• Hip & pelvis
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• 제36권1호
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• pp.55-61
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• 2024

Purpose: This study sought to examine the utilization of bone health evaluations in geriatric hip fracture patients and identify risk factors for the development of future fragility fractures. Materials and Methods: A consecutive series of patients ≥55 years who underwent surgical management of a hip fracture between September 2015 and July 2019 were identified. Chart review was performed to evaluate post-injury follow-up, performance of a bone health evaluation, and use of osteoporosis-related diagnostic and pharmacologic treatment. Results: A total of 832 patients were included. The mean age of the patients was 81.2±9.9 years. Approximately 21% of patients underwent a comprehensive bone health evaluation. Of this cohort, 64.7% were started on pharmacologic therapy, and 73 patients underwent bone mineral density testing. Following discharge from the hospital, 70.3% of the patients followed-up on an outpatient basis with 95.7% seeing orthopedic surgery for post-fracture care. Overall, 102 patients (12.3%) sustained additional fragility fractures within two years, and 31 of these patients (3.7%) sustained a second hip fracture. There was no difference in the rate of second hip fractures or other additional fragility fractures based on the use of osteoporosis medications. Conclusion: Management of osteoporosis in geriatric hip fracture patients could be improved. Outpatient follow-up post-hip fracture is almost 70%, yet a minority of patients were started on osteoporosis medications and many sustained additional fragility fractures. The findings of this study indicate that orthopedic surgeons have an opportunity to lead the charge in treatment of osteoporosis in the post-fracture setting.

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.289-297
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• 2014

Objectives: This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea. Methods: The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs). Results: Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture. Conclusions: Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

• Structural Engineering and Mechanics
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• 제68권6호
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• pp.747-760
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• 2018

In the present study, a methodology for developing fragilities of arch concrete dams to assess their performance against seismic hazards is introduced. Firstly, the probability risk and fragility curves are presented, followed by implementation and representation of the way this method is used. Amirkabir arch concrete dam was subjected to non-linear dynamic analyses. A modified three dimensional rotating smeared crack model was used to take the nonlinear behavior of mass concrete into account. The proposed model considers major characteristics of mass concrete. These characteristics are pre-softening behavior, softening initiation criteria, fracture energy conservation, suitable damping mechanism and strain rate effect. In the present analysis, complete fluid-structure interaction is included to account for appropriate fluid compressibility and absorptive reservoir boundary conditions. In this study, the Amirkabir arch concrete dam is subjected to a set of 8 three-component earthquakes each scaled to 10 increasing intensity levels. Using proposed nonlinear smeared crack model, nonlinear analysis is performed where the structure is subjected to a large set of scaled and un-scaled ground motions and the maximum responses are extracted for each one and plotted. Based on the results, fragility curves were plotted according to various and possible damages indexes. Discrete damage probabilities were calculated using statistical methods for each considered performance level and incremental nonlinear analysis. Then, fragility curves were constructed based on the lognormal distribution assumption. Two damage indexes were introduced and compared to one another. The results indicate that the dam has a proper stability under earthquake conditions at MCE level. Moreover, displacement damages index is more conservative and impractical in the fragility analysis than tensional damage index.

• 대한치과의사협회지
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• 제51권1호
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• pp.6-11
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• 2013

Dental ceramics is well known to have excellent esthetics, biocompatibility as well as high compressive strength. However, the fragility of ceramics against tensile and shear loads leading to the delayed fracture of micro crack on ceramic surface and the backwardness of ceramic fabrication technique limit the usage of ceramic materials in dentistry. Among all ceramic materials, zirconia has been introduced to overcome the drawback of conventional dental ceramics in the field of dentistry due to the nature of zirconia featuring proper opalescence and high fracture toughness. Also, novel manufacturing techniques enable ceramic materials to prepare high esthetic anterior and posterior all ceramic system. In this paper, it is introduced and discussed that novel techniques characterizing the bond strength between zirconia core and veneering ceramics and analyzing the fluorescence of dental ceramics in order to overcome the gap between the results of basic research and the feasibility of the results in the field of dental clinics.

• 한국정밀공학회지
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• 제18권1호
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• pp.111-116
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• 2001

A practical scheme to reduce failure of the PCB(Printed Circuit Board) of a monitor is introduced using deformed mode shape under mechanical shock. When the monitor is given critical shock loads, cracks are commonly initiated at the tip of a hole on the PCB. Accordingly, a deformed mode shape of the PCB is obtained using a FEM code to define a weak point on the PCB under mechanical shock, and then the position and direction of the hole is determined to prevent the failure at the critical mode shape. Also, the stress intensity factor around the weak point on the PCB is calculated to check the possibility of fracture by normal tensile stress. In conclusion, present research is useful to assist the practical design of components-layout on the PCB.

