• Journal of Trauma and Injury
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• v.26 no.4
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• pp.286-290
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• 2013

Purpose: To report the postoperative Clinical and Radiological outcomes following distal femoral fractures in elderly patients compared with young patients. Methods: From March, 1996 to March, 2012, 83 patients who received surgical treatment for fractures of the distal femur were enrolled in this retrospective study. Ages more than 65 was named group A. Group A was 49 cases and mean age is 72.5 year(65~91year). Group B was 49 cases and mean age is 45.7 year(16~61 year). Surgical methods are retrograde IM nail, locking compression plate, cannulated screw and postoperative rehabilitation is no difference between two groups. Clinical results were evaluated using Neer scores, radiographic results and the presence of clinical complications. Results: The mean union period was 18.4(12-40) weeks in group A and 17(10-24) weeks in group B. Neer functional scores are no significant statistical difference between two groups. There are 5 cases metal breakage in group A and 1case in group B. There are 3 cases nonunion in group A and 1 case in group B. Conclusion: In the case of fractures of the distal femur in elderly patients, locking plate using minimally invasive percutaneous periosteal osteosynthesis (MIPPO) technique may be one of the most effective methods and preoperative bone stock evaluation in important.

• Proceedings of the Korean Society of Tribologists and Lubrication Engineers Conference
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• 2003.11a
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• pp.91-94
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• 2003

Ceramic femoral heads in the total hip replacement have been developed to reduce the polyethylene liner wear. Alumina and zirconia (3Y-TZP) are using in clinical application worldwide and there are many good test reports. However, alumina has a risk of catastrophic failure, and zirconia has the low temperature degradation in spite of enhanced fracture toughness. Recently, novel zirconia/alumina composite having low temperature degradation-free character and high fracture tough . was developed and it leads the lower wear 3f polyethylene than alumina and zirconia. In the present study, in order to optimise the microstructure of low temperature degradation (LTD)-free zirconia/alumina composite for the best wear resistance of polyethylene, various compositions of (LTD)-free zirconia/alumina composites were fabricated, and the sliding wear of UHMWPE against these novel composites were examined and compared with that against alumina and zirconia ceramics used for total hip joint heads.

• Journal of Trauma and Injury
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• v.20 no.1
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• pp.26-32
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• 2007

Purpose: Hemorrhagic shock is the leading cause of death in patients with pelvic bone fractures. The majority of blood loss is due to injured pelvic arteries and retroperitoneal veins and to bleeding from the fracture site itself. Pelvic angiography and embolization of injured vessels is an effective way to control continuous bleeding. However, identifying the bleeding focus in hemodynamically unstable patients before diagnostic intervention is difficult. The purpose of this study was to determine the correlation between fracture patterns in hemodynamically unstable patients with pelvic fractures and later pelvic angiography findings. Methods: We performed a retrospective study of 21 hemodynamically unstable patients with pelvic fractures admitted to our emergency department between April 2001 to April 2006. All 21 patients underwent pelvic angiography. Pelvic fractures were assessed according to the Tile's classification and the degree of injury was assessed using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). The hemodynamic status of the patients was defined using vital signs, base excess, and blood lactate. Fracture patterns were compared with hemodynamic status and angiography findings. Results: In the 5year study period, 21 hemodynamically unstable pelvic bone fracture patients were admitted; ten were men (47.6%), and 11 were women (52.4%). The mean age was 41.1 years (range: ${\pm}20.1$). Of the 21 embolization was performed in 6 patient (28.6%): 1 patient of the 5 unstable pelvic bone fracture patients (20%), and 5 patients of 16 the stable pelvic bone fracture patients (31.3%). There were no significant differences between the RTS (p=0.587) and embolization rate (p=0.774) for either the stable patients or the unstable patients. Patients with arterial injury on angiography had a lower RTS compared with patients without arterial injury but there was no significant difference in ISS between the two groups. The angiographic injured sites were five internal femoral arteries and one external femoral artery. Conclusion: The findings in this study suggest that the pelvic fracture pattern in hemodynamically unstable patients with pelvic fractures does not correlate with pelvic angiography findings.

• Advances in biomechanics and applications
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• v.1 no.1
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• pp.1-14
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• 2014

In this paper, a simple and accurate finite element model coupled to quasi-brittle damage law able to describe the multiple cracks initiation and their progressive propagation is developed in order to predict the complete force-displacement curve and the fracture pattern of human proximal femur under quasi-static load. The motivation of this work was to propose a simple and practical FE model with a good compromise between complexity and accuracy of the simulation considering a limited number of model parameters that can predict proximal femur fracture more accurately and physically than the fracture criteria based models. Different damage laws for cortical and trabecular bone are proposed based on experimental results to describe the inelastic damage accumulation under the excessive load. When the damage parameter reaches its critical value inside an element of the mesh, its stiffness matrix is set to zero leading to the redistribution of the stress state in the vicinity of the fractured zone (crack initiation). Once a crack is initiated, the propagation direction is simulated by the propagation of the broken elements of the mesh. To illustrate the potential of the proposed approach, the left femur of a male (age 61) previously investigated by Keyak and Falkinstein, 2003 (Model B: male, age 61) was simulated till complete fracture under one-legged stance quasi-static load. The proposed finite element model leads to more realistic and precise results concerning the shape of the force-displacement curve (yielding and fracturing) and the profile of the fractured edge.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.138-143
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• 2020

