• Title/Summary/Keyword: calcaneus

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Tricortical-allobone Grafting in Screw Fixation for Intra-articular Calcaneal Fracture via Ollier Approach (관절 내 종골 골절에서 Ollier 접근법을 이용한 나사못 고정술 시 삼면 피질골 이식)

  • Bang, Taejung;Bae, Su-Young;Woo, Seung Hun;Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.27-32
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    • 2017
  • Purpose: Bone grafting is often necessary to maintain a reduction and prevent delayed collapse of reduced fracture in a treatment of severely displaced comminuted intra-articular calcaneal fractures. Herein, we analyzed the usefulness and necessary conditions to perform tricortical-allobone grafting in open reduction of calcaneal fracture via the Ollier approach. Materials and Methods: We performed a retrospective review of 57 intra-articular calcaneal fractures that underwent an operation via the Ollier approach between April 2009 and April 2015. They were divided into two groups: Group 1 (n=17) included those with tricortical-allobone grafts underneath the posterior facet fragment, and group 2 (n=40) included cases without a bone graft. We measured the $B{\ddot{o}}hler$ angle, Gissane angle, height, and width of the calcaneus at preoperative, postoperative, and final follow-up radiograph. We measured the sagittal rotational angle of the posterior facet fragment of preoperative computed tomography to analyze the effect and necessary conditions for bone grafting. We also reviewed the clinical results by the American Orthopaedic Foot and Ankle Society (AOFAS) scale, visual analogue scale (VAS), and any complications. Results: According to the Sanders classification, there were 3 type-II fractures, 12 type-III fractures, and 2 type-IV fractures in Group 1; whereas in Group 2, there were 26 type-II fractures, 13 type-III fractures, and 1 type-IV fracture (p=0.002). Regarding the preoperative radiologic parameters, there were significant differences in the $B{\ddot{o}}hler$ angle (p=0.006), Gissane angle (p=0.043), and rotational angle of the posterior facet fragment (p=0.001). No significant difference was observed in the preoperative calcaneal height and width, as well as postoperative radiologic parameters. There was no significant clinical difference between the two groups (p=0.546). Conclusion: We suggest that a tricortical-allobone graft may be useful in open reduction and screw fixation via the Ollier approach for displaced intra-articular calcaneal fracture with a bony defect after reduction of collapsed posterior facet fragment. This graft can contribute to the stable reduction via a small approach, even without a plate.

Clinical and Radiological Results of Treatment in Bilateral Calcaneal Fracture (양측 종골 골절 환자의 치료 후 임상적 및 방사선학적 결과)

  • Lee, Jeong-Gil;Kim, Gab-Lae;Hyun, Yoon-Suk;Koo, Bon-Jae;Lee, Hyo-Beom;Lee, Jae-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.229-234
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    • 2012
  • Purpose: The purpose of this study is to find out clinical and radiological outcomes in 70 patients of both calcaneal fracture. Materials and Methods: From March 1993 to March 2011, 70 patients underwent non-operative management or operative management at our hospital. Conservative management was performed in 15 cases of undisplaced fracture (Group A). Operative management was performed in 125 cases including 32 cases of undisplaced fracture (Group B), 60 cases of joint depression type fracture (Group C), 33 cases of tongue type fracture (Group D). Results were evaluated by VAS score, AOFAS score, circle draw test, Bohler angle (BA), Gissane angle, width & height of calcaneus. Results: VAS scores were 2.0 in group A, 2.0 in group B, 2.2 in group C, 2.7 in group D. AOFAS scores were 90.4 in group A, 91.9 in group B, 72.2 in group C, 79.2 in group D. Circle draw tests were 8.4 cm in group A, 10.1 cm in group B, 7.6 cm in group C, 7.9 cm in group D. Bohler angles (BA) and Gissane angles were $19.1^{\circ}$, $96.7^{\circ}$ in group A, $21.8^{\circ}$, $119.1^{\circ}$ in group B, $26.3^{\circ}$, $121.2^{\circ}$ in group C, $19.7^{\circ}$, $119.7^{\circ}$ in group D. Calcaneal widths and heights were 39.5 mm, 31.6 mm in group A, 32.7 mm, 37.0 mm in group B, 34.4 mm, 39.2 mm in group C, 35.2 mm, 38.7 mm in group D. Conclusion: The main cause of bilateral calcaneal fracture is an injury from a fall, and the cases were more frequently occurred in men than women. Also the fracture in the right side tend to occur more severely compared to the left side. The surgical treatment shows better results than conservative treatment in bilateral calcaneal fracture.

