• 제목/요약/키워드: hip fracture

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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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    • 제35권4호
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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.

노인 낙상 - 넘어짐 그리고 인체손상의 과학, 넘어지면 다 죽는가?: 문헌 고찰 (Science of Falling and Injury in Older Adults - Do All Falls Lead to Death?: Literature Review)

  • 최우철;임기택;김승수;이세영
    • 한국전문물리치료학회지
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    • 제28권3호
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    • pp.161-167
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    • 2021
  • Understanding sciences behind fall-related hip fractures in older adults is important to develop effective interventions for prevention. The aim of this review is to provide biomechanical understanding and prevention strategies of falls and related hip fractures in older adults, in order to guide future research directions from biomechanical perspectives. While most hip fractures are due to a fall, a few of falls are injurious causing hip fractures, and most falls are non-injurious. Fall mechanics are important in determining injurious versus non-injurious falls. Many different biomechanical factors contribute to the risk of hip fracture, and effects of each individual factors are known well. However, combining effects, and correlation and causation among the factors are poorly understood. While fall prevention interventions include exercise, vision correction, vitamin D intake and environment modification, injury prevention strategies include use of hip protectors, compliant flooring and safe landing strategies, vitamin D intake and exercise. While fall risk assessments have well been established, limited efforts have been made for injury risk assessments. Better understanding is necessary on the correlation and causation among factors affecting the risk of falls and related hip fractures in older adults. Development of the hip fracture risk assessment technique is required to establish more efficient intervention models for fall-related hip fractures in older adults.

고관절 골절 수술후 발생한 섬망환자의 치과보철물에 의한 폐렴 (Dental Prosthesis Causing Pneumonia in a Delirious Elderly Patient after Hip Fracture Surgery)

  • 이영균;하용찬;구경회
    • Journal of Trauma and Injury
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    • 제25권3호
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    • pp.97-100
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    • 2012
  • We report a case of delayed diagnosed pneumonia due to an aspirated metallic crown, which had been detached from a molar tooth. Dental prosthesis should be checked and a careful review of the chest radiograph is mandatory when an elderly patient with delirium after hip fracture surgery develops pneumonia postoperatively.

Surgical Treatment of the Atypical Femoral Fracture: Overcoming Femoral Bowing

  • Lee, Kyung-Jae;Min, Byung-Woo
    • 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.

Assessing the Necessity of Extra Reduction Aides in Intramedullary Nailing of Intertrochanteric Hip Fractures

  • John W. Yurek;Nikki A. Doerr;Alex Tang;Adam S. Kohring;Frank A. Liporace;Richard S. Yoon
    • Hip & pelvis
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    • 제35권3호
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    • pp.183-192
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    • 2023
  • Purpose: This study aims to determine which intertrochanteric (IT) hip fracture and patient characteristics predict the necessity for adjunct reduction aides prior to prep and drape aiming for a more efficient surgery. Materials and Methods: Institutional fracture registries from two academic medical centers from 2017-2022 were analyzed. Data on patient demographics, comorbidities, fracture patterns identified on radiographs including displacement of the lesser trochanter (LT), thin lateral wall (LW), reverse obliquity (RO), subtrochanteric extension (STE), and number of fracture parts were collected, and the need for additional aides following traction on fracture table were collected. Fractures were classified using the AO/OTA classification. Regression analyses identified significant risk factors for needing extra reduction aides. Results: Of the 166 patients included, the average age was 80.84±12.7 years and BMI was 24.37±5.3 kg/m2. Univariate regression revealed increased irreducibility risk associated with RO (odds ratio [OR] 27.917, P≤0.001), LW (OR 24.882, P<0.001), and STE (OR 5.255, P=0.005). Multivariate analysis significantly correlated RO (OR 120.74, P<0.001) and thin LW (OR 131.14, P<0.001) with increased risk. However, STE (P=0.36) and LT displacement (P=0.77) weren't significant. Fracture types 2.2, 3.2, and 3.3 displayed elevated risk (P<0.001), while no other factors increased risk. Conclusion: Elderly patients with IT fractures with RO and/or thin LW are at higher risk of irreducibility, necessitating adjunct reduction aides. Other parameters showed no significant association, suggesting most fracture patterns can be achieved with traction manipulation alone.

