• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.177-182
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• 2017

Schwannomas are benign nerve sheath tumors that are typically located in soft tissue. Occasionally, schwannomas involve osseous structures. These intraosseous schwannomas are generally benign neoplasms that account for less than 0.2% of primary bone tumors. Schwannomas are very rarely observed in long bones. We present a case of a schwannoma affecting the proximal femur with a coincident subchondral fracture of the femoral head. A 38-year-old-male presented with left hip pain without deteriorating locomotor function. Plain film radiographs displayed a lobulating contoured lesion within the intertrochanteric portion of the femur. The magnetic resonance imaging (MRI) scans showed a tumor occupying the intertrochanteric region. Diffuse bone marrow edema, especially in the subchondral and head portions of the femur that was possibly due to the subchondral insufficiency fracture was also noted. The lesion was surgically excised and bone grafting was performed. Histologically, there was diffuse infiltrative growth of the elongated, wavy, and tapered cells with collagen fibers, which are findings that are characteristic of intraosseous schwannoma. Although very rare, intraosseous schwannoma should be included in the differential diagnosis of radiographically benign-appearing, non-aggressive lesions arising in the femur. The concomitant subchondral fracture of the femoral head confounded the correct diagnosis of intraosseous schwannoma in this case.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.220-225
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• 2019

Purpose: Mechanical ventilation (MV) is an essential life-saving modality for severely injured patients. However, the long-term use of MV is a major risk factor for late mortality. The surgical correction of long bone fractures plays a critical role not only in improving functional outcomes, but also in reducing physiological derangements, including MV duration. This study investigated the factors affecting prolonged MV (PMV) in severely injured patients with femur fractures. Methods: We retrospectively evaluated all severely injured patients (injury severity score >15) with femur fractures who were taken to the emergency department within 12 hours of the causative accidents between January 2016 and December 2018. PMV was defined as MV lasting for ≥7 days. We analyzed the factors affecting PMV. Results: In total, 35 patients were enrolled and 21 (33.3%) were included in the PMV group. The PMV group required more red blood cell (RBC) transfusions within 7 days RBC (7dRBC) (12.8 vs. 6.8 units; p=0.03) and the time to femur fracture fixation (TFFF) was longer (7.9 vs. 2.7 days; p=0.018). The area under the curve (AUC) for TFFF was 0.740 (95% confidence interval [CI]: 0.572-0.908; p=0.018) and the AUC for 7dRBC was 0.718 (95% CI: 0.546-0.889; p=0.031). Conclusions: This study indicates that TFFF is an independent risk factor for PMV. Early fixation of femur fractures might prevent PMV and its associated complications.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.346-349
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• 2015

Objective : To investigate the value of lumbar bone mineral density (BMD) in fracture risk assessment (FRAX) tool. Methods : One hundred and ten patients aged over 60 years were enrolled and divided into 2 groups as non-osteoporotic vertebral fracture (OVF) and OVF groups. The 10-year-risk of major osteoporotic vertebral fracture of each group was calculated by FRAX tool with femoral and lumbar spine BMDs to compare the usefulness of lumbar spine BMD in prediction of OVF. The blood level of osteocalcin and C-terminal telopeptide (CTX) as markers of activities of osteoblast and osteoclast, respectively were analyzed using the institutional database. Results : In the OVF group, the ratio of patients with previous fracture history or use of glucocorticoid was higher than those in non-OVF group (p=0.000 and 0.030, respectively). The levels of T-score of femur neck and lumbar spine in OVF group were significantly lower than those in non-OVF group (p=0.001 and 0.000, respectively). The risk of OVF in FRAX using femur BMD in non-OVF and OVF groups was $6.7{\pm}6.13$ and $11.4{\pm}10.06$, respectively (p=0.007). The risk of using lumbar BMD in the 2 groups was $6.9{\pm}8.91$ and $15.1{\pm}15.08$, respectively (p=0.002). The areas under the receiver operator characteristic curve in the FRAX risk with lumbar and femur neck BMD were 0.726 and 0.684, respectively. The comparison of osteocalcin and CTX was not significant (p=0.162 and 0.369, respectively). Conclusion : In our study, the 10-year risk of major osteoporotic fracture in the OVF group of our study was lower than the recommended threshold of intervention for osteoporosis. Hence, a lower threshold for the treatment of osteoporosis may be set for the Korean population to prevent OVF. In the prediction of symptomatic OVF, FRAX tool using lumbar spine BMD may be more useful than that using femur neck BMD.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.2
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• pp.19-35
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• 2020

Objectives The aim of this study is to evaluate the fracture healing effect of Jinmu-tang (JM) on femur fractured rats. Methods Rats were randomly divided into 5 groups (normal, control, positive control, JM extract with low concentration and JM extract with high concentration). All group except normal group went through both femur fracture. Normal and control group received no treatment at all. Positive control group were medicated with tramadol (20 mg/kg) once a day for 14 days. Experimental group was orally medicated with JM extract (10 mg/kg for low concentration, 50 mg/kg for high concentration) once a day for 14 days. In order to investigate fracture healing process, plasma and serum were obtained. Also, micro-computed tomography was conducted to see the frature site visually. Immunohistochemistry for transforming growth factor-β1, Ki67, alkaline phosphatase, runt-related transcription factor 2, receptor activator of nuclear factor kappa-β, tartrate resistant acid phosphatase was conducted to observe bone healing progress after 14 days since fracture occured. Aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine levels were measured in plasma, for hepatotoxicity and nephrotoxicity of JM extract. Osteocalcin was measured to observe activity of osteoblast. Results Through Micro-CT, more fracture healing was observed on both experimental group than control and positive control group. Through Hematoxylin & Eosin and safranin O staining showed bone cell proliferation and bone formation in the experimental group. RANK was significantly increased in the experimental groups. JM with high concentration showed statistically significant of TGF-β and Osteocalcin. NO, TRAP and ALP were not significantly changed. Liver toxicity was not significantly observed. Creatinine significantly increased in both experimental groups after 28 days. Conclusions As described above, JM extract showed anti-inflammatory effect, promoted fracture healing by stimulating the bone regeneration factor, and showed little hepatotoxicity and nephrotoxicity. In conclusion, JM extract can promote fracture healing and it can be used clinically to patients with fracture.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.6-12
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• 2013

