• Title/Summary/Keyword: Neck fracture

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Mid-term outcomes of bony increased offset-reverse total shoulder arthroplasty in the Asian population

  • Tankshali, Kirtan;Suh, Dong-Whan;Ji, Jong-Hun;Kim, Chang-Yeon
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.125-134
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    • 2021
  • Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

A Study on Characteristics of Motorcycle Accident among Korean Elderly using Medical Record Information (의무기록 정보를 활용한 노인 오토바이 운수사고의 특성에 관한 연구)

  • Hye-Rang Kim;Moo-Sik Lee;Arma Park;Kwang-Hwan Kim
    • Journal of Digital Convergence
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    • v.21 no.2
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    • pp.17-25
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    • 2023
  • The purpose of this study was to analyze the characteristics of elderly motorcycle accidents according to data from elderly inpatients to prepare prevention measures for the elderly against injury in motorcycle accidents. Chi-squared test, independent sample t-test, and canonical correlation analysis were performed on the Korea Disease Control and Prevention Agency's National Hospital Discharge In-depth Injury Survey data from 2015 to 2019, from which the records of 1,384 elderly inpatients hospitalized because of motorcycle accidents were obtained. intracranial injury(S06) was the most common care and treatment characteristic for both age groups. The most frequent injury site was the head and neck, and the most frequent injury type was a fracture. The above findings show that prevention education and policy formulation at the national level are necessary to identify and manage the factors of elderly motorcycle accidents. This study provides basic data for developing measures and policies to prevent and reduce injuries, making it significant for public health causes.

Comparison Study of Different Approach (Deltoid Splitting Approach and Delto-pectoral Interval Approach) for Proximal Humeral Fractures (근위 상완골 골절의 수술적 치료에서 삼각근 분할 도달법과 삼각 대흉간 도달법의 임상적, 방사선학적 추시 결과 비교)

  • Kim, Seung-Hee;Dan, Jinmyoung;Kim, Byoung-Kook;Lee, Yun-Seok;Kim, Hyoeng-Jung;Ryu, Keun-Jeong;Lee, Jin-Hyun;Kim, Jae-Hwa
    • Clinics in Shoulder and Elbow
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    • v.16 no.1
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    • pp.17-26
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    • 2013
  • Purpose: A comparison of the radiographic and the clinical outcomes between two different surgical approaches-Deltoid splitting and Delto-pectoral interval-on the proximal humerus fractures treated by locking compressive plate (LCP), is done. Materials and Methods: Medical records and pre- and postoperative radiographs were reviewed retrospectively for 75 adult patients who underwent surgical fixations with locking compressive plates from May 2005 to December 2011. Patients were divided into two groups according to the surgical methods. Differences in the neck-shaft angle between immediate postoperative period and final follow-up were compared between the two groups. Differences in constant score and Korean shoulder score (KSS) between affected arms and contralateral arms at final follow-up were also compared. Results: The differences in the neck-shaft angle between immediate postoperative period and at final follow-up was 12.04 degrees on average in Deltoid splitting approach and 10.20 degrees in Delto-pectoral interval approach, which was not statistically significant. Differences in constant score/KSS between the affected arm and the contralateral arm were 13.78/22.74 points in deltoid-splitting approach on average and 19.41/31.13 points in Delto-pectoral interval approach, showing that deltoid-splitting approach is significantly superior. Conclusion: Deltoid-splitting approach showed better functional outcomes in the fracture reduction and internal fixation using LCP for the treatment of unstable proximal humerus fractures.

The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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Effect of Tightening Torque on Abutment-Fixture Joint Stability using 3-Dimensional Finite Element Analysis (임플란트 지대주나사의 조임회전력이 연결부 안정성에 미치는 영향에 관한 3차원 유한요소해석 연구)

  • Eom, Tae-Gwan;Suh, Seung-Woo;Jeon, Gyeo-Rok;Shin, Jung-Wook;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.125-135
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    • 2009
  • Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.

Relationships of Changing Social Atmosphere, Lifestyle and Bone Mineral Density in College Students (대학생의 골밀도와 사회분위기 및 생활습관과의 관계)

  • Lee, In-Ja;Ko, Yo-Han;Kim, Chung-Kyung;Kim, Hee-Sol;Park, Da-Jeong;Yoon, Hyeo-Min;Jeong, Yu-Jin
    • Journal of radiological science and technology
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    • v.36 no.4
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    • pp.263-271
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    • 2013
  • The decrease of bone mineral density gives rise to the outbreak of osteopenia and makes the possibility of a bone fracture. It makes health problems in society. It's very important to prevent osteopenia in advance. Also it's critical to prevent and take care of it in adolescent because it's the most developing period comparing to middle ages because that bone mineral density decreases. There are genetic, physical and enviromental factors that affect bone mineral density. Recently, a lifestyle and eating habits are also changing as the society atmosphere is gradually doing. This study have shown that 134 women and 75 men was chosen and responded to the survey of measuring bone mineral density and investigating a lifestyle. The measure of bone mineral density is to use Dual energy X-ray absorptiometry(DEXA) and check femoral neck and lumbar spine. Also questionaries was required to pre-made survey about their lifestyles. Analysis of data was done with SPSS program. Multiple regression analysis was used for the relation of bone mineral density, the heigths and BMI. The sample of Groups are checked for drinking, smoking or excercising about differences by t-test. The results of the experiments were; first, there is statistically significant differences in the comparisons between BMD and BMD. But there isn't any special correlation between drinking, smoking and BMD. Secondly, bone mineral density becomes low related to an intake of caffeine. Particularly, this is statically significant on women. Also there is statically significant correlation between femoral neck and quantity of motion for both men and women. Third, there is significant relation between eating habits and bone mineral density on women's lumbar spine. However, there is no significant relation between men's lumbar spine and women's one. Therefore, to prevent osteopenia, it's good to abstain from intaking caffeine within an hour after a meal. In addition, it's helpful to walk or run regularly and have a balanced meal.

