• 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.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.89-96
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• 2024

The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.

• 대한골관절종양학회지
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• 제18권2호
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• pp.99-103
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• 2012

악성 종양 환자에게서 졸레드론산과 같은 비스포스포네이트를 예방적으로 투여받은 경우 이와 관련한 비전형적 대퇴골 골절의 발생 위험성은 아직까지 명확하게 밝혀진 바가 없으며, 국내에 지금까지 보고된 예가 매우 드물다. 본 증례는 다발성 골수종 환자에서 고농도 졸레드론산을 지속적으로 투여받았던 환자에서 큰 외상의 병력 없이 우측 대퇴골 전자하 부위의 비전형적 골절이 발생한 경우로 폐쇄적 정복술 및 골수강 내 금속정 내고정술로 치료한 경험을 보고하고자 한다.

• 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.

• 대한관절경학회지
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• 제2권2호
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• pp.185-188
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• 1998

Spontaneous osteonecrosis of the knee was first described by Ahlbck et al in 1968 as the spontaneous and sudden onset of severe pain, usually on the medial side of the knee joint, in old age(>60 years) with no specific etiologic factors. They differentiate the disease from osteochondritis dissecans, osteoarthritis, fracture, infection, neuropathic joint and secondary osteonecrosis of the knee joint. So far many investigators described this disease but had never observed cases developed in young patient with familial occurrence. The report presented here is a case of spontaneous osteonecrosis of both medial and lateral femoral condyles involving the bilateral knee joint that were treated by arthorscopic loose body removal and multiple drilling.