• Title/Summary/Keyword: Hip Fracture

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Diagnosis of Coxofemoral Joint Luxation in a Whooper Swan (Cygnus Cygnus) Using Computed Tomography and Radiography

  • Jinho Jang;Jong-pil Seo;Hyohoon Jeong;Seyoung Lee;YoungMin Yun
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.139-142
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    • 2024
  • A wild Whooper swan (Cygnus Cygnus) with limping due to an injured left pelvic limb in an accident was rescued on the seashore and transferred to the Jeju Wildlife Rescue Center on November 23rd, 2020. On physical examination, its body condition score was 1 out of 5 due to starvation and dehydration. The left coxofemoral joint was also examined by careful palpating and estimating the damage. Moderated soft tissue swelling and crepitus surrounding the hip joint were confirmed. Radiography and computed tomography (CT) were used together for an accurate diagnosis of the joint. By radiographs readings, it was difficult to accurately confirm the condition of the proximal femur due to superimposition of the synsacrum and internal organs. However, signs such as avulsion fracture of the femoral head and a few fragments around the joint were revealed by CT imaging. Besides, through three-dimensional (3D) image analysis of CT, the dislocated area and condition of the left hip joint could be accurately and easily confirmed. The diagnostic process showing in this paper could be used as a good reference for diagnosing coxofemoral joint luxation in wild swan.

Prediction of Stress Distribution in the Ceramic Femoral Head after Total Hip Replacement (인공고관절 치환술 후 세라믹 대퇴골두에서 발생하는 응력분포 예측)

  • Han, Sung-Min;Chu, Jun-Uk;Song, Kang-Il;Park, Sung-Hee;Choi, Jae-Bong;Kim, Jung-Sung;Suh, Jun-Kyo Francis;Choi, Kui-Won;Youn, In-Chan
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.6
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    • pp.680-685
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    • 2012
  • Ceramic femoral heads are now widely used in Total Hip Replacement (THR). Due to their high biocompatibility and low ductility, ceramic femoral heads are considered to be suitable for young and active patients. However, as in testing the mechanical stability of the femoral head, the conventional proof test (standard ISO 7206-10) has its limit of showing axisymmetric stress distribution on the contact surface, while non-uniformed stress distribution is expected after THR. Since non-uniformed stress distribution can result in the increased probability of ceramic femoral head fracture, it is considerable to evaluate the stress distribution in vivo-like conditions. Therefore, this study simulated the ceramic femoral heads under in vivo-like conditions using finite element method. The maximum stress decreased when increasing the size of the femoral head and stress distribution was concentrated on superior contact surface of the taper region.

Decision-Making and Principle of Management in Periprosthetic Femoral Fracture after Total Hip Arthroplasty (고관절 치환술 후 삽입물의 안정성 판단과 대퇴 삽입물 주위 골절의 치료 원칙)

  • Kim, Beom-Soo;Lee, Kyung-Jae;Min, Byung-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.200-207
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    • 2021
  • Periprosthetic femoral fractures remain as one of the most challenging complications following total hip arthroplasty. A thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are essential to obtain optimal results for these fractures. The Vancouver classification system is a simple, effective, and reproducible method for the planning treatments of these injuries. The fractures associated with a stable femoral stem can be treated effectively with osteosynthesis, but periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. This paper describes the principle of the treatment of patients with periprosthetic femoral fractures and how to assess the stability of the femoral stem.

An Intraosseous Schwannoma Combined with a Subchondral Fracture of the Femoral Head: a Case Report and Literature Review

  • Kim, Hyun Young;Ryu, Kyung Nam;Park, Yong Koo;Han, Jung Soo;Park, Ji Seon
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.177-182
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    • 2017
  • Schwannomas are benign nerve sheath tumors that are typically located in soft tissue. Occasionally, schwannomas involve osseous structures. These intraosseous schwannomas are generally benign neoplasms that account for less than 0.2% of primary bone tumors. Schwannomas are very rarely observed in long bones. We present a case of a schwannoma affecting the proximal femur with a coincident subchondral fracture of the femoral head. A 38-year-old-male presented with left hip pain without deteriorating locomotor function. Plain film radiographs displayed a lobulating contoured lesion within the intertrochanteric portion of the femur. The magnetic resonance imaging (MRI) scans showed a tumor occupying the intertrochanteric region. Diffuse bone marrow edema, especially in the subchondral and head portions of the femur that was possibly due to the subchondral insufficiency fracture was also noted. The lesion was surgically excised and bone grafting was performed. Histologically, there was diffuse infiltrative growth of the elongated, wavy, and tapered cells with collagen fibers, which are findings that are characteristic of intraosseous schwannoma. Although very rare, intraosseous schwannoma should be included in the differential diagnosis of radiographically benign-appearing, non-aggressive lesions arising in the femur. The concomitant subchondral fracture of the femoral head confounded the correct diagnosis of intraosseous schwannoma in this case.

Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

  • Park, Shin-Hyung;Kim, Jae-Chul;Lee, Jeong-Eun;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.269-276
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    • 2011
  • Purpose: To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Materials and Methods: Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT. bone scintigraphy were reviewed to evaluate the patients with PIF. Results: Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. Conclusion: PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

Rare Imaging of Fat Embolism Seen on Computed Tomography in the Common Iliac Vein after Polytrauma

  • Lee, Hojun;Moon, Jonghwan;Kwon, Junsik;Lee, John Cook-Jong
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.103-106
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    • 2018
  • Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

Synthesis and Rapid Consolidation of W-1.5 ZrO2 Composite (W-1.5 ZrO2 복합재료 합성과 급속소결)

  • Kim, Seong-Eun;Shon, In-Jin
    • Korean Journal of Materials Research
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    • v.28 no.11
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    • pp.653-658
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    • 2018
  • $ZrO_2$ is a candidate material for hip and knee joint replacements because of its excellent combination of biocompatibility, corrosion resistance and low density. However, the drawback of pure $ZrO_2$ is a low fracture toughness at room temperature. One of the most obvious tactics to cope with this problem is to fabricate a nanostructured composite material. Nanomaterials can be produced with improved mechanical properties(hardness and fracture toughness). The high-frequency induction heated sintering method takes advantage of simultaneously applying induced current and mechanical pressure during sintering. As a result, nanostructured materials can be achieved within very short time. In this study, W and $ZrO_2$ nanopowders are mechanochemically synthesized from $WO_3$ and Zr powders according to the reaction($WO_3+3/2Zr{\rightarrow}W+3/2ZrO_2$). The milled powders are then sintered using high-frequency induction heating within two minutes under the uniaxial pressure of 80MPa. The average fracture toughness and hardness of the nanostructured W-3/2 $ZrO_2$ composite sintered at $1300^{\circ}C$ are $540kg/mm^2$ and $5MPa{\cdot}m^{1/2}$, respectively. The fracture toughness of the composite is higher than that of monolithic $ZrO_2$. The phase and microstructure of the composite is also investigated by XRD and FE-SEM.

Comparison of Subchondral Fracture on Radiographs with MR Images in Evaluation of Osteonecrosis in LCP Patients (LCP 환아에서 골괴사의 평가방법으로 연골하 골절선과 자기공명영상의 비교)

  • Kim, Jin-Won;Park, Mee-Jung;Choi, Ho-Chul;Cho, Jae-Min;Ryoo, Jae-Wook;Jeong, Seong-Hoon;Kim, Dong-Hee;Lee, Gyung-Kyu;Na, Jae-Boem
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.177-182
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    • 2009
  • Purpose : To compare the subchondral fracture on plain radiography and MR image as a method for assessing osteonecrosis in Legg-Calve-Perthes(LCP) pateients. Materials and methods: We retrospetively reviewed 15 hip joint MR images and plain radiography which visualized subchondral fracture. With basis of the Salter-Thompson classification, extent of necrosis was graded group A to B, as follows; Group A = < 50%, B = > 50%. On PACS workstation, necrotic area of each MR image was measured to calculate the volume of necrotic portion: volume = necrotic area $\times$ slice thickness. Necrotic areas on MR images were graded group A to B and results were compared with that measured in Salter-Thompson classification. On follow up, bone resorption was measured and the extent was compared with subchondral fracture representing necrotic area and that on MR volume method respectively. Results : In 9 joints of 15 hip joints (60%), the degree of necrosis in Salter-Thompson classification on plain radiographs was different from that on MR volume method. Based on plain radiographs by Salter-Thompson classification, the degree of necrosis was overestimated in 6(67%) joints, and underestimated in 3(33%) joints compared with MR volume method. On follow up study, bone resorption was not correlated with necrotic extent of subchondral fracture and MR volume method. Conclusion : The extent of femoral head necrosis measured by subchondral fracture was different from that measured by MR and was not correlated with bone resorption on follow up. Therefore, usefulness of subchondral fracture as a prognostic factor may be limited.

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Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report

  • Jung, Ga Hyeon;Lee, Hyun;Ryu, Hwa Yeon;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.37 no.3
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    • pp.187-192
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    • 2020
  • Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and self-reported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

Fabrication and Tensile Properties of Alloy 617 base ODS Alloy (Alloy 617계 산화물 분산강화(ODS) 합금의 제조와 인장특성)

  • Min, Hyoung-Kee;Kang, Suk-Hoon;Kim, Tae-Kyu;Han, Chang-Hee;Kim, Do-Hyang;Jang, Jin-Sung
    • Journal of Powder Materials
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    • v.18 no.6
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    • pp.482-487
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    • 2011
  • Alloy 617, Ni-22Cr-12Co-9Mo base oxide dispersion strengthened alloy was fabricated by using mechanical alloying, hot isostatic pressing and hot rolling. Uniaxial tensile tests were performed at room temperature and at $700^{\circ}C$. Compared with the conventional Alloy 617, ODS alloy showed much higher yield strength and tensile strength, but lower elongation. Fracture surfaces of the tensile tested specimens were investigated in order to find out the mechanism of fracture mode at each test temperature. Grain adjustment during tensile deformation was analyzed by electron backscattered diffraction mapping, inverse pole figures and TEM observation.