• Title/Summary/Keyword: Fracture prevention

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Analysis on Statins for The Treatment of Bone Fracture (스타틴계 고지혈증치료제의 골절치료효과에 대한 분석)

  • Choi, Byung-Chul
    • YAKHAK HOEJI
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    • v.53 no.4
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    • pp.206-216
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    • 2009
  • 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (Statins) are potent inhibitors of cholesterol biosynthesis. Cholesterol-lowering therapy using statins significantly reduces the risk of coronary heart disease. Various discovery of statins as bone anabolic agents has spurred a great deal of interest among both basic and clinical bone researchers. In-vitro and some animal studies suggest that statins increase the bone mass by enhancing bone morphogenetic protein-2 (BMP-2)-mediated osteoblast expression. Clinical and animal test results of statins focusing on the prevention and treatment of bone fractures was collected. Three independent literature searches were performed by using from January 1, 2002 to September 2008 for clinical and animal test results. Search term included statins, HMG-CoA reductase inhibitors, pleiotropic effects, fracture, osteoporosis and clinical and animal test. No consensus has been reached whether clinical use of statins has beneficial effects on bone health, partly due to lower statin concentrations because of first-pass metabolism by the liver. Experimental use of statins as stimulators of bone formation suggests that they may have widespread applicability in the field of orthopaedics. With their combined effects on osteoblasts and osteoclasts, statins have the potential to enhance resorption of synthetic materials and improve bone ingrowth. In conclusion, The use of statins in the prevention and treatment of bone fractures requires further study. But observational studies suggest that statins for decreasing bone fractures including osteoporosis have to be considered local direct administration like transdermal or subcutaneous type over oral adminstration.

Bucket Handle Type Fracture of the Glenoid (Bucket Handle양상의 관절와 골절 - 증례보고-)

  • Shin, Sang-Jin;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.80-84
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    • 2003
  • We report a patient with an anterior dislocation of the shoulder with uncommon bucket handle type fracture of the anterior glenoid fossa with intact glenoid labrum. The fracture fragment was displaced into the posterior aspect of the glenohumeral joint resulting in prevention of reduction of the shoulder. Excellent fixation was obtained with suture anchors and bioabsorbable interfragmentary screws. This allowed stable range of motion exercises, optimizing the patient's functional outcome.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.291-300
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    • 2012
  • The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

A Study on the Elderly Patients Hospitalized by the Fracture from the Fall (낙상 사고에 의한 골절로 입원한 노인 환자에 대한 조사 연구)

  • 전미양;정현철;최명애
    • Journal of Korean Academy of Nursing
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    • v.31 no.3
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    • pp.443-453
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    • 2001
  • Purpose: To identify age, gender, medication, seasons and place of fall, and areas of the fractures from the fall among the hospitalized elderly patients in order to provide the basic data for future fall prevention program for the elderly. Methods: This study was conducted for 106 elderly patients admitted into a university hospital by fractures from the fall during the period from January 1, 1999 to December 31, 1999. Data on the age, gender, medication, season and place of the fall, areas of the fracture were collected based on their medical records. Result: The age range of the subjects were from 60 to 96 years old. The subjects were aged between 60-69 years old 49(46.2%), between 70-79 years old 31(29.2%), between 80-89 years old 24(22.6%), and over 90 years old 2(1.9%). Male patients comprised was 34(28.3%), while female patients comprised 76(71.7%). The fall occurred in Winter most frequently 34(32%). The place of the fall included room 81(76.4%), streets 13(12.3%), bathroom 6(5.7%), stair 4(3.8%), and mountain 2(1.9%). Twenty-two subjects (20.8%) had medication regularly, while 84 subjects (79.2%) had no medication. The areas of the fracture from the fall included upper extremities 20(18.9%) and lower extremities 86(81.1%). Radius fracture (7.5%) was the area where the fracture occurred most frequently in upper extremities and femur fracture (52.8%) was the area where the fracture occurred most frequently in lower extremities. A significant difference was found in the fracture area by age, season and place of the fall (p<.05). No significant difference was found in the fracture area by gender and medication. In all age groups, seasons and places of the fall, occurrence of fracture in lower extremity was significantly higher than that in upper extremity.

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Simulation study on the mechanical properties and failure characteristics of rocks with double holes and fractures

  • Pan, Haiyang;Jiang, Ning;Gao, Zhiyou;Liang, Xiao;Yin, Dawei
    • Geomechanics and Engineering
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    • v.30 no.1
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    • pp.93-105
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    • 2022
  • With the exploitation of natural resources in China, underground resource extraction and underground space development, as well as other engineering activities are increasing, resulting in the creation of many defective rocks. In this paper, uniaxial compression tests were performed on rocks with double holes and fractures at different angles using particle flow code (PFC2D) numerical simulations and laboratory experiments. The failure behavior and mechanical properties of rock samples with holes and fractures at different angles were analyzed. The failure modes of rock with defects at different angles were identified. The fracture propagation and stress evolution characteristics of rock with fractures at different angles were determined. The results reveal that compared to intact rocks, the peak stress, elastic modulus, peak strain, initiation stress, and damage stress of fractured rocks with different fracture angles around holes are lower. As the fracture angle increases, the gap in mechanical properties between the defective rock and the intact rock gradually decreased. In the force chain diagram, the compressive stress concentration range of the combined defect of cracks and holes starts to decrease, and the model is gradually destroyed as the tensile stress range gradually increases. When the peak stress is reached, the acoustic emission energy is highest and the rock undergoes brittle damage. Through a comparative study using laboratory tests, the results of laboratory real rocks and numerical simulation experiments were verified and the macroscopic failure characteristics of the real and simulated rocks were determined to be similar. This study can help us correctly understand the mechanical properties of rocks with defects and provide theoretical guidance for practical rock engineering.

