• Hip & pelvis
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• v.34 no.3
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• pp.172-176
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• 2022

A 58-year-old-male patient presented with worsening pain and restricted movements of his right hip after undergoing multiple procedures for treatment of an inter-trochanteric fracture. Secondary arthrosis and an incorporated intramedullary fibular cortical bone graft which caused severe narrowing of the medullary canal were observed by imaging. Total hip arthroplasty (THA) using knee arthroscopic tools was performed for preparation of the severely narrowed femoral canal. A satisfactory clinical outcome was achieved and stable components were observed on radiographs at the 11-year follow-up. The technique described here may be considered when attempting to perform a conversion THA for preparation of a severely narrowed femoral canal using a fibular strut in order to minimize morbidity and prevent structural destabilization.

• Fashion & Textile Research Journal
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• v.18 no.4
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• pp.520-530
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• 2016

This research aims to propose an ergonomic design process for hip protector based on previous studies, existing products, multidisciplinary experts opinion, and wearing test. The elderly are more likely to suffer a hip fracture when they fall due to their physical changes in skeletal form, muscle quantity, bone density, and joint movement. A hip protector is an effective product to prevent hip fractures in the elderly but it also has a problem in that it is uncomfortable. Therefore there is a high chance that it won't be able to prevent hip fractures properly. Since the comfort of a hip protector is one of the most critical elements in preventing a hip fracture, we need to keep improving the hip protector for mobility and usability. Based on the previous studies and limitations of current hip protector products, we need to come up with an optimal design for the Korean elderly. First, knowledge has to be built relating to the ergonomic design of the hip protector considering body shape and size analysis using 3D-scan data, and biomechanical analysis on hip fracture. Second, we need to develop a design process including hip protector pattern design, and wearing evaluation with virtual system. Third, we suggest to reevaluate and verify the design procedure from impact evaluation using testing simulator, virtual evaluation of impact, to wearing comfort and usability evaluation. This design process presented in this study would be expected to contribute to the development of ergonomic hip protector which is suitable for the Korean elderly.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.161-165
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• 2024

Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

• Journal of Korean Biological Nursing Science
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• v.21 no.1
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• pp.54-61
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• 2019

Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

• Hip & pelvis
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• v.35 no.4
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• pp.259-267
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• 2023

Purpose: Nondisplaced femoral neck fractures have traditionally been treated with in situ fixation. However, poor surgical and clinical outcomes have been reported for fractures with valgus deformity >15°, and the reduction of valgus impaction has recently been emphasized. In addition, early degenerative osteoarthritis can be caused by cam-type femoroacetabular impingement after healing of femoral neck fractures. This study was designed with the objective of confirming the difference in progression of radiographic osteoarthritis according to the severity of the valgus deformity. Materials and Methods: Patients who underwent internal fixation using multiple cannulateld screws for management of nondisplaced femoral neck fractures were divided into two groups: high valgus group (postoperative valgus angle ≥15°) and low valgus group (postoperative valgus angle <15°). Evaluation of demographic data and changes in the joint space width from the immediate postoperative period to the latest follow-up was performed. Results: A significant decrease in joint space width in both hip joints was observed in the high valgus group when compared with the low valgus group, including cases with an initial valgus angle less than 15° and those corrected to less than 15° of valgus by reduction. No complications requiring surgical treatment were observed in either group; however, two cases of avascular necrosis, one in each group, which developed in the low valgus group after reduction of the fracture, were followed for observation. Conclusion: Performing in situ fixation in cases involving a valgus deformity ≥15° in non-displaced femoral neck fractures may cause accelerated narrowing of the hip joint space.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.70-73
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• 2023

The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.1-7
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• 2015

PURPOSE: The aims of this study were to assess the intra-tester and inter-tester reliability and validity of hip range of motion using a smart phone in hip operative patients. METHODS: Twenty-five patients (eight total hip arthroplasty and seventeen femur neck fracture) participated in this study. The range of motions in active and passive hip flexion, abduction and external rotation were measured with a goniometer and smart phone over two times by two observers. The intra-tester and inter-tester reliability were evaluated using the intraclass correlation coefficient (ICC2,1). The validity was measured by Pearson's correlation coefficient RESULTS: The intra-observer reliability was good in all measured items (ICC>0.78). The inter-observer reliability was high with ICC (>0.90). All correlation coefficients of smart phone and goniometer was greater than 0.85 and showed a significant positive correlation (p<0.01). CONCLUSION: The range of motion measurement with a smart phone showed acceptable reliability. Therefore, it could be convenient and have economical benefits to measure the range of motion of the hip joint using a smart phone.

