• Archives of Reconstructive Microsurgery
• /
• v.25 no.2
• /
• pp.72-74
• /
• 2016

The keystone flap is a fascia-based island flap with two conjoined V-Y flaps. Here, we report a case of successful treatment of a trochanter pressure sore patient with the traditional keystone flap. A 50-year-old male patient visited our department with a $3{\times}5cm$ pressure sore (grade III) to the left of the greater trochanter that was covered with eschar. Debridement was done and the defect size increased to $5{\times}8cm$ in an elliptical shape. Doppler ultrasound was then used to locate the inferior gluteal artery perforator near the wound. The keystone flap was designed to the medial side. The perforator based keystone island flap covered the defect without resistance. The site remained clean, and no dehiscence, infection, hematoma, or seroma developed. In general, greater trochanter pressure sores are covered with a perforator based propeller flap or fascia lata flap. However, these flaps have the risk of pedicle kinking and require a large operation site. For the first time, we successfully applied the keystone flap to treat a greater trochanter pressure sore patient. Our design was also favorable with the relaxation skin tension lines. We conclude that the keystone flap including a perforator is a reliable option to reconstruct trochanteric pressure sores.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.1
• /
• pp.86-91
• /
• 2000

Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.27 no.2
• /
• pp.81-82
• /
• 2023

A 55-year-old female patient, referred by the endocrine metabolism department, was recommended for orthopedic surgery because a lesion was found in the proximal femur in the bone mineral densitometry (BMD). Pelvis AP and frog-leg images performed by the orthopedic department found an intraosseous mass (more likely a benign tumor) in the greater trochanter of the left femur. However, she did not need special treatment and decided to keep observing. The role of a radiologic technologist is important in BMD and it provides significant assistance in the treatment of patients.

• Imaging Science in Dentistry
• /
• v.36 no.2
• /
• pp.95-101
• /
• 2006

Purpose : Bony strength is dependent on bone mass and bony structure. So this study was designed to investigate the relationship between the bone mass and bony trabecular characteristics. Subjects and Methods : Study subjects were 51 females (average age 68.6 years) and 20 males (average age 66.4 years). Bone mineral density (BMD, $grams/cm^2$) of proximal femur was measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized radiographs of proximal femur. A customized computer program processed morphologic operations (MO) of ROIs. 44 skeletal variables of MO were calculated from ROIs on the Ward's triangle and greater trochanter of femur. WHO BMD classes were predicted by MO variables of the same ROI. Classification and Regression Tree analysis was used for calculating weighted kappa values, sensitivity and specificity of MO. Results : The discriminating factors of morphologic operation were branch point, branch point [per cm sq]. Age also played important role in distinguishing osteoporotic classes. The sensitivity of MO at Ward's triangle and Greater Trochanter was 91.8%, 65.6%, respectively. The specificity of MO was 100% at Ward's triangle and Greater Trochanter. Conclusion : Bony trabecular characteristics obtained using radiological bone morphometric analysis seem to be related to bone mass.

• Journal of the Korean Society of Clothing and Textiles
• /
• v.46 no.3
• /
• pp.454-463
• /
• 2022

This study aims to provide basic size data for the development of a hip dislocation prevention garment for cerebral palsy (CP) children and useful information for the design of garment products for CP children through identifying differences in body shape between CP and non-CP children and reviewing the tibial-stature prediction formulas of previous studies. Forty-seven Korean children with CP aged 2 to 14 years were measured for body size from October 2019 to August 2020. Body measurements of 18 sites, including greater trochanter length, which is an important site for a hip dislocation prevention garment, were collected and analyzed. Data of non-CP children were taken from same age of Size Korea and compared. Tibial-stature prediction formulas suggested in four previous studies were also reviewed. CP children had significantly lower stature as well as circumferential dimensions when compared to non-CP children. Greater trochanter length is difficult to predict through other body dimensions. Thus, direct measurement is required. Of the general key dimensions used in the clothing industry, only hip circumference could explain the body shape of CP children. Tibial-stature prediction formulas cannot always but tend to largely predict the actual stature of CP children.

• Journal of Korea Entertainment Industry Association
• /
• v.13 no.1
• /
• pp.207-215
• /
• 2019

This study examines the effect of the height of cane that hemiplegic patients due to stroke use on their plantar pressure in standing position, gait speed. The study suggests a new standard for appropriate cane height that considers the change of average height of population. Research subjects included 12 patients hospitalized in S Medical Care Hospital located in Gwangju Metropolitan City in South Korea who were diagnosed with stroke. Group A uses a cane of the height of the greater trochanter of femur, group B uses a cane of 5cm above the height of the greater trochanter of femur, and group C is a cane of 10cm above the height of the greater trochanter of femur. In the study result, non-affected side plantar pressure and affected side plantar pressure showed a significant difference among the cases where the cane height was the same as the A group, B group, C group. In the post-hoc analysis result, a significant difference was observed between the case of A group and C group. Gait speed showed no significant difference among the case of the A group, B group, C group. The asymmetry of the stroke affects not only the posture but also the walking that is related to daily life. Changes in the height of the cane did not affect walking speed. The change in the height of the cane showed a change in the weight support ratio, which is thought to have a positive effect on the asymmetry. In future clinical setting, this study result will be able to provide fundamental data regarding the cane height in the standing or walking therapy for hemiplegic patients due to stroke with cane application.