Risk Factors for Hip Fracture among the Elderly (노인들의 고관절골절 위험요인에 관한 환자-대조군 연구)

  • Kim, Yong-Kwon;Cho, Young-Ha
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.25-36
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    • 2002
  • Objectives: This study was conducted to find out risk factors related to elderly hip fracture, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. Methods: The data were collected from 199 cases hospitalized in 4 university hospitals in Pusan from January, 1996 to December, 1998, 193 healthy controls who visited elderly facilities in Pusan. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed for 2-test and multiple logistic regression. The risk factors were shown with odds ratios and their 95% confidence intervals. Results: In univariate analysis, the odds ratio of hip fracture risk was estimated to be 1.9 for the elderly aged 75 years as compare with those aging less than 65 years; 42 for those with job as compared with those without job; 3.3 for those with more than 6 children as compared with those with one or two children. For the variables related to physical characteristics, small height (p=0.015), light weight (p=0.000), and low BMI (p=0.014) were risk factors for elderly hip fracture. Sane variables related to health, such as previous history of illness (OR=3.3.), abnormal blood pressure (OR=1.6), previous fracture history (OR=22), lower limbs weakness (OR=12.1) and gait disturbance (OR=42.6), were significantly associated with the risk of hip fracture. In multiple logistic regression, risk factors for hip fracture were age, having job, lower limb weakness and previous history of illness. The adjusted odds ratios of hip fracture risk among the elderly were age (OR=1.1), having jobs (OR=11.7), weak lower limb (OR=10.8) and previous history of illnesses (OR=3.3), respectively. Conclusion: This study suggests that the plan for improving the daily living environment for the elderly systematically should be implemented to avoid the chances of fall, and that programs encouraging to practice regular exercise for physical activity and to promote health of the elderly should be developed.

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Hydro-mechanical coupling behaviors in the failure process of pre-cracked sandstone

  • Li, Tingchun;Du, Yiteng;Zhu, Qingwen;Ren, Yande;Zhang, Hao;Ran, Jinlin
    • Geomechanics and Engineering
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    • v.24 no.6
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    • pp.573-588
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    • 2021
  • The interaction of cracks and water significantly affects the fracture mechanism of rocks. In this study, laboratory tests were conducted using sandstone samples containing a single fissure to explore the hydro-mechanical behaviors in the failure process of pre-cracked rocks. The internal crack characteristics were also analyzed using X-ray CT scanning. The results show that the confining pressure has the greatest effect on the mechanical properties (e.g., strengths, elastic modulus, and Poisson's ratio), followed by the fissure inclination and water pressure. At a lower fissure inclination, the confining pressure may control the type main cracks that form, and an increase in the water pressure increases the number of anti-wing cracks and the length of wing cracks and branch cracks. However, the fracture behaviors of samples with a higher fissure inclination are only slightly affected by the confining pressures and water pressures. The effect of fissure inclination on the internal crack area is reduced with the propagation from the fissure tips to the sample ends. The fissure inclination mainly affects the value of permeability but not affect the trend. The impact of pre-existing fissure on permeability is smaller than that of confining pressure and water pressure.

Prevention for Collapse Using Aqua Splint® in Zygoma Arch Fractures (관골궁 골절 환자에서 함몰 방지를 위한 Aqua splint®를 이용한 보호대)

  • Seo, Woo Jin;Kim, Chang Yeon;Hwang, Weon Jung;Kim, Jeong Tae
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.813-817
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    • 2007
  • Purpose: The zygomatic arch is a key element which composes the facial contour. In many cases of zygomatic arch fracture, it is difficult to fix rigidly the fractured segments. If reduced bone segments were not fixed rigidly, they are proven to be displaced by mastication or unintentional external forces. So, unfixed zygomatic arch fracture after reduction may require a external device of prevention of collapse. We introduce a new protector which stabilizing the fractured segments to prevent for collapse of the reduced zygomatic arch fracture. Methods: After reduction of zygomatic arch with blind approach(Gillies', Dingman or Keen's approach), bone segments was pulled with percutaneous traction suture in medial aspect of zygomatic arch. Then, the suture was fixed with Aqua $splint^{(R)}$, externally. And intraoperative and postoperative X-ray was done. The splint was removed on 14 days after the operation. Results: 5 patients were treated with this method. 4 patients of total patients had no collapse in zygomatic arch. There was minimal collapse in one patient. Postoperative complications such as facial nerve injury, mouth opening difficulty, contour deformity, infection, scar were not observed. Conclusion: In comparison with other techniques, this technique has several advantages which are simple and easy method, short operation time, no scar, less soft tissue injury, and facilitated removal of splint. Therefore, Aqua $splint^{(R)}$ would be a good alternative to prevent for collapse in unstable zygomatic arch fractures