• Title/Summary/Keyword: hip fractures

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A Basic Study on Fall Patterns for Fracture Prevention System (골절방지 시스템을 위한 낙상 패턴에 관한 기초 연구)

  • Kim S.H.;Kim K.;Jung S.H.;Kim G.B.;Kwon T.K.;Hong C.U.;Kim N.G.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.1925-1928
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    • 2005
  • In recent years, the importance of the characterization of fall for a fracture prevention system keeps increasing since fracture from a fall can lead to serious health problems. Fall is one of the major sources which increase morbidity in elderly people. In terms of the cost and the influence to the quality of life, the most serious injury with hip fractures is caused by falls. The traditional methods in characterizing fall patterns have been mainly by the epidemiological surveys. With surveys, the exact data of fall patterns can not been acquired. In this paper, we measured and analyzed with the parameters related to fall pattern such as velocities and accelerations during the motion of falls using 3D motion capture program. We acquired the parameters of the fall pattern of intentional and unexpected fall. The result showed that the variation of velocity and acceleration during fall was very important in characterizing fall pattern, which of vital importance for the development of a fracture prevention system and for the safety of the elderly

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Injury in Football: Groin Injuries (축구의 특별한 손상: 서혜부 손상)

  • Young, Ki-Won;Kim, Jin-Su;Kim, Jun-Ho;Kim, Jang-Yeol;Park, Sung-Ryul;Choi, Jae-Hyuck
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.100-104
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    • 2006
  • The Incidence of groin injury was about 10% in football player These injuries occur most commonly in athletes participating in sports Involving cutting, quick accelerations and decelerations and sudden directional changes. Symptoms may range from intermittent episodes of mild discomfort to severe and chronic career-ending pain. Groin injuries may result from a variety of causes. We must keep in mind that many other conditions may also affect the groin. Because of the anatomy of the region is so complex. Ligament/muscle strains, nerve entrapment syndromes, sportsman's hernia, symphysitis, stress fractures and various hip pathologies are reviewed as causes of groin pain are reviewed as common causes of groin pain.

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Early Definitive Closure of an Open Abdomen by Using Porcine Dermal Collagen Graft: A Case Report (외상환자의 손상통제 수술 후 돼지진피아교질 이식편을 이용한 조기 완전 폐복의 사례보고)

  • Park, Sung Jin;Kim, Jae Hun;Yun, Sung Pil;Choi, Sun Woo;Kim, Seon Hee
    • Journal of Trauma and Injury
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    • v.26 no.1
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    • pp.14-17
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    • 2013
  • Purpose: The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen. Methods: A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery. Results: There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery. Conclusion: Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen.

Management of a traumatic anorectal full-thickness laceration: a case report

  • Fortuna, Laura;Bottari, Andrea;Somigli, Riccardo;Giannessi, Sandro
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.215-218
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    • 2022
  • The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

Efficacy of Statins on BMB or Fracture Risk in Postmenopausal Women (스타틴이 폐경기 여성의 골밀도 혹은 골절위험에 미치는 효과 -보고된 임상연구결과 분석을 중심으로-)

  • Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.86-91
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    • 2006
  • There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

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Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

Complete Rupture of the Origins of Rectus Femoris Occurred During Relay Race - A Case Report - (릴레이 경주 중에 발생한 대퇴직근 기시부의 완전 파열 - 증례보고 -)

  • Jeon, Seung-Ju;Jeon, Ho-Seung;Moon, Chan-Sam;Noh, Haeng-Kee;Ha, Seung-Joo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.151-155
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    • 2008
  • During sports activity, rectus femoris muscle can be commonly injured as the quadriceps contracts forcefully to extend the knee and flex the hip, and rectus femoris muscle has a high percentage of type II muscle fibers which enable it to produce rapid forceful activity and the muscle is the only biarticular muscle of the quadriceps. Avulsion fractures by the traction of rectus femoris from the anterior inferior iliac spine in children are often reported. Rarely, complete rupture of proximal musculotendinous junction of rectus femoris muscle in adult may occurs by chronic repetitive stimulation and may mimic soft tissue neoplasm in the case of no history of antecedent trauma. However, there has been no report of acute complete rupture of origins of the rectus femoris muscle during relay race till now. So, we report a case of acute complete rupture of origins of the rectus femoris muscle occurred during relay race in middle-aged man, diagnosed by magnetic resonance image and treated by surgical repair with review of current literature.

