• Title/Summary/Keyword: Orthopedic treatment

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Fragility Fractures of the Pelvis and Sacrum: Current Trends in Literature

  • Erick Heiman;Pasquale Jr. Gencarelli;Alex Tang;John M. Yingling;Frank A. Liporace;Richard S. Yoon
    • Hip & pelvis
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    • v.34 no.2
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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.

Treatment of Osteoporosis after Hip Fracture: Survey of the Korean Hip Society

  • Jung-Wee Park;Je-Hyun Yoo;Young-Kyun Lee;Jong-Seok Park;Ye-Yeon Won
    • Hip & pelvis
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    • v.36 no.1
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    • pp.62-69
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    • 2024
  • Purpose: To assess current practice in the treatment of osteoporosis in patients who underwent treatment for hip fracture in South Korea. Materials and Methods: A survey of 97 members of the Korean Hip Society, orthopedic hip surgeons who administer treatment for hip fractures in South Korea, was conducted. The survey was conducted for assessment of demographic data and perceptions regarding the management of osteoporosis in patients who have undergone treatment for hip fracture. Analysis of the data was performed using descriptive statistical methods. Results: The majority of participants were between the age of 41 and 50 years, and 74% were practicing in tertiary hospitals. Testing for serum vitamin D levels (82%) was the most commonly performed laboratory test. Calcium and vitamin D were prescribed for more than 80% of patients by 47% and 52% of participants, respectively. Denosumab was the most commonly used first-line treatment option for osteoporosis in hip fracture patients. Bisphosphonate was most often perceived as the cause of atypical femoral fractures, and the most appropriate time for reoperation was postoperative 12 months. Teriparatide was most preferred after cessation of bisphosphonate and only prescribing calcium and vitamin D was most common in high-risk patients for prevention of atypical femoral fracture. Conclusion: The results of this study that surveyed orthopedic hip surgeons showed that most participants followed the current strategy for management of osteoporosis. Because the end result of osteoporosis is a bone fracture, active involvement of orthopedic surgeons is important in treating this condition.

Diagnosis and treatment of calcific tendinitis of the shoulder

  • Kim, Min-Su;Kim, In-Woo;Lee, Sanghyeon;Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.23 no.4
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    • pp.203-209
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    • 2020
  • Calcific tendinitis is the leading cause of shoulder pain. Among patients with calcific tendinitis, 2.7%-20% are asymptomatic, and 35%-45% of patients whose calcific deposits are inadvertently discovered develop shoulder pain. If symptoms are present, complications such as decreased range of motion of the shoulder joint should be minimized while managing pain. Patients with acute calcific tendinitis respond well to conservative treatment and rarely require surgery. In contrast, patients with chronic calcific tendinitis often do not respond to conservative treatment and do require surgery. Clinical improvement takes time, even after surgical treatment. This review article summarizes the processes related to the diagnosis and treatment of calcific tendinitis with the aim of helping clinicians choose appropriate treatment options for their patients.

Conservative Treatment of the Knee Injury and Pain (슬관절 손상과 동통의 보존적 치료)

  • Bin Seoung-I1;Nam Tae-Seok;Ahn Ji-Hyun;Jung Kwang-Whan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.107-110
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    • 2004
  • Treatment of knee injury and pain consists of conservative and surgical treatment. Although conservative treatment is suffice in many cases, surgical treatment is performed which is not necessary. Therefore, thorough knowledge of injury mechanism and selection of treatment modalities are required. Injury mechanism and conservative treatment of knee injury patients will be discussed.

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Lateral Epicondylitis: Current Concept

  • Jeon, In-Ho;Kekatpure, Aashay Laxmikant;Sun, Ji-Ho;Shim, Kyeong-Bo;Choi, Sung-Hoon;Lim, Sung-Joon;Chun, Jae-Myeung
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.138-144
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    • 2014
  • Lateral epicondylitis is one of the most common causes of elbow pain and has been known to be caused by degeneration of the extensor carpi radialis brevis (ECRB). Nonoperative treatment should be tried first in all patients, because it has been deemed highly successful; however only few prospective studies suggest that symptoms frequently was completely resolved. Operative treatment is indicated for recalcitrant pain after failed conservative treatment, which involves excision of the pathologic portion of the ECRB and results in a high degree of subjective relief and functional restoration. We will review the pathology of the lateral epicondylitis and operative and nonoperative treatment of lateral epicondylitis.