Comparison Between Ultrasonic and X-ray Methods for Imaging the Children′s Growth Plate (어린이 성장판 영상화를 위한 초음파와 X-선 방식의 비교 평가)

  • Kim Sang Hoo;Kim Hyung Jun;Han Eun Ok;Han Seung Moo
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.551-556
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    • 2004
  • The purpose of this study was to suggest a systematic and scientific method for measurement of children's growth development, in which the accuracy of existing diagnosis method has not been concretely examined yet. The most popular method for diagnosis of children's growth is to analyze the opening degree of growth plate in each joint by X-ray image. However, X-ray method has some disadvantages; it is impossible to measure the diagnosis of growth periodically and repeatedly due to the radiation problem. Hence, this study introduced a profile analysis and the algorithm of analyzing the image of growth plate with the BUA(Broadband Ultrasound Attenuation) of calcaneus, to verify the possibility of alternative ultrasonic method harmless to human body. We obtained the images of growth plate in proximal tibiae, phalanges, and calcanei of 269 children (7∼16 years old) with X-ray. And the image of growth plate in calcanei was also obtained front those children with ultrasound. The results showed that the time of the opening degree of growth plate in each joint was almost consistent between X-ray and ultrasonic images. Also, the images of growth plate measured by X-ray and ultrasound showed the high correlation. Therefore, it is expected that the algorithm of ultrasonic profile analysis introduced in this study can replace the existing X-ray method to measure the growth plate correctly.

Correlations of Lumbar and Femoral Bone Mineral Densities with Calcaneal Speed of Sound in Osteoporotic Woman (골다공증 여성에서 요추골 밑 대퇴골 부위의 골밀도와 종골 음속 사이의 상관관계)

  • Lee, Kang-Il;Choi, Min-Joo
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.6
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    • pp.542-547
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    • 2009
  • In this in vivo study, correlations of lumbar and femoral bone mineral densities (BMDs) with calcaneal speed of sound (SOS) were investigated in 36 osteoporotic women. Areal BMDs of the L2-L4 lumbar spine and the right femoral neck were measured by using dual energy X-ray absorptiometry (DEXA). SOS of the right calcaneus was measured by using ultrasound bone densitometry. Pearson's correlation coefficient (r) and level of significance (p) were used to evaluate the correlations between measurements. Lumbar BMD was highly correlated with femoral BMD (r=0.81). Lumbar and femoral BMDs exhibited similar comparable negative correlations with age (r=-0.52 and r=-0.55). A moderate negative correlation was found between calcaneal SOS and age (r=-0.45). Calcaneal SOS was significantly correlated with lumbar and femoral BMDs, with a higher correlation with femoral BMD rather than with lumbar BMD (r=0.54 and r=0.62). However, calcaneal SOS may not be an optimum index for the estimation of BMD of the most important fracture sites, such as the lumbar and the femur, because it showed lower correlations with lumbar and femoral BMDs compared to that with calcaneal BMD. Therefore, the development of a quantitative ultrasound technology for the direct measurement of acoustic properties at the lumbar and the femur is required to estimate BMD of these sites more accurately.

