• 한국건강관리협회지
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• 제2권2호
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• pp.137-148
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• 2004

Objective : To identify the risk factors for postmenopausal osteoporosis in Korea Materials and methods : Bone mineral density (BMD) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry in 808 apparently normal postmenopausal Korean women. Questions about life style, demographic parameters, medical history and social habits etc. were asked on these women; 2ll women with normal bone mineral density, and 597 women with osteopenia or osteoporosis. Results 'Age of >50 years, low body mass index (BMI; <18.5 kg/m2), long duration of menopause(>10 years), and previous history of fracture were associated with increased prevalence of osteopenia or osteoporosis. Women without the outside activity also showed a higher frequency of low bone mass, Risk for osteopenia or osteoporosis was low in women with high BMI (>23 kg/m2) and women with job. The prevalence of low bone mass appeared to be independent of the following parameters: socioeconomic status, familial history, smoking, drinking, exercise, previous use of oral contraceptive, coffee or milk consumption, and degree of sunlight exposure. Conclusion 'Age, BMI, duration of menopause, previous history of fracture and degree of outside activity are the risk factors for postmenopausal osteoporosis in Korea.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권4호
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• pp.174-181
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• 2016

Objectives: This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. Materials and Methods: The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Results: Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were $35.0{\pm}11.8$ years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P <0.001). Conclusion: The most common etiology of maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients.

• Restorative Dentistry and Endodontics
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• 제48권4호
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• pp.38.1-38.10
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• 2023

Objectives: The aim of this study was to examine the use of hand or rotary files by pre-graduation (fourth- and fifth-year) and postgraduate students in endodontic treatments and to determine the incidence of file fracture and the management of cases with broken instruments. Materials and Methods: A total of 2,168 teeth undergoing primary endodontic treatment were included in this study. It was determined that 79 of these teeth resulted in broken tools. In the case of broken tools, the education level of the treating clinician, the tooth that was being treated, the canal and fracture level, the curvature of the tooth and the management of the broken instrument were recorded. Periapical radiographs of the patients were used to calculate curvature following the Schneider method. Results: There was no significant difference in the incidence of broken tools according to education level (p > 0.05). The incidence of file fracture in molar teeth (73.4%) was higher than in other teeth (p < 0.05). More files were broken in the mandibular molar MB canal (20.25%) and in the apical third of the canals (72.1%). The risk of instrument fracture was high in teeth with moderate (44.3%) and severe (38%) curvature canals. The management of apically broken (80%) files mostly involved lefting (p < 0.05). Conclusions: There was no statistically significant difference between fourth-year students, fifth-year students and postgraduate students in terms of instrument fracture.

• Archives of Plastic Surgery
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• 제39권3호
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• pp.204-208
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• 2012

Background : Isolated pure blowout fractures are clinically important because they are the main cause of serious complications such as diplopia and limitation of extraocular movement. Many reports have described the incidence of blowout fractures associated with diplopia and limitation of extraocular movement; however, no studies have statistically analyzed this relationship. The purpose of this study was to demonstrate the correlation between the location of isolated pure blowout fractures and orbital symptoms such as diplopia and limitation of extraocular movement. Methods : We enrolled a total of 354 patients who had been diagnosed with isolated pure blowout fractures, based on computed tomography, from June 2008 to November 2011. Medical records were reviewed, and the prevalence of extraocular movement limitations and diplopia were determined. Results : There were 14 patients with extraocular movement limitation and 58 patients complained of diplopia. Extraocular movement limitation was associated with the following findings, in decreasing order of frequency: floor fracture (7.1%), extended fracture (3.6%), and medial wall (1.7%). However, there was no significant difference among the types of fractures (P=0.60). Diplopia was more commonly associated with floor fractures (21.4%) and extended type fractures (23.6%) than medial wall fractures (10.4%). The difference was statistically significant (Bonferroni-corrected chi-squared test P<0.016). Conclusions : Data indicate that extended type fractures and orbital floor fractures tend to cause diplopia more commonly than medial wall fractures. However, extraocular movement limitation was not found to be dependent on the location of the orbital wall fracture.

