• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.80-86
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• 2010

Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.187-201
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• 2024

Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.1-6
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• 2002

Purpose : Evaluation and analysis of the incidence and causes of intraoperative and postoperative complications after arthoscopic anterior cruciate ligament(ACL) reconstruction using bone-patella. tendon-bone (BPTB) auto graft. Materials and Methods : We reviewed 85 cases of arthroscopic ACL reconstruction using BPTB autograft which had been followed up for more than 1 year. Intraoperative complications had been recorded and corrected during the operation. Postoperative complications were analyzed and compared between 3 groups which were classified by the last follow-up period after the operation. Results : There were a few intraoperative complications including patellar fracture(1 case), contamination of harvested graft(1 case), impingement of graft(2 cases), blow-out of tile posterior wall of the femoral tunnel(1 case) and intraarticular retraction of the screw(1 case). The result of the comparison of postoperative complications among the groups shows that the incidence of anterior knee pain, donor site pain and patellofemoral crepitation were significantly decreased after 2 years. But there was no significant decrease in these complications after 3 years. Conclusion : Intraoperative complications after arthroscopic ACL reconstruction using BPTB autograft were due to incorrect technique and carelessness of the operation team, and can be prevented by improvement of surgical technique and accumulation of experience. Postoperative complication were somewhat unavoidable but gradually improved with time; hence, we should consider it for the selection of graft donor.