Factors Related to Q Angle in Healthy Adults (20대 정상성인의 대퇴사두근각(Q angle)에 영향을 미치는 요인)

  • Kwon, Hyuk-Cheol
    • Physical Therapy Korea
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    • v.6 no.1
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    • pp.1-14
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    • 1999
  • The quadriceps angle (Q angle) has been used to reflect the quadriceps muscle's force on the patella in the frontal plane. Previous investigations of the Q angle and it's relationship to knee disorders have yield equivocal results. The purpose of this study was to analyze the factors related to the Q angle and it's relation to other variables such as leg length, body weight, CTA (calcaneus to tibia angle), TOA (toe out angle), and pelvic width in normal subjects. The participants were 60 students (30 men and 30 women) who had no orthopedic and neurological impairments, aged from 20 to 29 years of age, with an average age of 22.1 years. Prior to participation, each subject was informed of the procedures of the experiment from a researcher and assistant researchers. The equipment used in this study were modified standard goniometer, ruler, marking pen, and Martin apparatus for pelvic width. In order to determine the statistical significance of the experiment, regression analysis, independent t-test, and Pearson correlation were used at the 0.05 level. The results were as follows: 1) It was found that the Q angle of women is greater than that of men's from both knees. 2) There was no significant difference between right and left quadriceps angle. 3) The Q angle decreased as the body weight (leg length) shifted from low to high. 4) It seems that factors related to the Q angle were body weight, CTA, and pelvic width, but there was no significant difference at the 0.05 level.

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Calcaneal Insufficiency Avulsion Fracture in a Well-Controlled Type 2 Diabetic Patient: A Case Report

  • Kim, Seong-Tae;Moon, Myung-Sang;Kwon, Ki-Tae;Park, Bong-Keun;Ha, Chang Won;Ahn, Jungtae
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.2
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    • pp.73-76
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    • 2015
  • The calcaneal insufficiency avulsion fracture usually occurs in an area of fused apophysis in adults without significant history of trauma or overuse activities. It is an uncommon injury which has been described in patients with complicated diabetes, Charcot neuroarthropathy, amyloidosis with neuropathy, severe osteoporosis, and other conditions. Discussion of the issue of fracture location is still not sufficient. We report on a case of a 50-year-old male who experienced a non-traumatic diabetic calcaneal insufficiency fracture. Intraoperatively, a biopsy specimen was obtained from the exposed fracture site for histological study. We assume that the calcaneal fused apophyseal line is the weak point of failure due to various incomplete mixtures of trabecular bone, woven bone, and cartilaginous tissues, and may fail when repeated tensile stress is imposed.

Bone Mineral Density and Factors influencing Bone Mineral Density in College Women (일 대학 여대생의 골밀도와 골밀도에 영향을 주는 요인)

  • Chon, Mi-Young;Jeon, Hye-Won;Kim, Myoung-Hee
    • Women's Health Nursing
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    • v.18 no.3
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    • pp.190-199
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    • 2012
  • Purpose: The purpose of this study was to identify the levels of bone mineral density (BMD) and to explain the factors influencing BMD among female college students in Korea. Methods: A cross-sectional study was conducted with 144 college women. Lifestyle factors were determined by self-report questionnaire. Body composition was measured by body composition analyzer and bone mineral density was measured by ultrasound bone densitometry. Data were analyzed using SPSS for windows, version 19.0. Results: The mean BMD at calcaneus site was 0.56$g/cm^2$ (mean T-score=-0.22). The incidence of osteopenia was 21.5%. Factors predicting BMD were menarche age (r=-.22, p=.009) and height (r=-.18, p=.030) with 7% of explained variance. Conclusion: These results suggest that health care professionals need to provide young women with program that is intended to affect their intention toward osteoporosis preventive behavior change.