• Hip & pelvis
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• 제35권4호
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• pp.217-227
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• 2023

Purpose: Periprosthetic femoral fracture (PFF) is a common complication after total hip arthroplasty, and open reduction and internal fixation (ORIF) is a common surgical treatment. We conducted a meta-analysis to compare the outcomes of ORIF in patients with different fracture patterns (Vancouver B1 and B2). Materials and Methods: We conducted a systematic search of PubMed, Embase, Cochrane Library and KoreaMed from inception to August 2022. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the 10 comparative studies and a proportional meta-analysis on the data from the 39 articles to determine a consensus. The outcomes were the incidence of reoperations that included osteosynthesis, irrigation/debridement and revision arthroplasty. Results: The pair-wise meta-analysis showed similar outcomes between two groups; the risk of reoperation (odds ratio [OR]=0.82, confidence interval [CI] 0.43-1.55, P=0.542), nonunion (OR=0.49; CI 0.22-1.10, P=0.085) and deep infection (OR=1.89, CI 0.48-7.46, P=0.361). In proportion meta-analysis, pooled prevalence of reoperation was 9% (95% CI, 6-12) in B1 and 8% (95% CI, 2-15) in B2 (heterogeneity between two groups (Q), P=0.772). The pooled prevalence of nonunion was same as of 4% in B1 and B2 (Q, P=0.678), and deep infection was 2% (95% CI, 1-3) in B1 and 4% (95% CI, 2-7) in B2 (Q, P=0.130). Conclusion: ORIF is a feasible treatment for B1 and B2 periprosthetic femoral fractures, with acceptable outcomes in terms of, nonunion and infection. The results of this study would help clinicians and provide baseline data for further studies validating PFF.

• 대한정형외과스포츠의학회지
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• 제9권1호
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• pp.16-21
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• 2010

최근 스포츠 활동 증가로 인한 하지의 과사용증후군인 만성 구획증후군 및 스트레스 골절의 빈도가 늘어가고 있다. 만성구획증후군은 운동 중 근육의 부피 증가와 이로 인한 구획압 증가로 야기된 가역적인 허혈상태로, 보존적 치료로 호전되지 않는 경우 근막절개술 등의 수술적 치료를 고려할 수 있다. 스트레스 골절은 정상적인 골에 비정상적인 스트레스가 가해져서 발생하는 피로 골절과 비정상적인 골에 정상적인 스트레스에 의해서 발생하는 부전골절로 분류할 수 있으며, 대부분의 스트레스 골절은 하지, 특히 경골부에 호발한다. 운동선수에서 피로 골절은 훈련 방법의 변화에 기인할 수 있고 진단은 일차적으로 단순방사선 촬영을 시행하며, 자기공명영상을 통해 확진 할 수 있다. 대부분의 경우 휴식 및 단기간의 고정 등을 통한 보존적 치료만으로 증상의 호전 및 운동 복귀가 가능하나, 경골의 신연부에 발생한 경우 수술적 치료를 요할 수도 있다.

• Hip & pelvis
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• 제35권2호
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• pp.88-98
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• 2023

