• Title/Summary/Keyword: femoral fracture

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Association of Common Vitamin D Receptor Gene Variations with Fracture Risk and Bone Mineral Density in Postmenopausal Korean Population

  • Hwang, Joo-Yeon;Lee, Seung Hun;Kim, Ghi-Su;Koh, Jung-Min;Go, Min-Jin;Kim, Tae-Ho;Hong, Jung-Min;Park, Eui-Kyun;Kim, Shin-Yoon;Lee, Jong-Young
    • Genomics & Informatics
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    • v.7 no.1
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    • pp.13-19
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    • 2009
  • Osteoporosis is characterized by impaired osteogenesis. BMD is a major determinant of bone strength. The role of the VDR gene in predisposition to primary osteoporosis has been recognized. However, population-based case-control studies have been reported controversial results for known candidate genes in an ethnically distinct group. To determine the genetic effects of VDR variants on osteoporosis and BMD, we directly sequenced the VDR gene in 24 unrelated Korean individuals and identified eighteen sequence variants. We investigated the potential involvement of eight SNPs in osteoporosis in postmenopausal women (n = 729). Two SNPs (LD) in intron 2, -5294G>C (rs2238135) and -4817G>A (rs17882443) showed the evidence of association with enhanced BMD of the femoral neck ($p_{additive}$=0.031 for rs2238135; $p_{additive}$=0.017 and $p_{dominant}$= 0.019 for 17882443). Moreover, VDR -4817G>A was significantly associated with protective effect on all fracture risk ($p_{recessive}$=0.035, OR=0.2, 95% CI=$0.05{\sim}0.89$), and tended to be higher BMD values at various proximal femur sites. Therefore, we suggest that the -4817G>A may be useful genetic marker for vitamin D-related metabolism and may have an important role in the increased BMD of the proximal femur in postmenopausal Korean women.

Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures with an Effective Wiring Technique

  • Jae-Hwi Nho;Gi-Won Seo;Tae Wook Kang;Byung-Woong Jang;Jong-Seok Park;You-Sung Suh
    • Hip & pelvis
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    • v.35 no.2
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    • pp.99-107
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    • 2023
  • Purpose: Bipolar hemiarthroplasty has recently been acknowledged as an effective option for treatment of unstable intertrochanteric fracture. Trochanteric fragment nonunion can cause postoperative weakness of the abductor muscle and dislocation; therefore, reduction and fixation of the fragment is essential. The purpose of this study was to perform an evaluation and analysis of the outcomes of bipolar hemiarthroplasty using a useful wiring technique for management of unstable intertrochanteric fractures. Materials and Methods: A total of 217 patients who underwent bipolar hemiarthroplasty using a cementless stem and a wiring technique for management of unstable intertrochanteric femoral fractures (AO/OTA classification 31-A2) at our hospital from January 2017 to December 2020 were included in this study. Evaluation of clinical outcomes was performed using the Harris hip score (HHS) and the ambulatory capacity reported by patients was classified according to Koval stage at six months postoperatively. Evaluation of radiologic outcomes for subsidence, breakage of wiring, and loosening was also performed using plain radiographs at six months postoperatively. Results: Among 217 patients, five patients died during the follow-up period as a result of problems unrelated to the operation. The mean HHS was 75±12 and the mean Koval category before the injury was 2.5±1.8. A broken wire was detected around the greater trochanter and lesser trochanter in 25 patients (11.5%). The mean distance of stem subsidence was 2.2±1.7 mm. Conclusion: Our wiring fixation technique can be regarded as an effective additional surgical option for fixation of trochanteric fracture fragments during performance of bipolar hemiarthroplasty.