Difference of Bone Density and Risk Factors Related to Osteopenia of Young Women in Their Twenties (20대 여성의 골밀도와 골감소증의 위험요인 비교)

  • Byeon, Young Soon
    • Korean Journal of Adult Nursing
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    • v.18 no.5
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    • pp.790-797
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    • 2006
  • Purpose: The purpose of this study was to investigate bone density and risk factors related to osteopenia to unmarried young adult women. Methods: The subjects consisted of 125 female college students. SPSS 12.0 program was used for the data analysis with t-test, ${\chi}^2-test$. The BMD of the calcaneus and body mass index (BMI) were measured with peripheral dual energy X-ray absorptionmetry. Other physical characteristics were measured with a scale and questionnaires. Results: The general characteristics of these people showed that the average age was 22.1 years old and that the average BMI was 20.8. The mean of BMD was normal, but 24.8% were osteopenia, 75.2% were normal. In the normal and osteopenia groups, there were significant differences in the status of the BMD according to age, height, weight, BMI, regular exercise, house chores, and the experiences of being on a diet. Conclusion: Women in their twenties had some osteoporosis risk, but they can change their BMD by doing regular exercise and by eating food to peak bone mass. For building peak bone mass, they need take exercise programs and education programs to prevent osteoporosis and follow-up care.

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Effect of Body Composition and Osteoporosis Self-efficacy on Bone Mineral Density of Female Nursing Students (간호대학생의 신체조성과 골다공증 자기효능감이 골밀도에 미치는 영향)

  • Lee, Kyu Eun;Kim, Nam Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.3
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    • pp.230-238
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    • 2013
  • Purpose: This study was done to identify the relationship among bone mineral density (BMD), body composition and osteoporosis self-efficacy and to identify predictors of BMD in female nursing students. Method: Participants were 154 nursing students. Osteoporosis self-efficacy was determined by a self-report questionnaire. BMD was measured by ultrasound bone densitometry and body composition by a body composition analyzer. Data were collected between April 1 and 27, 2013 and analyzed using descriptive statistics, ANOVA, Scheff$\acute{e}$ test, Pearson correlation coefficient, and multiple regression with SPSS 18.0. Results: Mean BMD at the calcaneus site was $0.58{\pm}1.31$ (T-score). Incidence of osteopenia was 11.7%. Percentage of body fat (PBF)-defined obesity had higher prevalence than body mass index (BMI)-defined obesity. BMD had significant positive correlations with skeletal muscle mass (r=.226, p=.005) and fat free mass (r=.225, p=.005). The factor predicting BMD was skeletal muscle mass with 4.7% of explained variance. Conclusion: Study results indicate that of body composition components, skeletal muscle mass is the prime predicting factor for BMD. Thus to promote healthy bones, it is important to strengthen the muscles using a program, based on balanced development of all muscles.

Analysis of Factors Affecting Bone Mineral Density with Different Age among Adult Women in Seoul Area (서울 일부지역 성인여성의 연령에 따른 골밀도에 영향을 미치는 요인 분석)

  • Kim, Myung-Suk;Koo, Jae-Ok
    • Korean Journal of Community Nutrition
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    • v.12 no.5
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    • pp.559-568
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    • 2007
  • Weight control diets induce reducing women' bone mineral density (BMD) that has a close relationship to risk in osteoporosis. This study was carried out to identify bone density risk factors affecting women's BMD, and to examine the relationship age, lifestyle and dietary habits for bone health by physical measurement and questonnaies. The subjects of this study were 194 women living on the Seoul area. When the subjects were divided into 4 age groups, BMI was the highest in the 50 years group (24.8) and the lowest in the 20 years group (21.63). Average T-score, which is BMD of forearm bone and calcaneus was the highest in the 40 years (-0.07) and the lowest in the 20 years (-0.59). The rate of eating breakfast was shown significantly higher in the 50 years group than that in the younger group. The frequencies of eating out, fried food intakes, and alcohol drinks were shown significantly different by age (p < 0.01). In conclusion, the risk rate of BMD was high in the 20syears and 50 years groups. It may due to the 20s' weight-control diet. Breakfast eating, exercise, intakes of anchovies, radishes, carrots, zucchinis and tomatoes were significantly important factors to prevent bone density risk.