Treatment of soft Tissue Sarcoma by General Orthopedic Surgeon Rather than Orthopedic Oncologist (골연부조직 종양 전공자가 아닌 일반 정형외과 전문의에 의해 치료된 연부조직육종)

  • Lee, Soon-Hyuck;Park, Jong-Hoon;Park, Sang-Won;Choi, In-Chung;Han, Seung-Beom;Lee, Suk-Ha;Kim, Ho-Joong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.75-80
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    • 2007
  • Purpose: To investigate the quality of training hospital based treatment, we evaluated the soft tissue sarcoma treatments afforded by general orthopedic surgeon rather than orthopedic oncologist. Materials and Methods: We reviewed the details of 25 patients with pathologically confirmed soft tissue sarcoma who registered in our hospital between July 1997 and 2006 September. We evaluated initial diagnoses, the surgical treatment (including adjuvant therapy) and the follow up method used and related these to the principles of soft tissue sarcoma treatment. Results: The study cohort comprised 16 men and 9 women of mean age of 50.2 years. A diagnostic biopsy was performed in 9(36%) cases before definitive surgical treatment. Wide excision was performed in 13(52%) cases. For the 12 cases in which the grade of sarcoma was estimated, adequate surgical treatment with adjuvant therapy was performed only in 4(33.3%) cases. In addition, an adequate follow up schedule was adopted in only 4(16%) of the 25 study subjects. Conclusion: Unexpectedly, many cases of soft tissue sarcoma were treated inadequately even in a training hospital. An intensive education program on the treatment of soft tissue sarcoma is necessary for all orthopedic surgeons.

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Considerations in Kaltenborn-Evjenth Concept Related History of Orthopedic Physical Therapy (Kaltenborn-Evjenth 정형물리치료에 대한 문헌적고찰(정형물리치료의 역사와 관련된 문헌을 중심으로))

  • Yoon, Jung-Gyu
    • Journal of Korean Physical Therapy Science
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    • v.7 no.1
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    • pp.275-284
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    • 2000
  • Orthopedic medicine specializes in the diagnosis and treatment of musculoskeletal conditions. The physical therapy speciality, Orthopedic Manipulative Therapy(OMT) is an important part of orthopedic medicine. Much of OMT is devoted to the evaluation and treatment of joint and related soft tissue disorders and one of the primary treatment methods is mobilization. When examination reveals joint dysfunction, especially decreased range of motion, joint mobilization techniques are often utilized. Soft tissue mobilization techniques are used to improve mobility and other soft tissues. The therapist should have precautions for a patient. These precautions are based on the patient's concurrent medical and surgical diagnosis. Lastly, the literature describing therapeutic interventions in patients with musculoskeletal problem is poor because the painful conditions are poorly characterized and the therapeutic interventions are poorly described; so, where Kaltenborn-Evjenth concept for patient with musculoskeletal problem were identified, the treatment concept are introduced.

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Comparative Study of Surgical Treatment for Concomitant Ankle Joint Injury in Tibia Shaft Fracture (경골 간부 골절에서 족관절 손상에 대한 수술적 치료의 비교 연구)

  • Jinho Park;Seungjin Lee;Hyobeom Lee;Gab-Lae Kim;Jiwoo Chang;Heebum Hahm
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.3
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    • pp.87-92
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    • 2023
  • Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

Treatment of Superficial Peroneal Nerve Entrapment Syndrome under Local Anesthesia using Ultrasonogram (초음파를 이용한 국소마취하 표재비골신경 포착증후군의 치료)

  • Lee, Kyung-Chan;Kwak, Ji-Hoon;Hwang, Chul-Ho;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.3
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    • pp.215-219
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    • 2013
  • Purpose: To review the outcomes of surgical treatment for superficial peroneal nerve entrapment. Materials and Methods: Ultrasonogram was used for diagnosis and surgical treatment. Seven superficial peroneal nerve entrapment were surgically treated with follow up of average 16 months (range, 6~29 months). Three patients were male and four patients were female with mean age 36.7 years (range, 19~51 years). Four cases developed after repetitive ankle sprain and three cases had no etiology. Results: Operation was performed mini-open and subcutaneous fasciotomy under local anesthesia. The results were excellent in two cases, good in four cases, fair in one case. Conclusion: Ultrasonogram was useful for diagnosis and surgical treatment of superficial peroneal nerve entrapment syndrome.