• Hip & pelvis
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• v.34 no.1
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• pp.18-24
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• 2022

Purpose: The aim of this study was to determine whether there is a correlation between the type and stability of intertrochanteric fractures caused by low-energy trauma and gluteus muscle volume. Materials and Methods: A total of 205 elderly (>65 years) patients with intertrochanteric fractures caused by low-energy trauma treated from January 2018 to December 2020 were included in this study. The mean age of patients was 81.24 years (range, 65-100 years). Fractures were classified according to the Jensen modification of the Evans classification. The cross-sectional area of the contralateral gluteus muscle (minimus, medius, and maximus) was measured in preoperative axial computed tomography slices. An analysis and comparison of age, body mass index (BMI), weight, height, and the gluteus muscle area in each fracture type group was performed. Results: In the uni-variable analysis, statistically significant taller height was observed in patients in the stable intertrochanteric fracture (modified Evans 1 and 2) group compared with those in the unstable intertrochanteric fracture (modified Evans 3, 4, and 5) group (P<0.05). In addition, significantly higher BMI-adjusted gluteus muscle area (gluteus muscle area/BMI) was observed for the stable intertrochanteric fracture group compared with the unstable intertrochanteric fracture group except for the BMI-adjusted gluteus minimus area (P=0.112). In multivariable analysis, only the BMI-adjusted gluteus maximus (P=0.042) and total gluteus areas (P=0.035) were significantly higher in the stable group. Conclusion: Gluteal muscularity around the hip, especially the gluteus maximus, had a significant effect on the stability of intertrochanteric fractures.

• Hip & pelvis
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• v.34 no.1
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• pp.10-17
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• 2022

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The cross-sectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion: Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

• Journal of Acupuncture Research
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• v.32 no.1
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• pp.119-126
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• 2015

Objectives : The purpose of this study was to investigate the clinical effects of Korean medical treatments combined with acupotomy on patients diagnosed with a herniated intervertebral disc of the lumbar spine. Methods : We reviewed the medical records of twenty in patients diagnosed with a herniated intervertebral disc of the lumbar spine. They had received Korean medical treatment combined with acupotomy on tender points in the gluteus minimus muscle and piriformis muscle at Gwangju Korean Medicine Hospital of Dong-Shin University from April, 2014 to December, 2014. To evaluate the efficacy of the treatments, the twenty in patients were asked to complete the Numerical Rating Scale(NRS) and the Oswestry Disability Index(ODI) before acupotomy, the first day after acupotomy, the third day after acupotomy, and the fifth day after acupotomy. Results : 1. NRS significantly decreased from $6.15{\pm}1.27$ to $3.90{\pm}1.45$. 2. ODI significantly decreased from $23.64{\pm}8.76$ to $15.95{\pm}7.35$. Conclusions : Korean medical treatment combined with acupotomy on tender points in the gluteus minimus muscle and piriformis muscle might be effective in reducing pain and improving the life quality of patients with a herniated intervertebral disc of the lumbar spine. We hope that further studies will be done to produce more clinical data and ensure effective application of these results.

• Korean Journal of Radiology
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• v.24 no.5
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• pp.434-443
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• 2023

Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.

• Korean Journal of Acupuncture
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• v.25 no.4
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• pp.17-29
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• 2008

Objectives : This study was carried out to investigate the correlation of meridian system in oriental medicine and muscular system in western medicine. Methods : Muscles were assigned to meridians by their main functions and the acupoints on them. New mutual relationships between meridians in lower limb were studied based on the muscular function. Results : In gluteal & femoral region, iliopsoas & quadratus femoris are assigned to spleen & stomach meridians, gluteus maximus & hamstrings to urinary bladder & kidney meridians, adductor muscle groups to liver meridian, gluteus medius & minimus & iliotibial tract to gall bladder meridian. In crural region, anterior crural muscles are assigned to stomach meridian, lateral crural muscles to gall bladder meridian, suferficial posterior crural muscles to urinary bladder (& kidney) meridian, deep posterior crural muscles to liver, spleen, kidney meridians. In lower limb, urinary bladder meridian and stomach meridian lead the muscular functions and correspond to each other, while spleen meridian assists stomach meridian, and kidney meridian assists urinary bladder meridian. Conclusions : Muscles may be assigned to meridians by their functions and the acupoints on them. From the view of muscular function, Yang meridians lead Yin meridians in lower limb.

• The Korean Journal of Pain
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• v.29 no.4
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• pp.274-276
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• 2016

Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

• Journal of Acupuncture Research
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• v.22 no.5
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• pp.29-36
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• 2005

Objectives : This study is performed to understand the interrelation between 'Foot soyang muscle of the Gall bladder channel' and 'muscular system' on the basis of the link between meridian muscle theory and myofascial pain syndrome. Methods : We have researched some of oriental medical books about meridian muscle theory and western medical books about anatomical muscular system. Results & Conclusion : 1. Myofascial pain syndrome is the medical treatment which finds the start point of the pain in fascia and then treats it on the basis of object and concrete anatomical theory, so its application is needed for objectification of the oriental medicine. 2. There is a wide difference between myofascial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. Foot soyang muscle contains Dorsal interosseous m, Extensor digitorum longus m, Musculus peroneus brevis, longus and, tertius, lliotibial tract, Vastus lateralis m, Gluteus m, Aximus m, Piriformis m, Tensor fasciae latae m, Gluteus minimus m, Obliquus internus & externus abdominis m, External & Internal intercostal m, Serratus anterior m, Pectoralis major m, Sternocleidomastoid m, Auricularis posterior m, Temporalis m, Masseter m, Orbicularis oculi m etc. on the basis of function and the nature of a disease reflected in muscle. 4. Foot soyang muscle keeps the balance of left md right of the body on the outside, while the Gall bladder keeps the balance of the JangBuKiHyeul(臟腑氣血) on the inside.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.142-145
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• 2007

Gastrointestinal stromal tumor (GIST) occurring outside the gastrointestinal tract is uncommon. When GIST is found outside the gastrointestinal tract, it has greater possibility to be diagnosed with metastatic lesion from other primary focus. But it rarely occurs in extragastrointestinal tract primarily, and then even outside abdomen. We experienced one case of GIST occurred from right buttock area of 25 year-old man. We could not find out the primary focus in abdomen. The tumor was developed inside gluteus medius and minimus and extended to pelvic inner area destroying iliac bone and adjacent sacrum. Here, we report the case of GIST with terminology of extragastrointestinal stromal tumor (EGIST).

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.161-165
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• 2024

Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.588-592
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• 2018

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient's clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.