고관절 골절 수술 후 한방 통합 치료를 시행한 2례 보고 (Integrative Oriental Medical Treatments after Hip Fracture Surgery: Two Case Report)

  • 이초인;김성진;최이정;이봉효;이현종;임성철;이윤규;정태영;김재수
    • Journal of Acupuncture Research
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    • 제30권4호
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    • pp.211-218
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    • 2013
  • Objectives : The purpose of this study is to show the clinical effects of integrative oriental medical treatments for femur pain and disfunction after hip fracture surgery. Methods : Two patients were treated using acupuncture, pharmacopuncture, herbal medication and other oriental medical treatments include moxibustion, cupping therapy, physical rehabilitation for 2~3 months. And the effects of these integrative treatments were measured with numeric rating scale(NRS) and functional recovery score(FRS). Results : NRS of femur pain was decreased from 8 to 4~5 in case 1 and from 6 to 4 in case 2. FRS was improved in both cases. Conclusions : Integrative oriental medical treatments maybe effective to the patients complaining pain and functional limitations after hip fracture surgery.

대퇴골(Femur)고정용 골 금속판 제작 및 강도 평가 (Practicability Strength Assessment of a Bone Metallic Plate at the Femur Fixation)

  • 김정래;안창식;서병도
    • 대한인간공학회지
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    • 제27권2호
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    • pp.83-89
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    • 2008
  • Study was developed the metallic plate for fixation in the femur fracture and plates has a firm place in fracture treatment. This plates can be stabilized for fracture fixation as well as biological and dynamical device. The device's designation and sizing has a optimization with bending structural stiffness and strength, known meaning that is reliable regardless of the plate by the short type and long type. The bending strength of the curved metallic long plate has to evaluate a 11,000N and the bending strength of the curved metallic short plate has to evaluate a 6,525N. This see the X-ray image of bending angle made certain of 15$^{\circ}$ at number 2 and same 82.87$^{\circ}$ at number 2, 4, 5, 7, 8, 9, 10 by outside angle, and confirmed 25.26$^{\circ}$ at number 3, 3.68$^{\circ}$ at number 6, 15.64$^{\circ}$ at number 9 by inside angle. This study shows that keep up the metallic plate for fixation in the femur fracture through X-ray Image and the device can be used to support Revision case of Hip Implant and to use a case of Hip screw compression of Hip Neck Fracture. Short plate have a wrapping of femur and long plate have to preserve a pole of femur.

수술 요법 없이 한방치료를 시행한 대퇴경부 골절환자 1례에 대한 증례보고 (A Case Report of Patient with Femoral Neck Fracture Treated Non-operative Korean Medical Treatments)

  • 김성진;이현종;이용은;이봉효;이윤규;임성철;정태영;김재수
    • Journal of Acupuncture Research
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    • 제30권5호
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    • pp.175-183
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    • 2013
  • Objjectives : The purpose on this report is to show the clinical efficacy of korean medical treatments for femoral neck fracture treated non-operatively. Methods : The patient with femoral neck fracture was treated using acupuncture, herbal medication, And the efficacy of treatment had been measured in visual analog scale(VAS) scores and Harris hip scores(HHS) per one month for seven months. Results : After treatment, HHS score had been increased from 0 to 74 and VAS of femoral pain had been decreased form 10 to 1.5. Conclusions : From the above results, It is demonstrated that korean medical treatments is effective on patient with femoral neck fracture treated non-operatively.

폐경기 골다공증 환자에서 데노수맙 사용에 대한 비용-효과 분석 (Cost-Effectiveness of Denosumab for Post-Menopausal Osteoporosis in South Korea)

  • 배그린;권혜영
    • 한국임상약학회지
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    • 제28권2호
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    • pp.131-137
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    • 2018
  • Background: In South Korea, 22.3% of women ${\geq}50years$ of age and 37% of women ${\geq}70years$ of age visit the doctor to obtain treatment for osteoporosis. According to the analysis of the National Health Insurance Services claim data between 2008 and 2012, the number and incidence of hip and vertebral fractures increased during the same period. Denosumab, a newly marketed medicine in Korea, is the first RANK inhibitor. Methods: A cost-utility analysis was conducted from a societal perspective to prove the superiority of denosumab to alendronate. A Markov cohort model was used to investigate the cost-effectiveness of denosumab. A 6-month cycle length was used in the model, and all patients were individually followed up through the model, from their age at treatment initiation to their time of death or until 100 years of age. The model consisted of eight health states: well; hip fracture; vertebral fracture; wrist fracture; other osteoporotic fracture; post-hip fracture; post-vertebral fracture; and dead. All patients began in the well-health state. In this model, 5% discounted rate, two-year maximum offset time, and persistence were adopted. Results: The total lifetime costs for alendronate and denosumab were USD 5,587 and USD 6,534, respectively. The incremental cost-effectiveness ratio (ICER) for denosumab versus alendronate was USD 20,600/QALY. Given the ICER threshold in Korea, the results indicated that denosumab was remarkably superior to alendronate. Conclusion: Denosumab is a cost-effective alternative to the oral anti-osteoporotic treatment, alendronate, in South Korea.