• Journal of muscle and joint health
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• v.22 no.2
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• pp.67-77
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• 2015

Purpose: This study was a qualitative research using focus group interviews to collect data on the health care providers' perceptions of physical function in older adults with arthroplasty from hip fracture. Methods: A total of 12 subjects participated in this study. In order to conduct focus group interviews, structured manuscript, field notes, visual recording, and debriefing notes were referred and thematic analysis was used in analysis phase. Results: The six themes were raised: 'burdensome client', 'health care providers' perception of functional decline in older adults after surgery', 'health care providers' perception of caregiver', 'medical environment perceived as affecting physical function', 'crucial components perceived as encouraging functional restoration', and 'difficulty of pain management' with 18 subthemes. Conclusion: Healthcare providers perceived functional decline of elderly after arthroplasty and identified points facilitating or disturbing physical function Moreover, various perspectives on pain management related to physical function were represented.

• Hip & pelvis
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• v.35 no.4
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• pp.268-276
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• 2023

Purpose: Resection remains the most reliable treatment for established heterotopic ossification, despite questions regarding its effectiveness due to the potential for complications. This study evaluated the clinical outcomes and complications of neurogenic heterotopic ossification (NHO) resection in stroke patients' ankylosed hips. Materials and Methods: We retrospectively analyzed nine hip NHO resections performed on seven patients from 2010 to 2018. The pre- and postoperative range of motion of the operated hip were compared. Analysis of postoperative complications, including infection, recurrence, iatrogenic fracture, and neurovascular injury was performed. Results: The mean operative time was 132.78±21.08 minutes, with a mean hemoglobin drop of 3.06±0.82 g/dL within the first postoperative week. The mean duration of postoperative follow-up was 52.08±28.72 months for all patients. Postoperative range of motion showed improvement from preoperative. Flexion and external rotation (mean, 58.89±30.60° and 16.67±18.03°, respectively) showed the greatest gain of motion of the operated hip joint. Postoperative infections resolved in two cases through surgical debridement, and one case required conversion to total hip arthroplasty due to instability. There were no recurrences, iatrogenic fractures, or neurovascular injuries. Conclusion: Resection is a beneficial intervention for restoring the functional range of motion of the hip in order to improve the quality of life for patients with NHO and neurological disorders. We recommend performance of a minimal resection to achieve a targeted functional arc of motion in order to minimize the risk of postoperative complications.

• Fashion & Textile Research Journal
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• v.16 no.6
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• pp.1001-1007
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• 2014

We surveyed the wearing characteristics of hip protectors. The problems of existing hip protectors were identified and the directions for improvement were presented. The evaluation of wearing characteristics was conducted on the 100 elderly women (60 to 85 years) with 5 types of hip protector. The questionnaire was composed of history and characteristics on falling, hip protector acceptance, preference, use characteristics and improvement requirements. The result of wearing characteristic evaluation indicated that 52% of the subject experienced falling in winter. Incidents resulting from falling occurred: outdoors (74.5%), bathroom (10.9%), and kitchen (5.5%). Body parts to be protected were in several areas: 35.6% for lumbar, 26.9% for hip joint, and 15% for hip bone. Participants prefer a belt B type design at a rate of 56.9% because it provided a sense of stability by clinging to the body and upholding the waist. Belt B type was the most appropriate in terms of fit, allowance, mobility, and design except pad thickness. To reduce the risk of hip fracture, hip protector needs to be designed in consideration of user's type of fall and body shape. The pattern and size of a hip protector has to be improved in regards to the amount of discomfort. An objective evaluation is needed for the ergonomic design of a hip protector based on and analysis of 3D body image of the elderly and the shock-absorbing quality of pad.