Objective : This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods : A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with a femur allograft, and 51 patients (64 segments) were treated with a fibular allograft. The mean follow-up period was 16.0 (range, 12-25) months in the femur group and 19.5 (range, 14-39) months in the fibular group. Cage fracture and breakage, subsidence rate, fusion rate, segmental angle and height and disc height were assessed by using radiography. Clinical outcomes were assessed using a visual analog scale and neck disability index. Results : At 12 months postoperatively, cage fracture and breakage had occurred in 3.4% (2/58) and 7.4% (4/58) of the patients in the femur group, respectively, and 21.9% (14/64) and 31.3% (20/64) of the patients in the fibular group, respectively (p<0.05). Subsidence was noted in 43.1% (25/58) of the femur group and in 50.5% (32/64) of the fibular group. No difference in improvements in the clinical outcome between the two groups was observed. Conclusion : The femur allograft showed good results in subsidence and radiologic parameters, and sustained the original cage shape more effectively than the fibular allograft. The present study suggests that the femur allograft may be a good choice as a fusion substitute for the treatment of cervical DDD.

• Advances in biomechanics and applications
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• v.1 no.2
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• pp.77-83
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• 2014

Creep phenomenon at the scale of bone tissue (small specimens) is known to be present and demonstrated for low strains. Here creep is demonstrated on a pair of fresh-frozen human femurs at the organ level at high strains. Under a constant displacement applied on femur's head, surface strains at the upper neck location increase with time until fracture, that occurs within 7-13 seconds. The monotonic increase in strains provides evidence on damage accumulation in the interior (probably damage to the trabeculae) prior to final fracture, a fact that hints on probable damage of the trabecular bone that occurs prior to the catastrophic fracture of the cortical surface layer.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.89-96
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• 2024

The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.16-23
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• 2002

To understand the micro-mechanical changes and the effects of the fluoride on rat's femur after administration of sodium fluoride, the three-point bending test, acoustic emission analysis during the three-point bending test and scanning electron microscopy were performed. The obtained results were as follows: 1. Bone strength increased in the rats given 1, 5, 10 and 20 ppm of fluoride but, there were no statistical significances (p>0.05). 2. With increasing the concentration of fluoride, most AE events released rapidly just before the maximum load and smaller events were recorded than the control group's. The average of cumulative AE event counts until maximum load of the femur in 20 ppm group were significantly small with respect to the control group's (p<0.05). 3. Fracture surfaces were well coincide with the results of acoustic emission behavior. Analyses of fracture surfaces indicated that, consistent with its the highest load, rat femur in 20 ppm fluoride group displays the roughest surface.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.505-509
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• 2000

A five-month old female dog was presented to Teaching Anilmal Hospital, Gyeongasng National University for femur fracture. Previously the dog had been presented to a local hospital. Orthopedic and blood examinations were conducted. There was absent response of conscious propri- oception. The dog stood knuckled onto the digits and had hock dropped, but showed no117a1 values in WBC.RBC, Hb, PCV, BUN, Creatine, Glucose, Cholesterol, AST and ALT. Plain radioaraphs were taken and there were abundant periosteal reaction and malalignment of fragments. The dog was anesthetized and prepared for aseptic surgery. Joshi external fixator and half pins were applied(uni lateral). AT 8 weeks after surgery, the pins were removed from the bone. The fracture was well healed wish no evidence of original fracture line. but mild muscle atropy and shortening of femur were found.

• Journal of muscle and joint health
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• v.22 no.1
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• pp.1-12
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• 2015

Purpose: The purpose of this study was to explore the relationships among pain, depression, health behaviors, and activities of daily living (ADL) in older adults after femur fracture surgery. Methods: This was a descriptive correlational study. Ninety seven outpatients aged 65 or older were selected, who agreed to participate and visited the four hospitals located in G providence. Numeric Rating Scale (NRS) for pain, a Short form Geriatric Depression Scale (SGDS) for depression, health behavior scale and Korean version of Bathel Index for ADL were used. Data were analyzed using t-test and ANOVA, Pearson's correlation and the hierarchical regression analysis in SPSS 18. Results: Pain and depression were positively correlated (r=.35, p<.001). Pain and health behaviors (r=-.30, p=.010), pain and ADL (r=-.21, p=.044), depression and health behaviors (r=-.51, p<.001), depression and ADL (r=-.29, p=.004) were negatively correlated. The variables affecting the ADL was intake of a painkiller or not (${\beta}$=-.32), age (${\beta}$=-.25), transitional period after discharge (${\beta}$=.23) and depression (${\beta}$=-.23). ADL was accounted for 33.4% in total by these four variables. Conclusion: Interventions for alleviating pain, and managing depression would be effective in enhancing ADL in older adults after femur fracture surgery.