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The effects of Cudrania tricuspidata extract on bone metabolism in ovariectomized rats

  • Jo, You-Young;Seo, Sang Deog;Kim, Ji-Won;Cho, Hyun-Ji;Chon, Jeong-Woo;Lee, Kwang Gill;Lee, Heui-Sam;Park, Yoo-Kyoung;Kweon, HaeYong
    • International Journal of Industrial Entomology and Biomaterials
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    • v.32 no.2
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    • pp.80-89
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    • 2016
  • The effects of Cudrania tricuspidata (CT) extract on markers of osteoporosis were examined in ovariectomized rats. We classified 26 rats into five groups and provided a pellet chow diet and tap water throughout the 27-wk experimental period. During the last 15 wk, we added oral injections to each group as follows: sham-operated (SHAM, n=4) and ovariectomized-control (OVX, n=5) with distilled water, alendronate with 10 mg/kg/d of alendronate sodium (ALEN, n=5), CT (CT100, n=6) with 100 mg/kg/d of CT, and CT (CT300, n=6) with 300 mg/kg/d of CT. After the experimental period, blood, urine, and micro-CT images were assessed. The CT100 and OVX groups did not show any significant differences in urinary n-terminal telopeptide (NTx) (p<0.05 ), but with increases in CT concentration, the NTx level was slightly reduced. Serum osteocalcin was significantly higher in the CT groups than in all other groups (p<0.05 ). Notably, the serum calcium levels of all groups were within the normal range, but urinary calcium levels in the CT groups were significantly lower than the OVX group (p<0.05 ). In addition, the CT groups exhibited higher trabecular BMD than the OVX groups while showing similar BMD to the ALEN group (p<0.05 ). The Tb.Th of the ALEN group was lower than all other groups. Based on the overall analysis of results, CT prevented bone loss by inhibiting bone resorption and enhancing bone formation. Although alendronate showed a similar effect in preventing bone loss, it did so by solely inhibiting bone resorption, and its long-term use reportedly causes paradoxical effects such as hip fractures. Thus, for osteoporosis induced by ovariectomy, we conclude that CT extract is an effective natural treatment without severe side effects.

Understanding and Prevention of Fall-related Injuries in Older Adults in South Korea: A Systematic Review (한국 노인의 넘어짐과 연계된 인체손상에 대한 이해와 예방: 체계적 문헌 고찰)

  • Lim, Ki-taek;Lee, Ji-eun;Park, Ha-eun;Park, Su-young;Choi, Woochol Joseph
    • Physical Therapy Korea
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    • v.26 no.2
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    • pp.34-48
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    • 2019
  • Background: Fall-related injuries in older adults are a major health problem, and the risks and mechanisms of these injuries should be affected by race, culture, living environment, and/or economic status. Objects: Research articles have been systematically reviewed to understand fall-related injuries in older adults in South Korea. Methods: 128 published research papers have been found through the Korea Citation Index and the Korean Studies Information Service System, and reviewed in various perspectives, including incidents, fall death rates, medical costs, causes, injury sites and types, locations where falls occurred, prevention strategies, scholarly fields interested in fall injuries, and the role of physical therapy. Results: Fall-related injuries were found to be more common in women than in men, and the number of incidents increased with age, with the highest rate found in individuals over 85 years old. Risk of fall injury was associated with education level, comorbidities, and fear of falling. Common places where falls occurred included the bathroom, living room, stairs, and hallway. Common types of injury included bruises, fractures, and sprains in the lower extremities. Intervention strategies included exercise programs, education, and protective clothing. Scholarly fields interested in fall-related injuries in older adults included medicine, nursing, physical therapy, occupational therapy, physical education, pharmacology, oriental medicine, biomedical engineering, design, clothing, and textiles. Physical therapy intervention using proprioceptive neuromuscular facilitation has been used to improve one's balance. Conclusion: Any movement during the activities of daily living can lead to a fall. Physical therapists are highly educated to analyze human movements and should be involved in more research and practices to solve fall-related injuries in older adults.

Three-Dimensional Printing Technology in Orthopedic Surgery (정형외과 영역에서의 삼차원 프린팅의 응용)

  • Choi, Seung-Won;Park, Kyung-Soon;Yoon, Taek-Rim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.103-116
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    • 2021
  • The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.