• Journal of Trauma and Injury
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• 제26권3호
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• pp.125-130
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• 2013

Purpose: This study was undertaken in order to identify the characteristics of patients diagnosed with occult an hip fracture after hip trauma. Methods: We retrospectively reviewed the medical records and radiology reports of all patients who underwent hip skeletal computed tomography (CT) for suspected hip fractures but had normal initial X-rays after hip trauma between August 2006 and January 2012. The variables evaluated included age, gender, body mass index (BMI), accident mechanism, previous fracture, independence, late presentation, ability to bear weight, pain on passive rotation, tenderness of the groin area, diagnosis and treatment. Patients were divided into two groups, with hip fracture (occult hip fracture group) and without hip fracture (no fracture group) to evaluate the characteristics associated with an occult hip fracture. Results: The patients, a total of 139, had a mean age of 58.3 years and included 72 male patients(51.8%). The occult hip fracture group included 43 patients(30.9%). Of those 43, 21 patients(48.8%) had intertrochanteric or trochanteric fractures, 8 patients(18.6%) had femur neck fractures and 14 patients(32.6%) had acetabular fractures. Of the 43, 15 patients(34.9%) needed operative treatment. Age was higher in the occult hip fracture group than it was in the no fracture group($64.4{\pm}19.1$ years vs. $55.5{\pm}23.6$ years, p=0.021). A previous fracture was associated with the presence of a new fracture (p=0.014; OR=3.971, 95% CI=1.314-11.997). Conclusion: Further evaluation of patients who are older or have history of fractures is prudent, even though the initial X-rays are normal.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.147-152
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• 2008

Objectives : Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Methods : Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. Results : The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the non-fluoridated cities. Conclusions : We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

• 대한물리치료과학회지
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• 제8권1호
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• pp.841-850
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• 2001

This study was conducted to find out current status and characteristics, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. The data were coolected from 199 cases hospitalized in 4 university hospitals in Pusan during three years period from January, 1966 to December, 1998. 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 with x2-test. The results were as follow: The mean age of elderly hip fractured cases was 75.7 years, and 61.8% were female. The average hospital stay of the cases was 30.8 days, and 73.9% survived. Femur neck fracture cases comprised 51.7% of the toral cases, while trochanteric fracture cases comprised 48.3%. The hip fracture occurred more frequently during the day, shown as 66.9%, and the most frequently due to trips(44.2%), followed by slips(322%), c1ash(14.6%), dizziness(7.5%), and 00 on. Femur neck fracture, however, occurred the most frequently due to trips(51.5%) and, on the other hand, trochanteric fracture due to slips(40.6%) and trips(36.5%). About two third of hip fracture(67.8%) occurred inside of the building. The most frequently mentioned location for hip fractures was rooms or floors(32.1%), followed by streets(24.1%), bathrooms(17.6%), stairways(13.1%), and so on. Trochanteric fracture, especially, more frequently occurred inside of the building(71.9%) as compared to femur neck fracture(64.1 %). The rate of independent indoor walking in femur neck fractured cases reduced from 88.3% to 74.8% after fracture incidences, while the rate reduced from 86.0% to 45.8% in trochanteric fracture cases. It indicated that trochanteric fractures affected the walking ability of the elderly more severely that femur neck fractures. In conclusion, hip fracture occurs as a combined result of aging characteristics, environmental factors, and health related characteristics. Future studies that investigaterisk factors of hip fracture in elderly are recommended.

• Hip & pelvis
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• 제36권1호
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• pp.55-61
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• 2024

Purpose: This study sought to examine the utilization of bone health evaluations in geriatric hip fracture patients and identify risk factors for the development of future fragility fractures. Materials and Methods: A consecutive series of patients ≥55 years who underwent surgical management of a hip fracture between September 2015 and July 2019 were identified. Chart review was performed to evaluate post-injury follow-up, performance of a bone health evaluation, and use of osteoporosis-related diagnostic and pharmacologic treatment. Results: A total of 832 patients were included. The mean age of the patients was 81.2±9.9 years. Approximately 21% of patients underwent a comprehensive bone health evaluation. Of this cohort, 64.7% were started on pharmacologic therapy, and 73 patients underwent bone mineral density testing. Following discharge from the hospital, 70.3% of the patients followed-up on an outpatient basis with 95.7% seeing orthopedic surgery for post-fracture care. Overall, 102 patients (12.3%) sustained additional fragility fractures within two years, and 31 of these patients (3.7%) sustained a second hip fracture. There was no difference in the rate of second hip fractures or other additional fragility fractures based on the use of osteoporosis medications. Conclusion: Management of osteoporosis in geriatric hip fracture patients could be improved. Outpatient follow-up post-hip fracture is almost 70%, yet a minority of patients were started on osteoporosis medications and many sustained additional fragility fractures. The findings of this study indicate that orthopedic surgeons have an opportunity to lead the charge in treatment of osteoporosis in the post-fracture setting.

