• Journal of Trauma and Injury
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• 제25권4호
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• pp.139-144
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• 2012

Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean $age=46.7{\pm}16.6years$) were enrolled for analysis. The average ISS of the patients was $16.2{\pm}7.9$, and the average amount of packed RBC transfusion for 24 hr was $3.9{\pm}4.6units$. The regression equation resulting from the multiple linear regression analysis was 'packed RBC units=1.40${\times}$(sacrum fracture)+1.72${\times}$(pubis fracture)+1.67${\times}$(ilium fracture)+0.36' and was found to be suitable (p=0.005). We simplified the regression equation to 'Pelvic Bleeding Score=sacrum+pubis+ilium.' Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management.

• Hip & pelvis
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• 제36권1호
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• pp.70-75
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• 2024

We report on the case of a 52-year-old female who presented with a stress fracture after undergoing an endoscopic resection of the lesser trochanter in ischiofemoral impingement, which was resistant to maximal conservative treatment. To the best of our knowledge, this complication has not been previously described. Non-weight-bearing and intravenous alendronic acid were prescribed for management. No additional surgery was required. The patient was pain free with the ability to perform sports on the same level as before and had no complaints.

• 한국임상수의학회지
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• 제15권1호
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• pp.222-227
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• 1998

This survey was based on the data of one hundred four dogs with 108 case,T of fracture admitted to the veterinary teaching hospital, College of Veterinary Medicine, Kyungpook National University and 24 private small animal hospitals from January, 1995 to Decemberi 1996. The results were analyzed as following criteria; the distribution of fractures causes of fractured age and sexual distributions month of the most frequencel total body weights presence of communicating external wound, extent of damaged direction of fracture line, location of fracture liner fracture managements fixations methods, fixations methods according to location of fracture. The results of survey were as follow: 1. Main distribution of fracture; radius . ulna (23.1%).2. Causes of fracture; road toraffic accident (39.4 T,). 3. Age; over 24 months (27.9%). 4. Sex; male (53.89)), female (46.2%). 5. Month of the most frequence; July (14.4%) 6. Total body weight: 2-5 kg (45.27)). 7. Presence of communicating external wound; closed fracture (94.2%). 8. Extent of damage; complete fracture (92.6%). 9. Direction of fracture line: comminuted fracture (27.8 To). 10. Location of fracture line; diaphysis (62.0%). 11. Fracture management; open reduction (58.3% ). 12. Fixation methods; not treat (22.2%). 13. Fixation methods according to location of fracture; radius ulna-Kirschner wire fixation (45.5%), femur. shaft-intramedullary pinning (71.4%), pelvis-bone plate (53.3%), metacarpus-not treat, Kirschner wire fixation (each 30.8%).

• Hip & pelvis
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• 제30권4호
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• pp.202-209
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• 2018

Atypical femoral fractures differ from ordinary femoral diaphyseal or subtrochanteric fractures in several aspects. Although several authors have reported the results of surgical treatment for atypical femoral fractures, the rate of complications (e.g., delayed union, nonunion, fixation failure, and reoperation) is still high. Therefore, we reviewed principles of surgical treatment and describe useful methods for overcoming femoral bowing in these high-risk patients.

• 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.

• Hip & pelvis
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• 제34권2호
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• pp.122-126
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• 2022

Tumoral calcinosis is a rare disease characterized by massive subcutaneous soft tissue deposits of calcium phosphate around large joints in patients with chronic kidney disease. Invasion of bone by tumoral calcinosis is rare. We experienced a case involving a femoral neck pathologic fracture due to bony invasion of tumoral calcinosis in a 46-year-old female with chronic kidney disease who had been on dialysis for 15 years. Successful outcomes were obtained by performance of total hip arthroplasty for treatment of the pathologic fracture of the femoral neck. Careful precaution is necessary to prevent pathologic fractures in patients with tumoral calcinosis around the hip joint.

• Hip & pelvis
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• 제34권4호
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• pp.191-202
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• 2022

The aim of this study was to provide helpful information for use in selection of an appropriate medication after osteoporotic fractures through conduct of a literature review. In addition, a review of the recommendations of several societies for prevention of subsequent fractures was performed and the appropriate choice of medication for treatment of atypical femur fractures was examined. Clinical perspective was obtained and an updated search of literature was conducted across PubMed and MEDLINE and relevant articles were selected. The articles were selected manually according to relevance, and the references for identified articles and reviews were also evaluated for relevance. The following areas are reviewed: Commonly prescribed osteoporosis medications: BPs (bisphosphonates), denosumab, and SERMs (selective estrogen receptor modulators) in antiresorptive medications and recombinant human parathyroid hormone teriparatide, recently approved Romosuzumab in anabolic agents, clinical practice guidelines for the management of osteoporosis, osteoporotic fracture, and atypical femur fracture. Most medications for treatment of osteoporosis do not delay fracture healing and the positive effect of teriparatide on fracture healing has been confirmed. In cases where an osteoporotic fracture is diagnosed, risk assessment should be performed for selection of very high-risk patients in order to prevent subsequent fractures, and administration of anabolic agents is recommended.

• Hip & pelvis
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• 제34권4호
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• pp.262-268
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• 2022

A fracture of the affected extremity in patients with Klippel-Trenaunay-Weber syndrome can be fatal due to massive bleeding and show poor results. A 42-year-old male presented with an old fracture of the right femoral shaft with metal failure. We planned an operation to remove the previously fixed plate and to perform re-fixation using an intra-medullary nail. Preoperative angiography was performed and the arteriovenous malformations were embolized in order to reduce the risk of bleeding. After angiography, the previously fixed plate was removed. After the operation, a second angiography was performed immediately and the venous malformation was embolized. One week after the first operation, a second operation was performed in order to reduce the fracture and to perform re-fixation using an intramedullary nail. The patient is being followed without major complication over a period of seven years after surgery. We recommend careful planning of preoperative and postoperative angiography and embolization in order to reduce the risk of bleeding in patients with Klippel-Trenaunay-Weber syndrome.

• Journal of Korean Neurosurgical Society
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• 제43권1호
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• pp.31-33
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• 2008

We present a rare case of fracture-dislocation at the level of the first sacral (S1) and second sacral (S2) vertebrae. The S1 was displaced forward into the pelvic cavity and was located just in front of the S2. Because the patient also had extensive neurological injury to the lumbar plexus and instability of the pelvic ring, surgery to stabilize the pelvis and to decompress the lumbar plexus was performed. The surgery was successful and the patient experienced marked improvement in neurological function.

• Hip & pelvis
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• 제36권2호
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• pp.155-160
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• 2024

We report two cases of postoperative total hip arthroplasty periprostehtic fracture of the acetabulum which treated by open reduction with internal fixation without acetabular cup revision. From these cases, we should consider open reduction with internal fixation as the first treatment option in cases where spot welding of the cup to the host bone is observed.