Purpose: The objectives of this study were to examine the prevalence and risk factors for development of periprosthetic occult femoral fractures during primary cementless total hip arthroplasty (THA) and to assess the clinical consequences of these fractures. Materials and Methods: A total of 199 hips were examined. Periprosthetic occult femoral fractures were defined as fractures not detected intraoperatively and on postoperative radiographs, but only observed on postoperative computed tomography (CT). Clinical, surgical, and radiographic analysis of variables was performed for identification of risk factors for periprosthetic occult femoral fractures. A comparison of stem subsidence, stem alignment, and thigh pain between the occult fracture group and the non-fracture group was also performed. Results: Periprosthetic occult femoral fractures were detected during the operation in 21 (10.6%) of 199 hips. Of eight hips with periprosthetic occult femoral fractures that were detected around the lesser trochanter, concurrent periprosthetic occult femoral fractures located at different levels were detected in six hips (75.0%). Only the female sex showed significant association with an increased risk of periprosthetic occult femoral fractures (odds ratio for males, 0.38; 95% confidence interval, 0.15-1.01; P=0.04). A significant difference in the incidence of thigh pain was observed between the occult fracture group and the non-fracture group (P<0.05). Conclusion: Occurrence of periprosthetic occult femoral fractures is relatively common during primary THA using tapered wedge stems. We recommend CT referral for female patients who report unexplained early postoperative thigh pain or developed periprosthetic intraoperative femoral fractures around the lesser trochanter during primary THA using tapered wedge stems.

• 대한골관절종양학회지
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• 제1권1호
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• pp.52-59
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• 1995

Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

• 대한족부족관절학회지
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• 제2권2호
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• pp.71-75
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• 1998

The fact that, under similar training activities performed in the same environment, march fractures develop in only a certain percentage of the trainees indicates that intrinsic factors are affecting the prevalence of these fractures. Among these intrinsic factors, the relation between foot arch type and the occurance of march fractures was investigated in this study. From 1997 to 1998, at one infantry medical company of infantry corps in Korea, 15 march fracture patients were detected among infantry soldiers. Quantitative measures of the foot arch (longitudinal) structure of 15(30feet) march fracture patients were established and compared with those of 15(30feet) normal person. The results were as follows. 1. From the lateral X-ray film, three parameters (i.e. calcaneal angle, forefoot angle, height to length ratio)were defined to describe the structure of the longitudinal arch of the foot. 2. The mean value of the calcaneal angle of march fracture group and normal control group showed 16.4 degree, 20.5 degree respectively. The difference between two groups was statistically significant (P>0.006), but those of forefoot angle and height to length ratio were not. 3. In the calcaneal angle twenty-six feet(87%) of march fracture group were lower than 17 degrees but twenty-five feet(83%) of normal control group were more than 17 degrees. That is, march fracture were more prevalent in feet with low calcaneal angle. 4. In the low arch foot, the orthotic device might relieve the energy load carried by the foot, thus reducing the incidence of march fractures, and should be analyzed in further study.

• The Journal of Advanced Prosthodontics
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• 제4권1호
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• pp.37-42
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• 2012

PURPOSE. The influence of the modified process in the fiber-reinforced post and resin core foundation treatment on the fracture resistance and failure pattern of premolar was tested in this study. MATERIALS AND METHODS. Thirty-six human mandibular premolars were divided into 4 groups (n = 9). In group DCT, the quartz fibre post (D.T. Light-post) was cemented with resin cement (DUO-LINK) and a core foundation was formed with composite resin (LIGHT-CORE). In group DMO and DMT, resin cement (DUO-LINK) was used for post (D.T. Lightpost) cementation and core foundation; in group DMO, these procedures were performed simultaneously in one step, while DMT group was accomplished in separated two steps. In group LCT, the glass fiber post (LuxaPost) cementation and core foundation was accomplished with composite resin (LuxaCore-Dual) in separated procedures. Tooth were prepared with 2 mm ferrule and restored with nickel-chromium crowns. A static loading test was carried out and loads were applied to the buccal surface of the buccal cusp at a 45 degree inclination to the long axis of the tooth until failure occurred. The data were analyzed with MANOVA (${\alpha}$= .05). The failure pattern was observed and classified as either favorable (allowing repair) or unfavorable (not allowing repair). RESULTS. The mean fracture strength was highest in group DCT followed in descending order by groups DMO, DMT, and LCT. However, there were no significant differences in fracture strength between the groups. A higher prevalence of favorable fractures was detected in group DMT but there were no significant differences between the groups. CONCLUSION. The change of post or core foundation method does not appear to influence the fracture strength and failure patterns.