Background: Severe pain associated with proximal femur fractures makes the positioning for regional anesthesia a challenge. Systemic administration of analgesics can have adverse effects. Individually, both the fascia iliaca block (FIB) and femoral nerve blocks (FNB) have been studied. However, there is little evidence comparing the two. The aim of this study was to compare the overall efficacy of the two blocks in patients with proximal femur fracture before positioning for spinal anesthesia. Methods: ASA (American Society of Anesthesiologists) class I, II, and III patients scheduled for elective and emergency surgery with the diagnosis of proximal femur fracture between October 2018 and June 2019 were included in the study. The patients were assigned to two groups by convenience nonprobability sampling of 35 each. Results: Our study showed a reduction in visual analogue scale scores at 3, 4, and 5 minutes after administration of the FIB being 5.1 ± 1.1, 4.1 ± 1.3, and 2.8 ± 0.8, and those after the FNB as 4.4 ± 1.1, 3.3 ± 1.1, and 2.1 ± 1.4 with P < 0.05, which was statistically significant. The mean first rescue analgesia time for the FIB was 7.1 ± 2.1 hours, while for the FNB it was 5.2 ± 0.7 hours. The P value was less than 0.001, which was significant. Conclusions: Both ultrasound guided FNB and FIB techniques provide sufficient analgesia for patient's positioning before spinal anesthesia. However, the duration of postoperative analgesia provided by FIB was greater than that of the FNB.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.17-22
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• 1988

Fractures of the femoral neck in children are rare and usually the result of severe trauma. The femoral necks in children, in contrast to those of adults, have many anatomic and physiologic differences. Among the late complications encountered are avascular necrosis, coxa vara, premature closure of the proximal capital femoral epiphysis and nonunion. In spite of careful management, significant complication rate often results. Nine cases of fractures of the femoral neck in children which were treated at Yeungnam University Hospital from June 1984 to August 1987 were reviewed. The results obtained are as follows: 1. The main causes of fractures were traffic accidents(5 cases). 2. Among 9 patients, 6 were girls and 3 were boys. 3. According to the classification of Delbet and Colonna, the transcervical fracture(6 cases) was the commonest type. 4. 4 cases were treated by closed reduction and internal fixation, 3 cases were treated by open reduction and internal fixation. 2 cases were treated by skin traction and cast. 5. The results were analyzed according to Ratliff's assessment. 6 cases showed good results, and 3 cases showed poor results. 6. Early diagnosis and good fixation method seemed to be vital to prognosis.

• Korean Journal of Agricultural Science
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• v.17 no.2
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• pp.142-145
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• 1990

A six months old, sika deer with metatarsal bone fracture was referred to the veterinary teaching hospital of Chungnam National University. Midshaft femoral amputation was performed. The sika deer was satisfactorily anesthetized with 1.2mg of xylazine per kg of body weight by intramuscular injection. Procedures of operation was same with those of midshaft femoral amputation in dogs. The sika deer revealed inconveniency in rising, walking and galloping just after operation but they became skilled after a month. After amputation morbid sign was not observed for about 6 months up to nowadays.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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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.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.61-65
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• 2021

A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.

• Journal of Veterinary Clinics
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• v.36 no.1
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• pp.53-61
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• 2019

Total hip arthroplasty (THA) is a successful surgical treatment for both patients with chronical lameness and dogs who are nonresponsive to medical treatments, providing excellent joint function for returning dogs to the normal gait in 80% to 98% of hip dysplasia (HD) patients. The THA surgical implant system manufactured by BioMedtrix and Kyon are today widely accepted. When comparing the BioMedtrix biological fixation (BFX) system to the BioMedtrix cemented fixation (CFX) system, the many advantages of BFX, which include longer potential implant life, decreased risk of postoperative or later infection, and better implant stability, become evident. However, BFX implies a greater risk of femoral fracture during reaming and requires a more precise surgical technique to achieve good implant fit, given the press-fit nature of cementless THA. The purposes of this study are to both describe the mistakes and complications during stem implantation for beginner surgeons with both the BFX and the CFX systems and to document the initial result of 12 implantations in canine cadavers. Given the detailed evaluations of 3 specialists, who are Diplomate American College of Veterinary Surgeons (DACVS), only 3 of 11 stems were appropriately sized. Specifically, 6 stems were anteverted rather than being retroverted; further, although 7 stems were coaxial with the femoral long axis in the frontal plane, the other stems were in the varus at the frontal plane, with the proximal medial stem adjacent to the medial femoral cortex. Moderate angulation from the cranial to the caudal directions was found in 4 cases in the sagittal plane. Additionally, 1 case of femoral fissure and 1 case of perforated femoral cortex were reported. It is not easy for surgeons performing cementless THA for the first time to achieve a good result, even though they completed an educational course about it and given that catastrophic complications often occurred during early surgical clinical cases. Therefore, ex-vivo studies are sincerely required to get an expertise by rehearsing the preparation of the femoral envelop in isolated bones. Further studies should be conducted to achieve both highly accurate implant size and correct orientation during the preoperative planning. Additionally, surgeons' learning curve should be examined in future investigations.