• Hip & pelvis
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• 제34권2호
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• pp.69-78
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• 2022

Fragility fractures of the pelvis (FFP) and fragility fractures of the sacrum (FFS), which are emerging in the geriatric population, exhibit characteristics that differ from those of pelvic ring disruptions occurring in the younger population. Treatment of FFP/FFS by a multidisciplinary team can be helpful in reducing morbidity and mortality with the goal of reducing pain, regaining early mobility, and restoring independence for activities of daily living. Conservative treatment, including bed rest, pain therapy, and mobilization as tolerated, is indicated for treatment of FFP type I and type II as loss of stability is limited with these fractures. Operative treatment is indicated for FFP type II when conservative treatment has failed and for FFP type III and type IV, which are displaced fractures associated with intense pain and increased instability. Minimally invasive stabilization techniques, such as percutaneous fixation, are favored over open reduction internal fixation. There is little evidence regarding outcomes of patients with FFP/FFS and more literature is needed for determination of optimal management. The aim of this article is to provide a concise review of the current literature and a discussion of the latest recommendations for orthopedic treatment and management of FFP/FFS.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.286-293
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• 2010

Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA) is increasing. The process of interpretation of pediatric DXA results is different from that of adults because normal bone mineral density (BMD) of children varies by age, body size, pubertal stage, skeletal maturation, sex, and ethnicity. Thus, an appropriate normal BMD Z-score reference value with Z-score should be used to detect and manage low BMD. Z-scores below -2.0 are generally considered a low BMD to pediatrician even though diagnoses of osteoporosis in children and adolescents are usually only made in the presence of at least one fragility fracture. This article will review the basic knowledge and practical guidelines on pediatric DXA based on the International Society for Clinical Densitometry (ISCD) Pediatric Official Positions. Also discussed are the characteristics of normal Korean children and adolescents with respect to BMD development. The objective of this review is to help pediatricians to understand when DXA will be useful and how to interpret pediatric DXA reports in the clinical practice for management of children with the potential to develop osteoporosis in adulthood.

• Clinical and Experimental Pediatrics
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• 제56권2호
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• pp.60-67
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• 2013

As chemotherapy and other sophisticated treatment strategies evolve and the number of survivors of long-term childhood cancer grows, the long-term complications of treatment and the cancer itself are becoming ever more important. One of the most important but often neglected complications is osteoporosis and increased risk of fracture during and after cancer treatment. Acquisition of optimal peak bone mass and strength during childhood and adolescence is critical to preventing osteoporosis later in life. However, most childhood cancer patients have multiple risk factors for bone mineral loss. Cancer itself, malnutrition, decreased physical activity during treatment, chemotherapeutic agents such as steroids, and radiotherapy cause bone mineral deficit. Furthermore, complications such as growth hormone deficiency and musculoskeletal deformity have negative effects on bone metabolism. Low bone mineral density is associated with fractures, skeletal deformity, pain, and substantial financial burden not only for childhood cancer survivors but also for public health care systems. Thus, it is important to monitor bone health in these patients and minimize their risk of developing osteoporosis and fragility fractures later in life.

• The Journal of the Acoustical Society of Korea
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• 제29권2E호
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• pp.64-72
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• 2010

Osteoporosis is a skeletal disease characterized by two factors: reduced bone mass and microstructure disruption of bone tissue. These symptoms increase bone fragility and can contribute to eventual fracture. In recent years, quantitative ultrasound (QUS) technologies have played a growing role in the diagnosis of osteoporosis. Most of the commercial bone sonometers measure speed of sound and/or broadband ultrasound attenuation at peripheral skeletal sites. However, QUS parameters are purely empirical measures that have not yet been firmly linked to physical parameters, such as bone strength or porosity, and the underlying physics for their variations in cancellous bone is not well understood yet. This paper reviews the QUS technologies for the diagnosis of osteoporosis and also addresses several theoretical models, such as the Biot model, the scattering model, the stratified model, and the modified Biot-Attenborough model, for ultrasonic wave propagation in bone.

• 한국전문물리치료학회지
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• 제12권2호
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• pp.20-27
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• 2005

Osteoporosis is characterized by low bone mass and the microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture. It has been suggested that speed of sound (SOS) and broadband ultrasound attenuation (BUA) of quantitative ultrasound sonography (QUS) may provide information about not only bone density but also the microarchitecture and elastic properties of bone. Physical inactivity reduced mechanical usage and it made process to the bone changes. This study aimed to association between the physical activity and the QUS parameters in 1305 (593 men, 712 women) aged 20 years over in a rural population. Two QUS parameters, BUA (p=.23) and SOS(p=.73) were measured at the right calcaneus of postmenopausal women, no significant associations were observed between sports index and SOS and BUA. These results suggest that work, non-sports leisure physical activity (p<.01) have a significant influence on QUS parameters in a rural population. Physical activity are meaningful predictor of QUS parameters of the calcaneus in a rural population.