• Journal of Nutrition and Health
• /
• v.32 no.1
• /
• pp.50-63
• /
• 1999

This study was conducted with 20 female gymnasts and 23 age-matched controls to examine the relationship of diet, menstrual function and bone mineral density (BMD). The results obtained are summarized as follows : Energy intake of gymnasts was 968.9$\pm$421.4kcal, and energy expenditure was 2091.4$\pm$361kcal showing negative energy balance(-1,122.5$\pm$534.6kcal). The average intakes of calcium, iron, vitamin A, thiamin, riboflavin and niacin did not meet the Recommended Dietary Allowances for their age groups. Mean age at menarche in gymnasts is 15.8$\pm$1.2 years compared with 11.8$\pm$2.8 years in age-matched controls. The profile of estradiol, progesterone, and luteinizing hormone was lower than age-matched controls but not significant. Athletic amenorrheic gymnasts(n=12) have the menstrual irregularity(n=10) and amenorrhea(n=2). A number of variables as such nutritional deficiency in diet, negative energy blasnce and hypogonadotropic hormonal status were included. The bone mineral density (BMD) of female gymnasts were significantly higher than controls for the lumbar neck(p<0.001), trochanter(p<0.01), and Ward's triangle(p<0.001), but there were no significant differences for the lumbar spine and forearm. The lumbar spine BMD had a positive correlation with age and lean body weight. The femoral neck BMD was significantly associated with age, group and lean body mass. The trochanter BMD had significant relationship with group, body mass index, energy expenditure and follicular stimulating hormone. Ward's triangle BMD were related to body mass index and follicular stimulating hormone. The significant association was deterced between forearm BMD and age and lean body weight. The major finding of this investigation is that the BMD of gymnasts were higher than age-matched controls despite the fact that gymnasts as a group had inadequate dietary calcium and a higher propensity to have an interruption of their menstrual cycle. These data indicate that grymnsts involved in sports producing significant impact loading on the skeleton had greater femoral neck, trochanter and Ward's triangle bone density than age-matched controls.

• Journal of the Ergonomics Society of Korea
• /
• v.31 no.2
• /
• pp.327-336
• /
• 2012

Objective: The purpose of this study is to find the problems of stability when people use the bassinet as an ambulatory aid for old people. Background: Many aged people use a bassinet as ambulatory aid. But the safety of using the bassinet as ambulatory aid has not been verified yet. Method: The 13 university-students who don't have musculoskeletal disorders volunteered to participate in this study. According to structural analysis of the both tools, we compared the structural stability of an outdoor rollator with the structural stability of a bassinet. And when the participants walked using both tools, the motions were captured and analysed. We measured the angle of shoulder joint and the angle of trunk from the ground when the participants were walking. And we found the distance from participants' pressure cone apex and greater trochanter. Results: Following the structural analysis, the bassinet has the lower structural stability than the outdoor rollator. When the people used the bassinet as ambulatory aid, the angle of the shoulder joint was bigger than to use the outdoor rollator. The angle of trunk wasn't different between the outdoor rollator and the bassinet. And distance from pressure cone apex to greater trochanter was far to use the bassinet than to use the outdoor rollator. Conclusion: Through the structure analysis and gait analysis of the bassinet and the outdoor rollator, we can be aware of that the bassinet has problem of stability. Therefore the people who use the bassinet as an ambulatory aid, especially supporting body weight, may be hurt due to the problems of stability. Application: This research can be used for developing a study of the ambulatory aid and preventing the accident when the aged people use the ambulatory aid.

• Journal of agricultural medicine and community health
• /
• v.43 no.4
• /
• pp.250-257
• /
• 2018

Objecctives: This study investigates the effects of using customized walking aids individualized for stroke patients by measuring the effects of different cane lengths to determine the ideal length of walking aids for stroke patients. Methods: Cane lengths were determined from the greater trochanter with walking aids measured 5cm below, at the greater trochanter and 5cm above. All patients walked for ten meters with each cane length to measure speed. Then, we measured the opto gait, timed up go test, and electromyography three times each. Statistical analysis was performed using a linear mixed model, and in the case of significance, the p-value was corrected using the Bonferroni method. Results: There was a statistically significant differences in time up and go test(TUGT), 10m walking, stride and speed between the groups. Conclusions: Long cane length increases body symmetry, stride, increasing muscle activity, and short cane length increases balance and walking.

• Hip & pelvis
• /
• v.35 no.2
• /
• pp.99-107
• /
• 2023

Purpose: Bipolar hemiarthroplasty has recently been acknowledged as an effective option for treatment of unstable intertrochanteric fracture. Trochanteric fragment nonunion can cause postoperative weakness of the abductor muscle and dislocation; therefore, reduction and fixation of the fragment is essential. The purpose of this study was to perform an evaluation and analysis of the outcomes of bipolar hemiarthroplasty using a useful wiring technique for management of unstable intertrochanteric fractures. Materials and Methods: A total of 217 patients who underwent bipolar hemiarthroplasty using a cementless stem and a wiring technique for management of unstable intertrochanteric femoral fractures (AO/OTA classification 31-A2) at our hospital from January 2017 to December 2020 were included in this study. Evaluation of clinical outcomes was performed using the Harris hip score (HHS) and the ambulatory capacity reported by patients was classified according to Koval stage at six months postoperatively. Evaluation of radiologic outcomes for subsidence, breakage of wiring, and loosening was also performed using plain radiographs at six months postoperatively. Results: Among 217 patients, five patients died during the follow-up period as a result of problems unrelated to the operation. The mean HHS was 75±12 and the mean Koval category before the injury was 2.5±1.8. A broken wire was detected around the greater trochanter and lesser trochanter in 25 patients (11.5%). The mean distance of stem subsidence was 2.2±1.7 mm. Conclusion: Our wiring fixation technique can be regarded as an effective additional surgical option for fixation of trochanteric fracture fragments during performance of bipolar hemiarthroplasty.