The Effects of COVID-19 Pandemic on the Recovery of Hip Fracture Patients

  • Young Yool Chung;Sung Nyun Baek;Tae Gyu Park;Min Young Kim
    • Hip & pelvis
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    • v.35 no.4
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    • pp.253-258
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    • 2023
  • Purpose: To figure out how complete control of family visits to prevent infection of coronavirus disease 2019 (COVID-19) affected the activity recovery of hip fracture patients admitted to nursing hospitals. Materials and Methods: Eighty-one patients with hip surgery in the two years prior to COVID-19 pandemic were classified as Group A, and 103 patients in the next two years were designated as Group B. The subjects' walking ability was evaluated by using the modified Koval index (MKI). In order to analyze the impact of the family visit control to the subjects, each group was classified into two different groups: (1) inpatients group who admitted to nursing hospitals and (2) home-treated patients. Additionally, statistical elements were processed in consideration of other factors that may affect the results of the experiment. Results: The MKI evaluated at 6 months postoperative was 3.31±1.79 in Group A and 2.77±1.91 in Group B, and it was meaningfully low after the pandemic (P=0.04). There was significantly low among both of Group A 2.74±1.76 and Group B 1.93±1.81 after the pandemic (P=0.03) among those treated at the nursing hospital. The rate of deterioration of the MKI was 35 (43.2%) in Group A and 57 (55.3%) in Group B, which increased by 12.1% after the pandemic. Conclusion: The pandemic had a negative effect on the recovery of postoperative activities of elderly hip fracture patients who admitted to nursing hospitals when family access was completely restricted to prevent infection.

Adult Proximal Humeral Locking Plate Is a Good Alternative Option in the Treatment of Adolescent Subtrochanteric Femur Fractures: A Case Series and Literature Review

  • Ceyhun Caglar;Serhat Akcaalan;Merve Bozer;Mustafa Akkaya
    • Hip & pelvis
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    • v.34 no.4
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    • pp.245-254
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    • 2022
  • Purpose: Management of pediatric subtrochanteric femur fractures (SFFs) is difficult. The aim of this study was to evaluate the outcomes of adolescent SFFs treated with adult proximal humeral locking plates (PHLPs). Materials and Methods: A retrospective analysis of 18 adolescents (11 male, 7 female) with a diagnosis of SFF who underwent internal fixation with a PHLP was conducted. Data regarding injury mechanism, fracture pattern, and time to union were recorded for all patients. In addition, a clinical and functional evaluation of patients was performed using the Harris hip score (HHS), Iowa hip score (IHS), modified Merle d'Aubigne-Postel score (MMAPS), Flynn criteria, and hip range of motion (ROM). Results: The mean age of the patients was 12.72±2.05 years (range, 10-16 years). Radiological observation was performed for evaluation of five different injury mechanisms and different fracture patterns in patients. The mean postoperative HHS was 92.27±5.61, the mean IHS was 90.88±6.46, and the mean MMAPS was 17.22±0.94. According to the Flynn criteria, excellent results were achieved in 14 cases and satisfactory results were obtained in four cases. Measurements of the patients' mean hip ROM values were as follows: 17.77±3.52° in extension, 115.27±6.74° in flexion, 43.05±3.48° in abduction, 27.50±4.28° in adduction, 42.22±4.60° in internal rotation, and 42.22±3.91° in external rotation. Conclusion: Surgery performed on adolescent patients using an adult PHLP showed good, safe results. Therefore, it should be considered as an alternative option.

Effects of the Rehmanniae Radix Preparat on Ovariectomized Rats (숙지황(熟地黃)이 난소적출(卵巢摘出)로 폐경(閉經)이 유발(誘發)된 흰쥐에 미치는 영향(影響))

  • Cho, Su-In
    • The Korea Journal of Herbology
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    • v.20 no.4
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    • pp.61-67
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    • 2005
  • Objectives : Obese and osteoporosis are diseases characterized by bone loss and morbidity with osteoporotic fracture is increasing in elderly. The present study was carried out to determine the effects of Rehmanniae Radix Preparat(RRP) on the postmenopausal obese. Methods : The variance of body weight, femoral bone weight, serum level of cholesterol and microscopic view of tibia were investigated. Animals were observed for 8 weeks, and vehicle and extracts of prescriptions were administered ad libitum. Results : Body weight increased significantly in 6 weeks after ovariectomy, and the weight of RRP administered group decreased significantly. RRP decreased the serum level of cholesterol. Conclusions : According to above results, RRP can be used for prevention and curing the postmenopausal obese.

