• Title/Summary/Keyword: femur fracture

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Congenital Insensitivity to Pain with Anhidrosis: Five-Year-Old Girl with a Neglected Distal Femur Fracture (선천성 무통증과 무한증: 5세 여아에서 발생한 방치된 원위 대퇴골 골절)

  • Woo, Seung Hun;Kim, Tae Woo;Bae, Jung Yun;Kwak, Sang Ho
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.463-468
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    • 2019
  • Congenital insensitivity to pain with anhidrosis (CIPA) is a rare disease that affects the sensory and autonomic nervous system. The patients do not have the ability to sense different sensations, such as pain, which tends to lead to different injuries. In addition, the patients suffer from fluctuations in body temperature due to autonomic involvement. The present case was a five-year-old girl with a neglected distal femur fracture. X-rays taken during the follow-up showed marked callus formation and pseudarthrosis of the distal femur. She had biting injuries of the tongue, auto-amputation of the fingers, some developmental delay and a history of recurrent fever with an unknown origin. The electrodiagnostic study was normal. The quantitative sudomotor axon reflex test revealed markedly reduced postganglionic sudomotor axonal responses at all sites recorded on the left. She was diagnosed with CIPA. As the initial presentation of CIPA involves the musculoskeletal system, orthopedic surgeons should have a high index of suspicion.

Association Between Pelvic Bone Computed Tomography-Derived Body Composition and Patient Outcomes in Older Adults With Proximal Femur Fracture

  • Tae Ran Ahn;Young Cheol Yoon;Hyun Su Kim;Kyunga Kim;Ji Hyun Lee
    • 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.

A Study on the Main Diagnostic Code according to the Analysis of the Frequency of Fall Patients by Case-Centered Damage External Code (사례 중심의 손상외인코드 별 낙상환자 빈도수 분석에 따른 주진단코드 연구)

  • Eun-Mee Choi;Ye-Ji Park;So-Hyeon Bang;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.6
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    • pp.533-539
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    • 2023
  • This study aimed to analyze patients hospitalized for injuries who fell using the data from 2020 to 2021 at institution A located in Gangneung-si, Gangwon-do, using codes for causes of injury. After classifying 20 codes from W00 to W19, which are external cause codes for fall patients, the most frequently occurring W18, W01, W10, and W13 were analyzed. The external cause of injury code W18 was other falls on the same plane, with the highest frequency of S72 and Z47, S72 being a fracture of the femur, and Z47 being orthopedic follow-up treatment. The external injury code W01 was determined to be a fall on the same plane due to slipping, tripping, and tripping, and like W18, S72, a fracture of the femur, and Z47, orthopedic follow-up treatment, were frequently reported. In W10, intracranial injuries such as concussion and epidural hemorrhage due to a fall on the stairs, S06, were common. Lastly, in W13, 91% of cases occurred in people in their 40s to 70s due to falls from buildings or structures, confirming that they occur frequently in middle-aged people, Z47 had the most frequent orthopedic follow-up treatment, and S72 had a fracture of the femur. It was found to be the second most common. In this way, the frequency of falling patients was analyzed, and the age and main diagnosis code at which most falls occurred were analyzed.

Effects of Extracts from Cnidium officinale and Angelica sinensis on Bone Fusion in Mice with Femoral Fracture (당귀천궁복합물이 대퇴골 골절 동물모델에서 골 유합에 미치는 영향)

  • Sang Woo Kim;Min-Seok Oh
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.1-14
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    • 2024
  • Objectives The purpose of this study is to evaluate the fracture healing effect of extracts from Cnidium officinale and Angelica sinensis (CO/AS) in mice with femoral fracture. Methods C57BL/6 mice were randomly divided into normal, control (phospate-bufferd saline), positive control (tramadol), CO/AS extract 40 mg/kg and 80 mg/kg. By using Collier's method, all groups except normal group went through femoral fracture. Aspartate aminotransferase (AST), alanine transferase (ALT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN) and creatinine were measured to evaluate the safety of CO/AS. Hematoxylin & eosin, Safranin O staining, x-ray, tensile and compressive force were conducted to assess the effect of CO/AS on fracture. Results The liver function test showed AST, ALT and LDH in CO/AS at 14th and 28th days were not significantly different compared with control group. The renal function test showed BUN in CO/AS at 14th days and BUN and creatinine in CO/AS at 28th days were significantly decreased compared with control group. The morphological & histological analysis and x-ray showed that CO/AS promoted cartilage and callus formation process compared with control group. The tensile and compressive forces test showed tensile in CO/AS 40 mg/kg and tensile & compressive forces in CO/AS 80 mg/kg were significantly increased compared with control group. Conclusions CO/AS extract showed the possibility that it promotes early fracture union and increases bone tensile and compressive strength, while does not have hepatotoxicity. In conclusion, CO/AS has a potential to promote healing of bone fracture and this study warranted the clinical usage of CO/AS at bone fracture.

