to open heart surgery in one case and reconstructive surgery of the ascending aorta in another.

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