• 대한방사선기술학회지:방사선기술과학
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• 제25권1호
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• pp.49-53
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• 2002

The femoral fracture is the most serious problem of old ages haying osteoporotic fractures. First of all, prevention to reduce the incidence of hip fracture and to identify the risk factor is essential subject. The purpose of this study is to investigate which geometric parameters of proximal femur are related to the hip fracture risk in old ages. Author analyzed the bone density and bone content of over 60 years old women who had suffered hip fracture (n=60) and non fracture groups (n=60). Author concluded that geometric measurements of proximal femoral part made on dual energy x-ray absorptiometry can predict hip fracture independently of bone mineral density.

• 동의생리병리학회지
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• 제34권5호
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• pp.263-268
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• 2020

The aim of this study was to observe the effectiveness of Korean Medicine treatments on pain reduction of patients who were diagnosed hip fracture - Acetabulum and Proximal Femur. We reviewed the 17 patients' records who had admitted to Daejeon Korean Medical hospital and diagnosed fracture of acetabulum or proximal femur bones from January 1, 2011 to April 30, 2020 during the admission retrospectively. Statistical analysis was done using the IBM SPSS statistics 25 program. We measured Numeric Rating Scale to evaluate the treatment's efficacy. Korean Medicine treatments reduced median of Numeric Rating Scale reduced statistically significantly from 6.00 to 3.00(p<0.05). During the admission, patients didn't experience the side effects of Korean Medicine treatments. In conclusion, these results implied that Korean medicine treatments showed a positive effect on pain reduction of hip fracture patients. Further research is required to confirm the effectiveness of Korean Medicine treatments.

• The Korean Journal of Pain
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• 제33권2호
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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.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.50-56
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• 2005

There are limited treatment options in the reconstruction of the very large defect in the metaphyseal portion of distal femur and proximal tibia. Fibula is one of the most popular donor of the long bone reconstruction in reconstructive microsurgical field. It has many advantages such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter and long pedicle. There are limited donor site problems such as transient peroneal nerve dysfunction. In those situations with the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transferred. We performed 7 cases of "doule barrel" fibular transplantation on the metaphyseal portion of distal femur and proximal tibial large defects in which it is very difficult to fill the bony gap with conventional bone graft or callotasis methods. It takes averaged 8.3 months since that procedure to obtain bony union. After solid union of the transferred double barrelled fibular graft. There were no stress fracture in our series. So we can propose double barrel fibular graft is useful method in those cases with very large bone defect on the metaphysis of large long bone.

• 한국콘텐츠학회논문지
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• 제12권12호
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• pp.335-344
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• 2012

우리나라는 급격한 경제성장과 의료기술의 발달로 고령화 사회가 되면서 골다공증 발병이 증가하고 있다. 또한 서구화된 식생활로 암질환이 증가하였고 항암치료과 방사선 치료 등으로 인해 골다공증이 발생하게 된다. 골다공증은 골밀도의 감소로 인한 것으로 대퇴근위부의 형태학적 구조 변화와도 밀접한 관계를 가지고 있으며, 대퇴 근위부의 형태학적 구조 변화는 고관절 골절의 위험을 나타내는 요인이다. 본 연구는 T-score변화에 따라 정상, 골감소증, 골다공증으로 분류하여 각 군별로 대퇴 근위부의 형태학적 변화를 관찰하고 상관관계를 분석하였다. 조사대상은 부산지역의 D종합병원의 남녀 350명을 대상으로 연령, 성별, T-score변화로 질환을 구분하여 분석하였다. 결과는 연령, 성별에 따라 골다공증의 발병빈도는 유의한 차이를 보였고, T-score변화에 따른 질환 분류와 대퇴근위부 형태학적 특성의 7가지 파라미터로서 Cortical ratio calcar, Cortical ratio shaft, Hip/shaft Angle, Strength index, Section modulus, CSMI, CSA는 유의한 차이를 보였으며 골다공증과 높은 상관관계가 있었다. 그러므로 연구 결과는 T-score변화에 따른 대퇴근위부의 형태학적 변화를 상관관계 분석함으로써 골다공증을 진단하는데 대퇴 근위부의 형태학적 변화가 지표로서 활용가능하리라 사료되며, 향후에 대퇴근위부의 형태학적 파라미터가 골다공증 진단의 정확성을 높이고 예측인자로서 임상활용이 가능하리라 판단된다.

• 대한골관절종양학회지
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• 제20권1호
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• pp.7-13
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• 2014

