• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.317-326
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• 2019

Purpose: To compare and analyze the rate of prevention of two venous thromboembolism prophylaxis guidelines in patients with artificial joint arthroplasty and hip joint fracture. Proper prophylaxis for preventing thromboembolism in orthopedic surgery is significant because of this fetal complication. Materials and Methods: This study compared and retrospective analyzed the rate of prevention using the medical records and radiographs of patients who underwent orthopedic surgery from March 2009 to February 2011 according to the American College of Chest Physicians (ACCP) guidelines and from March 2012 to February 2014 according to the American Academy of Orthopedic Surgeons (AAOS) guidelines. Results: The guidelines for venous thromboembolism prophylaxis have been applied to patients with artificial joint replacement and hip joint fracture, the compliance rate of the ACCP guidelines was 56.0% before surgery, 67.0% after surgery with chemical prophylaxis, and 80.5% with mechanical prophylaxis. In addition, the compliance rate of the AAOS guidelines was 74.1% with chemical prophylaxis, and 88.3% with mechanical prophylaxis, which was higher than the ACCP guidelines. The compliance rates of mechanical and chemical prophylaxis before and after surgery of the ACCP guidelines, and the compliance rate of mechanical and chemical prophylaxis of the AAOS guidelines were compared and analyzed. The results revealed statistical significance (p<0.05) before and after total knee replacement arthroplasty and hip joint fracture internal fixation and total high risk orthopedic surgery. Conclusion: Raising the compliance rate of prophylaxis of venous thromboembolism in high risk orthopedic surgery is necessary and people should follow the guidelines for a unified direction depending on which situation they are in.

• Journal of Korean Academy of Nursing
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• v.24 no.1
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• pp.115-128
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• 1994

The purpose of this study was to observe the change of circumference, volume and strength of normal and operated lower extremities on 3rd, 7th, 10th, and 14th days of postoperation following THRA compared with their condition on preoperation day. Subjects consisted of 13 male and 7 female Patients operated with THRA between the age of 20 and 69 years with a mean age of 38.55(SD=15.1). Circumference of upper and lower leg was measured by tape, leg volume was determined according to formula (Moor & Thornton, 1987) with measurement of 8 circumferences of leg. Leg strength was measured by pressing the center of digital health meter in supine position. The results can be summarized as follows : 1. Circumference of operated thigh decreased significantly at 14 following THRA compared with preoperative value, while that of normal thigh decreased significantly at day 3, 7, 10 and 14 after THRA compared with preoperative value. 2. Circumference of midcalf in both operated and normal limb decreased significantly at day 3, 7, 10 and 14 following THRA compared with preoperative value. 3. Leg volume of operated lower limb decreased significantly at 10, 14 following THRA compared with preoperative value, while that of normal limb decreased significantly at day 7 & 10 after THRA compared with preoperative value.4. Leg strength of operated limb decreased significantly at day 3, 7, 10, 14 following THRA compared with preoperative value. No significant difference of normal leg strength was shown following THRA. 5. Circumference of midcalf differed significantly at day 14 after THRA between normal and operated extremity. From these results, it can be suggested that a decreased activity after THRA caused muscle atrophies in normal and operated extremity.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.11-22
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• 1985

Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture In itself were noted, but we have analyzed 18 femur neck fractures of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slip-down accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and Internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. 4 undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with pre-existing disease in the same hip Joint (total hip replacement).