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Delayed Post-traumatic Coarctation of Distal Abdominal Aorta - A Case Report - (수직추락후 발생한 복부대동맥 협착 1례 보)

  • Park, Guk-Yang;Lee, Hong-Seop;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.199-201
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    • 1987
  • We have recently experienced a rare case of abdominal aortic injury caused by deceleration force during fall in upright position. The patient was 43-year-old brick-layer fell from 12 meter height and sustained compression fracture of the spine and both legs. The aortic injury was unnoticed at that time. About 2 years later, marked stenosis of the distal abdominal aorta was found together with clinical manifestations of ischemia of both legs. Aorto-femoral bypass on both sides has completely relieved the symptoms, Similar type of abdominal aortic injuries could not be found in the literatures.

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Clinical Experience of a Complex Regional Pain Syndrome Type II Patient -A case report- (복합부위통증 증후군 II형(CRPS Type II) 환자의 치험 -증례 보고-)

  • Yoon, Keon-Jung;Kim, Jong-Lul
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.426-429
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    • 1996
  • Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

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Proximal Tibia Fracture after Proximal Tibia Autograft Harvest

  • Kim, Jin-Kak;Song, Jong-Hyeop;Lee, Kyungbum;Cho, Jae-Woo;Moon, Ki-Ho;Yeo, Do-Hyun;Kim, Beom-Soo;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.247-252
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    • 2017
  • Bone-grafting procedures are common in orthopedic trauma surgeries. There are only few reports on the morbidity after proximal tibia harvesting. Here, we report an experience of complication after proximal tibia harvesting while treating subtrochanteric femoral osteomyelitis.

Incidental Detection of a Pseudoaneurysm at an Amputation Stump in a Tc-99m HMPAO labeled Leukocyte Scan (Tc-99m HMPAO 표지 백혈구스캔상 대퇴 절주에서 우연히 발견된 가성동맥류)

  • Sohn, Myung-Hee;Jeong, Hwan-Jeong;Lim, Seok-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.337-338
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    • 2007
  • A 20-year-old man underwent a Tc-99m HMPAO labeled leukocyte scan for the evaluation of an infection at the stump of an AK amputation, which was conducted due to an open communicated fracture of the left lower leg. Blood-flow and blood-pool images demonstrated a pseudoaneurysm with a focus of intense activity medial to the stump, and centered within a large photopenic defect by surrounding hematoma. Delayed image obtained at 3 hours post-injection showed persistent intense and slight increased activity, Contrast angiography confirmed the presence of a pseudoaneurysm arising from a branch of the left superficial femoral artery.

Computed Tomographic Assessment of Experimentally Induced Legg-Calve-Prethes Disease in Dogs (허혈성 대퇴골두 괴사 유발견에서 전산화 단층 영상 평가)

  • Bae, Sun-Hee;Seong, Yun-Sang;Eom, Ki-Dong;Kim, Jae-Hoon;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.9-14
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    • 2008
  • This purpose of this study was to describe and compare the radiographic and computed tomographic(CT) appearance of the experimentally induced Legg-Calve-Perthes Disease(LCPD) in dogs. LCPD was experimentally induced at the left femoral head in 7 litters of a dog. The lesions were evaluated with radiography, CT, and contrast CT every week from day 7 to day 70 after operation. Histopathologic examination was performed on 92th day after operation. Every images were evaluated according to the staging system of the osteonecrosis published by Association Research of Circulation Osseous in 1997 and the scoring(0-4). On CT scan, diffuse porotic lesion and focal sclerotic lesion were detected on day 14 and on day 21 after operation, respectively. Subchondral fracture, articular collapse and crescent sign with decreased attenuation were shown on day 28 after operation for the first time and no change of the sign were detected from operation day 9 to day 70 after operation. Focal porotic lesion and irregular radiopacity of femoral head were detected on day $41{\pm}7.48$ and on day $51{\pm}5.29$ after operation respectively on radiographs. In scoring evaluation, 2.00 was scored on day 14 after operation on CT scan, on day 56 after operation on radiographs, respectively This study has shown that CT is more suitable for early diagnosis of LCPB and has superior sensitivity than radiography. Also, CT has been expected to be important for staging and treatment of LCPD.