목적: 대퇴골 근위부에 발생한 악성 골 종양의 치료로 사지 구제술을 시행하는 경우 환자의 생존과 더불어 술 후 보행 등의 기능회복이 중요하다. 대퇴골 근위부의 악성 골 종양에 의한 통증 또는 병적 골절이 발생한 환자에 대하여 종양 대치물을 이용한 사지 구제술 시행 후 임상 결과에 대해서 분석하였다. 대상 및 방법: 2005년 2월부터 2014년 1월까지 대퇴골 근위부 악성 골 종양을 진단 받고 통증 또는 병적 골절이 발생하여 대퇴골 근위부 절제술 및 종양 대치물을 이용한 사지 구제술을 시행한 20예(19명)를 대상으로 하였다. 평균 연령은 63.1세(범위 35-86세)였으며 남자가 14예, 여자가 6예였다. 평균 추시 기간은 20개월(1-94개월)이었고, 전이성 골 종양 15예, 골육종 4예, 다발성 골수종 1예였으며, 전이성 병변의 원발 암은 폐암 4예, 간암 3예, 신장암 3예였고, 유방암, 갑상선암, 대장암, 전립선암, 악성 방추 세포암이 각각 1예씩 이었다. 사용된 종양 대치물은 모두 조립형 종양 대치물로 Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey)가 3예에서 사용되었고, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany)이 17예에서 사용되었다. 수술 전 후의 동통 정도를 Visual Analogue Scales(VAS)로 평가하였으며, 술 후 하지의 기능적 평가를 위해 Musculoskeletal Tumor Society score(MSTS) grading system 을 이용하였다. 결과: 최종 추시 시 20예(19명) 중 11예(10명)가 생존하고 9예(9명)가 사망하였으며 사망한 환자의 술 후 평균 생존기간은 10.1개월(1-38개월) 이었다. VAS 점수는 술 전 평균 8.40점(5-10점)에서 술 후 평균 1.35점(0-3점)으로 호전 되었고, 수술 후 MSTS 기능적 평가는 평균 19.65점(65.50%) (7-28점)이었다. 수술과 관련된 합병증으로는 국소 재발 2예, 혈종 3예, 감염 3예, 음낭 종창 2예, 탈구 1예였고 치환물 주위 골절이나 해리는 없었다. 결론: 대퇴골 근위부에 발생한 악성 골 종양에 의한 통증 또는 병적 골절이 발생한 경우 종양 대치물을 이용한 사지 구제술은 조기의 통증 감소 및 기능 회복을 위한 적절한 치료로 생각된다.

• Molecules and Cells
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• 제23권2호
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• pp.246-251
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• 2007

Osteoporosis is a common metabolic bone disease characterized by low bone mineral density (BMD) with an increased risk of fracture. Low bone mass results from an imbalance between bone formation by osteoblasts and bone resorption by osteoclasts. Microphthalmia-associated transcription factor (MITF) plays a critical role in osteoclast development and thus is an important candidate gene affecting bone turnover and BMD. In order to investigate the genetic effects of MITF variations on osteoporosis, we directly sequenced the MITF gene in 24 Koreans, and identified fifteen sequence variants. Two polymorphisms (+227719C > T and +228953A > G) were selected based on their allele frequencies, and then genotyped in a larger number of postmenopausal women (n = 560). Areal BMD ($g/cm^2$) of the anterior-posterior lumbar spine and the non-dominant proximal femur was measured by dual-energy X-ray absorptiometry. We found that the MITF + 227719C > T polymorphism was significantly associated with low BMD of the trochanter (p = 0.005-0.006) and total femur (p = 0.02-0.03) (codominant and dominant models), while there was no association with BMD of the lumbar spine. The MITF+228953A > G polymorphism was also associated with low BMD of the femoral shaft (p = 0.05) in the recessive model. Haplotype analysis showed that haplotype 3 of the MITF gene (MITF-ht3) was associated with low BMD of the trochanter (p = 0.03-0.05) and total femur (p = 0.05) (dominant and codominant models). Our results suggest that MITF variants may play a role in the decreased BMD of the proximal femur in postmenopausal women.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2001년도 춘계 심포지움
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• pp.36-36
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• 2001

• Investigative Magnetic Resonance Imaging
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• 제21권3호
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• pp.177-182
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• 2017

Schwannomas are benign nerve sheath tumors that are typically located in soft tissue. Occasionally, schwannomas involve osseous structures. These intraosseous schwannomas are generally benign neoplasms that account for less than 0.2% of primary bone tumors. Schwannomas are very rarely observed in long bones. We present a case of a schwannoma affecting the proximal femur with a coincident subchondral fracture of the femoral head. A 38-year-old-male presented with left hip pain without deteriorating locomotor function. Plain film radiographs displayed a lobulating contoured lesion within the intertrochanteric portion of the femur. The magnetic resonance imaging (MRI) scans showed a tumor occupying the intertrochanteric region. Diffuse bone marrow edema, especially in the subchondral and head portions of the femur that was possibly due to the subchondral insufficiency fracture was also noted. The lesion was surgically excised and bone grafting was performed. Histologically, there was diffuse infiltrative growth of the elongated, wavy, and tapered cells with collagen fibers, which are findings that are characteristic of intraosseous schwannoma. Although very rare, intraosseous schwannoma should be included in the differential diagnosis of radiographically benign-appearing, non-aggressive lesions arising in the femur. The concomitant subchondral fracture of the femoral head confounded the correct diagnosis of intraosseous schwannoma in this case.

• 대한수의학회지
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• 제51권4호
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• pp.297-301
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• 2011

The racehorses that under arthroscopic surgery due to be injured his limbs were studied during exercise or training at Busan Race Park from 2005 to 2010. Rate of arthroscopic surgical treatments was 1.4% (63/4,642). Affected bones were radius, radial carpal bone, third carpal bone, proximal phalanx, third metacarpal bone, femur, tibia, proximal sesamoid bone and intermediate carpal bone. The lesions were fracture, chip fracture, slap fracture, osteochonrosis, and osteochondrotitis dissencans. Number of patients under arthroscopic surgery were 63. Success horses of returned to racetrack or tried to return to racetrack were 58, and 5 horses were in training or resting at the time of publication. Success horses of returned to their previous use in the patients were 49 horses (84.4%) and no returned to the racetrack were 9 horses (15.6%) in 58 horses.