• Title/Summary/Keyword: Femoral neck

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A Clinical Study on the Fractures of the Femoral Neck in Children (소아 대퇴골 경부골절의 임상적 고찰)

  • Kim, Se-Dong;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.17-22
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    • 1988
  • Fractures of the femoral neck in children are rare and usually the result of severe trauma. The femoral necks in children, in contrast to those of adults, have many anatomic and physiologic differences. Among the late complications encountered are avascular necrosis, coxa vara, premature closure of the proximal capital femoral epiphysis and nonunion. In spite of careful management, significant complication rate often results. Nine cases of fractures of the femoral neck in children which were treated at Yeungnam University Hospital from June 1984 to August 1987 were reviewed. The results obtained are as follows: 1. The main causes of fractures were traffic accidents(5 cases). 2. Among 9 patients, 6 were girls and 3 were boys. 3. According to the classification of Delbet and Colonna, the transcervical fracture(6 cases) was the commonest type. 4. 4 cases were treated by closed reduction and internal fixation, 3 cases were treated by open reduction and internal fixation. 2 cases were treated by skin traction and cast. 5. The results were analyzed according to Ratliff's assessment. 6 cases showed good results, and 3 cases showed poor results. 6. Early diagnosis and good fixation method seemed to be vital to prognosis.

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A Cost-effectiveness Analysis of the Medication for Osteoporosis (골다공증 치료약제의 비용-효과 분석)

  • 임지영;권순만
    • Health Policy and Management
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    • v.11 no.3
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    • pp.71-88
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    • 2001
  • The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991g/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834g/$cm^2$, respectively.

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Risk Factors of the 2-Year Mortality after Bipolar Hemiarthroplasty for Displaced Femoral Neck Fracture

  • Jung Wook Huh;Han Eol Seo;Dong Ha Lee;Jae Heung Yoo
    • Hip & pelvis
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    • v.35 no.3
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    • pp.164-174
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    • 2023
  • Purpose: This study investigates the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), albumin, and 2-year mortality in elderly patients having hemiarthroplasty for displaced femoral neck fracture (FNF). Materials and Methods: We retrospectively reviewed 284 elderly patients who underwent hemiarthroplasty for Garden type IV FNF from September 2014 to September 2020. Using the receiver operating characteristic curve, optimal cutoff values for LCR, NLR, and albumin were established, and patients were categorized as low or high. Associations with 2-year mortality were evaluated through univariate and multivariate Cox regression analyses. Results: Of the 284 patients, 124 patients (45.9%) died within 2 years post-surgery. The optimal cutoff values were: LCR at 7.758 (specificity 58.5%, sensitivity 25.0%), NLR at 3.854 (specificity 39.2%, sensitivity 40.0%), and albumin at 3.750 (specificity 65.9%, sensitivity 21.9%). Patients with low LCR (<7.758), high NLR (≥3.854), and low albumin (<3.750) had a statistically significant reduced survival time compared to their counterparts. Conclusion: Lower preoperative LCR and albumin levels, along with higher NLR, effectively predict 2-year mortality and 30-day post-surgery complications in elderly patients with Garden type IV FNF undergoing hemiarthroplasty.

Diagnosis of Legg-Calve-Perthes Disease in 2 Dogs (개의 Legg-Calve-Perthes Disease 진단 2례)

  • 윤정희;이영원;이희천;김종민;권오경;성재기
    • Journal of Veterinary Clinics
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    • v.13 no.1
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    • pp.93-95
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    • 1996
  • Legg-Calve-Perthes diseases were diagnosed in 2 dogs showing signs of lameness. In radiographs, the abnormal size and shape was due to the collapse of the left capital bone and enlarged femoral neck was seen at case I. The completely deformed left femoral head resulted from the earlier collapse of the osteolytic bone of the caput femoris at case II. In treatment, femoral head ezcision was performed in one dog.

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Hip Range of Motion Estimation using CT-derived 3D Models (CT기반 3차원 모델을 이용한 고관절 운동범위 예측)

  • Lee, Yeon Soo
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.115-122
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    • 2018
  • The success of the total hip arthroplasty is revealed as initial stability, range of motion, and long term pain, etc. Depending upon choice of implantation options such as femoral neck offset, diameter of the femoral head, the lateral opening tilt. Especially the impingement between femoral head component and acetabular cup limits the range of motion of the hip. In this sense, estimation or evaluation of the range of motion before and after the total hip arthroplasty is important. This study provides the details of a computer simulation technique for the hip range of motion of intact hip as well as arthroplasty. The suggested method defines the hip rotation center and rotation axes for flexion and abduction, respectively. The simulation uses CT-based reconstructed 3D models and an STL treating software. The abduction angle of the hip is defined as the superolateral rotation angle from sagittal plane. The flexion angle of the hip is defined as the superoanterior angle from the coronal plane. The maximum abduction angle is found as the maximum rotation angle by which the femoral head can rotate superolaterally about the anterior-posterior axis without impingement. The maximum flexion angle is found as the maximum rotation angle by which the femoral head can rotate superoanteriorly about the medial-lateral axis without impingement. Compared to the normal hip, the total hip replacement hip showed decreased abduction by 60 degrees and decreased flexion by 4 degrees. This measured value implies that the proposed measurement technique can make surgeons find a modification of increase in the femoral neck offset or femoral head, to secure larger range of motion.

Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail

  • Kim, Beom-Soo;Cho, Jae-Woo;Yeo, Do-Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.96-102
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    • 2018
  • Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

Comparative Study for the Measurement of Fermoral Anteversion by Manual Method and Image Viewer (대퇴골 전염각 측정을 위한 수 작업 방법과 Image Viewer 방법과의 비교 연구)

  • Gwon, Dae-Cheol;Park, Beom
    • Journal of the Ergonomics Society of Korea
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    • v.20 no.3
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    • pp.27-35
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    • 2001
  • The measurement of the fermoral anteversion is an important factor in the practice of orthopedic surgery. The anteversion is measured by means of the axis of head and neck of the femur. In this study. widely used computed tomography method of measuring anteversion was tested on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In January and February 2001, 30 patients 3 to 6 years of age were randomly selected from Seoul National University Hospital. the purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing image viewer program. This new method was more accurate and convenient than the conventional manual method. No significant difference was observed between the manual method and the image viewer measurement of femoral anteversion. In conclusion, image viewer program was statistically more reliable in determining the angle of the fermoral anteversion.

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Spontaneous Femoral Capital Physeal Fracture with Proximal Tibial Epiphyseal Dysplasia in a Cat

  • Yoo, Saejong;Kim, Dae-Hyun;Lee, Yunsub;Yeo, Seungyeob;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.112-115
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    • 2019
  • An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.

A Study of Related Factors in the Bone Mineral Density of the Institutionalized Elderly (시설노인의 골다공증 관련요인 연구)

  • Kim, Hee-Ja
    • Research in Community and Public Health Nursing
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    • v.8 no.1
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    • pp.31-44
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    • 1997
  • The purpose of this study was to measure and determine the relationship of femoral neck and lumbar bone mineral density with their and related factors. It were measured and determined the relationships among bone mineral density, bone mineral content in the lumbar and femoral neck, muscle strength (arm, back, leg), muscle endurance, instrumental activity of daily living (IADL), quality of life, cognitive perceptual variables(self efficacy, perceived health status), age, age at menopausal period. The twenty five subjects participating in this study consisted of twelve males and thirteen females at a C-institution in Chung Buk province. The mean age of subjects was 73.64 years. The data was collected from August, 1993 to September, 1993. The data was analyzed with $x^2-test$, t-test, Correlation, multiple regression using a SPSS pc+ program. 1. The mean femoral neck bone mineral density was $0.636g/cm^2$, 66.7% of young bone mineral density, the mean lumbar($L_2-L_4$) bone mineral density was $0.807g/cm^2$, 79.86% of young bone mineral density. The mean fermoral neck bone mineral content was 2.906g and the mean lumbar bone mineral content was 36.898g. 2. The mean muscle strength was 17.14kg(grip strength), 32.05kg(back lift strength), 17.14kg (leg lift strength) and the mean muscle endurance was 9.92times. 3. Men showed a significantly higher score (p<0.01) in muscle strength and muscle endurance than women, as well as a significantly higher score on self efficacy and perceived health status(p<0.05). 4. The femur neck bone mineral density had a significant correlation(p<0.0l) with leg lift strength, back lift strength, and their was a significant correlations (p<0.05) with arm strength and muscle endurance. Lumbar ($L_2-L_2$) bone mineral density had a significant correlation(p<0.05) with muscle endurance, grip strength and IADL. 5. With the multiple regression analysis the most significant predictor for lumbar bone mineral density were IADL, the most significant predictor for femoral neck bone mineral density was leg strength. This study concluded: As the mean bone mineral density and bone mineral content were low, the aged showed osteopenia. Bone mineral density, muscle strength and IADL were correlated. The aged could pro mote muscle strength, bone mineral density and IADL through Leg Press exercise which was safe and efficient for the aged. This Leg Press exercise contributed to prevention of osteoporosis and promoted the health of the aged.

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Clinical Application of Great Saphenous Vein Graft in the Oral and Maxillofacial Reconstruction (구강악안면 재건을 위한 대복재정맥의 유용성)

  • Park, Jung-Min;Kim, Soung-Min;Seo, Mi-Hyun;Kang, Ji-Young;Myoung, Hoon;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.140-147
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    • 2012
  • Microvascular reconstruction, in the oral and maxillofacial regions, is a widely accepted as the best way to overcome the complex oral cavity defects. Many patients requiring composite reconstructions have been treated previously with radiation therapy, chemotherapy, selective and/or functional neck dissection or any of these combinations. In many cases of these patients, inadequate neck vessels for the microanastomosis of free flap are available, due to a lack of recipient vessels in the neck, poor vessel quality or vessel caliber mismatch. To achieve a tension-free anastomosis, vein grafting must be considered to span the vessel gap between the free flap pedicle and the recipient neck vessels. Although most microsurgeons believed that interpositional grafts are to be avoided due to vessel thrombosis and increased number of necessary microanastomosis, we, authors have some confidence of equivalency between reconstruction with and without interpositional saphenous vein graft. The great saphenous vein, also known as the long saphenous vein, is the large subcutaneous superficial vein of the leg and thigh. It joins with the femoral vein in the region of femoral triangle at the saphenofemoral junction, and coursed medially to lie on the anterior surface of the thigh before entering an opening in the fascia lata, called the saphenous opening. For a better understanding of the great saphenous vein graft for the interpositional vessel graft in the oral cavity reconstructions, and an avoidance of any uneventful complications during these procedures, the related surgical anatomies with their harvesting tips are summarized in this review article in the Korean language.