The Mediating Effect of Fall Risk Perception on the Relationship between Fracture Risk and Fall Prevention Behaviors in Women with Osteoporosis (골다공증 여성의 골절위험도와 낙상예방행위와의 관계에 미치는 낙상위험지각의 매개효과)

  • Lee, Eun Nam;Choi, Eun Jung;Jang, Moon Jung;Hwang, Hyun Ju
    • Journal of muscle and joint health
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    • v.22 no.2
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    • pp.130-137
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    • 2015
  • Purpose: This study aims to establish a theoretical framework for the fall prevention behavior improvement program by verifying the associations between fracture risk, fall risk perception, and fall prevention behaviors in women with osteoporosis. Methods: A survey was conducted in 122 women who were diagnosed as osteoporosis by having T-score of the femur bone density below -2.5 standard deviation from the bone density examination performed in 2 orthopedic clinics located in B metropolitan city between July 2014 and September 2014. The risk of fracture, level of fall risk perception, and fall prevention behaviors were measured. Results: Fall risk perception had a complete mediating effect on the relationship between the fracture risk and fall prevention behaviors in women with osteoporosis. Conclusion: The perception of fall risk is important to enhance fall prevention behaviors in women with osteoporosis, and the development of various education programs to improve awareness of fall risk is needed.

Alteration of Hepatic Drug Metabolizing Function after Traumatic Injury

  • Lee, Woo-Yong;Lee, Sang-Ho;Lee, Sun-Mee
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.301.1-301.1
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    • 2002
  • The aim of present study was to investigate effects of blunt trauma on alterations in cytochrome P-450 (CYP)-dependent drug metabolizing function and to determine the role of Kupffer cells in the hepatocellular dysfunction Rats underwent closed femur fracture (FFx) with associated soft-tissue injury under anesthesia. Control animals received only anesthesia. To deplete Kupffer cells in vivo, gadolinium chloride (GdCl3) was injected intravenously via the tail vein at 7.5 mg/kg body wt. 1 and 2 days before surgery. (omitted)

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Bilateral anterior dislocation in the hips: a case report

  • Dheeraj Makkar;Ravi Sauhta
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.70-73
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    • 2023
  • The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.

Two Solitary Lesions of Fibrous Dysplasia in the Tibia (A Case Report) (경골 내에 동시에 발생한 독립된 2개의 섬유성 골 이형성증(1예 보고))

  • Lee, Jin-Young;Kim, Gab-Lae;Kang, Jung-Woo;Ahn, Joo-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.32-35
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    • 2011
  • Fibrous dysplasia is a benign disease that causes replacement of the medullary bone with fibrous tissue in one or more bones. Long bone like femur, tibia and fibular are often affected and occurring under 30 years old. We report a case of two solitary lesions of fibrous dysplasia with pathologic fracture treated with bone curettage, bone graft, plate fixation, who complains of lower leg pain.

Analysis of Fracture Risk due to Alterations of Bone Quality by Metastatic Bone Tumor (전이성 골암으로 인한 골질 변화와 이로 인한 골절 위험성 분석)

  • Lim, Dohyung
    • Journal of Biomedical Engineering Research
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    • v.33 no.4
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    • pp.213-222
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    • 2012
  • While much has been learned about the mechanisms of metastatic spread of cancer to bone, there has been little headway in establishing guidelines for monitoring the alteration in bone quality and estimating fracture risk. The aims of this study are, therefore, 1) to evaluate bone quality induced by metastatic bone tumor by analyzing the characteristics on bone microarchitecture and degree of bone mineralization and 2) analyze fracture risk increased secondary to the bone quality changes by metastatic bone tumor through calculating mechanical rigidities based on in-vivo micro CT images. For this study, eighteen female SD rats (12 weeks old, approximate 250 g) were randomly allocated in Sham and Tumor groups. W256 (Walker carcinosarcoma 256 malignant breast cancer cell) was inoculated in the right femur (intraosseous injection) in Tumor group, while 0.9% NaCl (saline solution) was injected in Sham group. The right hind limbs of all rats were scanned by in-vivo micro-CT to acquire structural parameters and degree of bone mineralization at 0 week, 4 weeks, 8 weeks, and 12 weeks after surgery. At the same time, urine was collected by metabolic cages for a biochemical marker test in order to evaluate bone resorption. Then, bone metastasis had been directly identified by positron emission tomography. Finally, axial, bending and torsional rigidities had been calculated based on in-vivo micro CT images for predict fracture risk. The results of this study showed that metastatic bone tumor might induce significant decrease in bone quality and increase of fracture risk. This study may be helpful to monitoring a degree of bone metastasis and predicting fracture risk due to metastatic bone tumor. In addition, this noninvasive diagnostic methodology may be utilized for evaluating other bone metabolic diseases such as osteoporosis.