• 대한물리치료과학회지
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• 제9권1호
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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.

• Hip & pelvis
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• 제34권1호
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• pp.62-67
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• 2022

Posterior wall fractures are the most common type of acetabular fractures. Treatment can be conservative or surgical. Operative treatment is indicated for acetabular fractures that result in hip joint instability and/or incongruity, as well injuries with incarceration of fragments of bone or soft tissue within the hip joint. Surgical treatment can range from open reduction and osteosynthesis to hip arthroplasty. Arthroscopy has recently been used as the main surgical technique or as a reduction aid. In this case a 26-year-old male with a fracture of the posterior wall who underwent a posterior miniinvasive approach, followed by hip arthroscopy. This allowed joint wash, removal of the loose body, confirmation of reduction and absence of intra-articular hardware. Excellent clinical and radiological results were obtained. This case demonstrates the advantage of using hip arthroscopy in assessment of fracture reduction, the absence of intra-articular hardware or fragments, as well as a less invasive approach.

• 대한정형도수물리치료학회지
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• 제15권2호
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• pp.44-49
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• 2009

Purpose : The purpose of this study was to evaluate the incidence and mortality for hip fracture in the elderly in Jeju-do. Methods : We enrolled 254 cases among 318 patients older than 50 years of age with a hip fracture during two years period(2003-2004). We investigated the incidence and mortality during follow up 3~4 years period until December 31, 2007. Results : The crude incidences of hip fracture the age group ${\geq}50$ years were 141(11.2/10,000) in 2003, 177(13.6/10,000) in 2004, and 249(17.0/10,000), 69(6.3/10,000) for women and men, respectively. The mean age of them was 78.3 years, male was 69(21.7%), female was 249(78.3%) among 318 patients. Survivor was in the 146(57.5%), death was in the 108(42.5%) among 254 cases period for follow up. In the death group, activity was significantly lower at the time of post-fracture 3(p=0.013), 6(p=0.000), and 12 months(p=0.000). The mortality of hip fracture and crude death rate(CDR) were 108(42.5%, n=254), 11,884(1.7%, n=675,889) in 2003~2007 in Jeju. Conclusion : Developing and applying a variety of activity programs that increase activity in post-fracture may improve activities of daily living, reduce burden of family and society, be useful in improving the quality of life and ultimately lower the mortality.

• Hip & pelvis
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• 제36권1호
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• pp.62-69
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• 2024

Purpose: To assess current practice in the treatment of osteoporosis in patients who underwent treatment for hip fracture in South Korea. Materials and Methods: A survey of 97 members of the Korean Hip Society, orthopedic hip surgeons who administer treatment for hip fractures in South Korea, was conducted. The survey was conducted for assessment of demographic data and perceptions regarding the management of osteoporosis in patients who have undergone treatment for hip fracture. Analysis of the data was performed using descriptive statistical methods. Results: The majority of participants were between the age of 41 and 50 years, and 74% were practicing in tertiary hospitals. Testing for serum vitamin D levels (82%) was the most commonly performed laboratory test. Calcium and vitamin D were prescribed for more than 80% of patients by 47% and 52% of participants, respectively. Denosumab was the most commonly used first-line treatment option for osteoporosis in hip fracture patients. Bisphosphonate was most often perceived as the cause of atypical femoral fractures, and the most appropriate time for reoperation was postoperative 12 months. Teriparatide was most preferred after cessation of bisphosphonate and only prescribing calcium and vitamin D was most common in high-risk patients for prevention of atypical femoral fracture. Conclusion: The results of this study that surveyed orthopedic hip surgeons showed that most participants followed the current strategy for management of osteoporosis. Because the end result of osteoporosis is a bone fracture, active involvement of orthopedic surgeons is important in treating this condition.

• Journal of Korean Biological Nursing Science
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• 제18권4호
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• pp.193-202
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• 2016

Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.

• Journal of Trauma and Injury
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• 제31권1호
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• pp.43-50
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• 2018

Traumatic hip joint dislocations account for 2-5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.