• Clinics in Shoulder and Elbow
• /
• v.10 no.2
• /
• pp.246-250
• /
• 2007

Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.

• 대한예방의학회:학술대회논문집
• /
• 1995.10a
• /
• pp.97-98
• /
• 1995

• Fashion & Textile Research Journal
• /
• v.16 no.6
• /
• pp.1001-1007
• /
• 2014

We surveyed the wearing characteristics of hip protectors. The problems of existing hip protectors were identified and the directions for improvement were presented. The evaluation of wearing characteristics was conducted on the 100 elderly women (60 to 85 years) with 5 types of hip protector. The questionnaire was composed of history and characteristics on falling, hip protector acceptance, preference, use characteristics and improvement requirements. The result of wearing characteristic evaluation indicated that 52% of the subject experienced falling in winter. Incidents resulting from falling occurred: outdoors (74.5%), bathroom (10.9%), and kitchen (5.5%). Body parts to be protected were in several areas: 35.6% for lumbar, 26.9% for hip joint, and 15% for hip bone. Participants prefer a belt B type design at a rate of 56.9% because it provided a sense of stability by clinging to the body and upholding the waist. Belt B type was the most appropriate in terms of fit, allowance, mobility, and design except pad thickness. To reduce the risk of hip fracture, hip protector needs to be designed in consideration of user's type of fall and body shape. The pattern and size of a hip protector has to be improved in regards to the amount of discomfort. An objective evaluation is needed for the ergonomic design of a hip protector based on and analysis of 3D body image of the elderly and the shock-absorbing quality of pad.

• Journal of Korean Biological Nursing Science
• /
• v.18 no.4
• /
• pp.193-202
• /
• 2016

Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.

• Journal of Korean Biological Nursing Science
• /
• v.21 no.1
• /
• pp.54-61
• /
• 2019

Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

• Journal of Biomedical Engineering Research
• /
• v.24 no.5
• /
• pp.401-410
• /
• 2003

This study investigates the biomechanical efficacies of various cement augmentation techniques with or without pressurization for varying degrees of osteoporotic femur. For this study, a biomechanical analysis using a finite element method (FEM) was undertaken to evaluate surgical procedures, Simulated models include the non-cemented(i.e., hip screw only, Type I), the cement-augmented(Type II), and the cemented augmented with pressurization(Type III) models. To simulate the fracture plane and other interfacial regions, 3-D contact elements were used with appropriate friction coefficients. Material properties of the cancellous bone were varied to accommodate varying degrees of osteoporosis(Singh indices, II∼V). For each model. the following items were analyzed to investigate the effect surgical procedures in relation to osteoporosis of varying degrees : (a) von Mises stress distribution within the femoral head in terms of volumetric percentages. (b) Peak von Mises stress(PVMS) within the femoral head and the surgical constructs. (c) Maximum von Mises strain(MVMS) within the femoral head, (d) micromotions at the fracture plane and at the interfacial region between surgical construct and surrounding bone. Type III showed the lowest PVMS and MVMS at the cancellous bone near the bone-construct interface regardless of bone densities. an indication of its least likelihood of construct loosening due to failure of the host bone. Particularly, its efficacy was more prominent when the bone density level was low. Micromotions at the interfacial surgical construct was lowest in Type III. followed by Type I and Type II. They were about 15-20% of other types. which suggested that pressurization was most effective in limiting the interfacial motion. Our results demonstrated the cement augmentation with hip screw could be more effective when used with pressurization technique for the treatment of intertrochanteric fractures. For patients with low bone density. its effectiveness can be more pronounced in limiting construct loosening and promoting bone union.

• Journal of muscle and joint health
• /
• v.22 no.2
• /
• pp.67-77
• /
• 2015

Purpose: This study was a qualitative research using focus group interviews to collect data on the health care providers' perceptions of physical function in older adults with arthroplasty from hip fracture. Methods: A total of 12 subjects participated in this study. In order to conduct focus group interviews, structured manuscript, field notes, visual recording, and debriefing notes were referred and thematic analysis was used in analysis phase. Results: The six themes were raised: 'burdensome client', 'health care providers' perception of functional decline in older adults after surgery', 'health care providers' perception of caregiver', 'medical environment perceived as affecting physical function', 'crucial components perceived as encouraging functional restoration', and 'difficulty of pain management' with 18 subthemes. Conclusion: Healthcare providers perceived functional decline of elderly after arthroplasty and identified points facilitating or disturbing physical function Moreover, various perspectives on pain management related to physical function were represented.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2012.05a
• /
• pp.1157-1158
• /
• 2012

• Journal of Trauma and Injury
• /
• v.25 no.3
• /
• pp.97-100
• /
• 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.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.2
• /
• pp.143-153
• /
• 2020

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion: Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.