Use of Mouthguard for Prevention of Oral and Maxillofacial Injury (구강악안면영역의 외상방지를 위한 마우스가드의 사용)

  • Shim, Young-Joo;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.251-256
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    • 2012
  • With today's heightened interest in quality of life, leisure and sports activities were popular in the general public. Accordingly, the incidence of oral and maxillofacial injury are also rising. Use of a mouth protector to prevent the trauma of the oral and maxillofacial region is growing in importance, and among the mouth protector the mouthguard is the most commonly used. Mouthguard has been suggested to protect injuries by (1) preventing tooth injuries by absorbing and deflecting blows to the teeth; (2) shielding the lips, tongue, and gingival tissues from laceration; (3) preventing opposing teeth from coming into violent contact; (4) providing the mandible with resilient support, which absorbs an impact that might fracture the unsupported angle or condyle of the mandible; (5) preventing neck and cerebral brain injuries. Although mouthguard is effective for prevention of oral and maxillofacial injury, it is not widespread to athletes or general public and they are lack of awareness about the importance of mouthguard. We present the types and materials of mouthguard, things to consider when mouthguard fabrication, and the usage. This should be helpful in awareness about the importance and popularization of mouthguard.

The Comparative Study on the Prevalence of Injury/Poisoning in the Agricultural and Fishery Population and the General Population (농어업인과 비농어업인의 손상, 중독 유병률 비교 연구)

  • Im, Hyoung-June;Kwon, Young-Jun;Yim, Jun;Ju, Young-Su;Lee, Kyung-Suk;Kim, Kyung-Ran
    • Journal of agricultural medicine and community health
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    • v.33 no.1
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    • pp.82-89
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    • 2008
  • Objective: We compared the prevalence of injury and poisoning in the agricultural and fishery population with that of the general population.Methods: The national health insurance data and agricultufor this study. The age-adjusted standardized morbidity ratio was used to compare the prevalence of all injuries and poisonings of the agricultural and fishery population with that of the general population for the year 2002, as well as the prevalence of certain injuries and poisonings common to the agricultural and fishery population. The age-adjusted standardized morbidity ratio and 95% confidence intervals were attained by using the general population as the standard population group.Results: The age-adjusted standardized morbidity ratio of total injuries and poisonings was significantly high in the agriculture and fishery population. The standardized morbidity ratio was 137.6 in the male agriculture and fishery population and 123.3 in the female agriculture and fishery population. In terms of injuries and poisonings common to the agriculture and fishery population, the age-adjusted standardized morbidity ratio was significantly high regarding the dislocations and strains of lumbar spine/pelvis, shoulder and neck, the fracture of rib/thoracic spine/sternum and pesticide poisoning.Conclusions: The overall prevalence of injury/poisoning was significantly higher in the agriculture and fishery population than in the general population. Various forms of research should be conducted on the injuries of the agriculture and fishery population in the future. In order to compare the differences in the prevalence rates of injuries according to time and region, standard definitions of injuries and occupation related injuries are required.

Bisphosphonates for Osteoporosis in Nonmetastatic Prostate Cancer Patients Receiving Androgen-deprivation Therapy: A Systematic Review and Meta-analysis

  • Ding, Hui;Yang, Li;Du, Wan;Teng, Yang;Fu, Sheng-Jun;Tao, Yan;Lu, Jian-Zhong;Wang, Zhi-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3337-3343
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    • 2013
  • This systematic review was conducted to assess the efficacy and safety of bisphosphonates for prevention and treatment of osteopenia or osteoporosis in men with non-metastatic prostate cancer receiving androgendeprivation therapy. We searched for randomised controlled trials (RCTs) of bisphosphonates compared with placebo from Pubmed, Embase, the Cochrane Library, and ISI - Science Citation Index. Meta-analyses of prespecified outcomes (bone mineral density, fractures, and adverse events) were performed using Review Manager. Ten RCTs with a total patient population of 1,017 were identified. There was generally more improvement in bone mineral density of the lumbar spine for patients who received bisphosphonate treatment than placebo or other medical treatment at 12 months (WMD 6.02,95%CI 5.39 to 6.65). Similar effects were also observed for total hip, trochanter or femoral neck bone mineral density. However, there was no significant reduction in fractures. Fever and gastrointestinal symptoms were the most common adverse events (10.4% vs. 1.2%; 0.10% vs. 0.03%). Currently, our meta-analysis suggested that oral and intravenous bisphosphonates caused a rapid increase in spine and hip or femoral BMD in non-metastatic prostate cancer patients receiving androgen-deprivation therapy. Fever and gastrointestinal symptoms were common with the use of bisphosphonates. These short-term trials (maximum of 12 months) did not show fracture reduction. In future, more efficient performance of higher quality, more rigorous, large sample, long-term randomised controlled trials (>12 months) are needed where outcomes are detailed.

Subtalar Distraction Arthrodesis Using Frozen Allobone Graft by Interpositional Structural (동결 동종골의 구조적 삽입을 이용한 거골하 신연 유합술)

  • Choi, Jang-Seok;Kwak, Ji-Hoon;Jun, Sung-Soo;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.201-206
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    • 2011
  • Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.