• 제목/요약/키워드: hip fracture

검색결과 208건 처리시간 0.022초

골반골 골절에서 손상 제어 개복술 후 지속적인 출혈의 치료: 동맥 색전술 -증례보고- (Treatment of Ongoing Bleeding after a Damage Control Laparotomy for a Pelvic Bone Fracture: Arterial Embolization -A Case Report-)

  • 김기훈;경규혁;김진수;박성진;남소현;김운원;김용한
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.159-163
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    • 2011
  • Massive bleeding due to traumatic pelvic bone fracture is a leading cause of death. Thus, several methods to control bleeding have been attempted, but none of these has yet been clearly established. After an automobile accident, a 34-year-old motorist was admitted to the Emergency Department for right hip,leg and abdominal pain. Because the patient's pressure remained consistently low and pelvic bone fracture and abdominal bleeding were found on radiologic examination, an explorative laparotomy was performed. After pelvic packing and bleeding control, bleeding still continued, so Angiography was performed, and arterial embolization for bleeding was performed.

세라믹 마멸에 있어서의 새로운 파라메터 제안 (I) 질화규소와 지르코니아의 마찰$\cdot$마멸 특성 (A Propotition of a New Parameter in Ceramic Wear(I) Friction and Wear Characteristics of Silicon Nitride and Zirconia)

  • 김석삼;김상우
    • 대한기계학회논문집
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    • 제17권6호
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    • pp.1441-1455
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    • 1993
  • 본 연구에서는 최신기법에 의해서 제조된 HIP제 질화규소와 지르코니아를 실험재료로 하여 무윤활하에서의 미끄럼마찰·마멸실험을 수행하여 마찰·마멸특성을 규명하고, SEM을 이용한 마멸면의 미시적 관찰을 통해서 세라믹의 마멸기구를 조사하 여 세라믹마멸기구의 마멸모델을 제시하고자 한다. 제시된 마멸모델에서 파괴역학을 도입하여 이론해석과 고찰을 수행하여 보다 실용적인 세라믹의 마멸율울 평가할 수 있 는 새로운 무차원 파라메터를 제안하고자 한다.

초기 허혈성 대퇴골두 괴사증을 보이는 개에서 임상학적, 수술적, 방사선학적, 컴퓨터단층촬영, 조직학적 소견 (Early Stage Legg-Calve-Perthes Disease in a Dog: Clinical, Surgical, Radiological, Computed Tomography and Histological Findings)

  • 탁민애;윤헌영;정순욱
    • 한국임상수의학회지
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    • 제30권5호
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    • pp.366-370
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    • 2013
  • 7개월령 암컷 포메라니안견이 오른쪽 후지 파행 증상으로 내원하였다. 내원시 신체 검사에서 오른쪽 대퇴 관절을 신장하였을 때 통증을 호소하였고 일반 방사선 사진에서 오른쪽 대퇴골두에 미약한 방사선 투과성 병변과 오른쪽 대퇴관절 공간의 확장을 확인하였다. 14일 후 일반 방사선 사진에서 오른쪽 대퇴골두 골단의 변위를 확인하였고 컴퓨터단층촬영에서 오른쪽 대퇴골두에 저음영의 병변과 골절선을 확인하였다. 오른쪽 대퇴골두 절제술을 실시하였고 조직학적 검사에서 골두 골간단과 골단의 괴사를 확인하였다. 본 증례는 초기 허혈성 대퇴골두 괴사증이 있는 개의 방사선학적, 컴퓨터단층촬영, 수술적, 조직학적 소견을 기술하였다.

A Comparative Study of Bipolar Hemiarthroplasty for Intertrochanteric Fracture: Direct Anterior Approach versus Conventional Posterolateral Approach

  • Young Yool Chung;Seung-Woo Shim;Min Young Kim;Young-Jae Kim
    • Hip & pelvis
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    • 제35권4호
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    • pp.246-252
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    • 2023
  • Purpose: The aim of this study was to compare short-term results from use of the direct anterior approach (DAA) and the conventional posterolateral approach (PLA) in performance of bipolar hemiarthroplasty for treatment of femoral intertrochanteric fractures in elderly patients. Materials and Methods: A retrospective review of 100 patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty was conducted. The PLA was used in 50 cases from 2016 to 2019; since that time we have used the DAA in 50 cases from 2019 to 2021. Measurements of mean operative time, blood loss, hospitalization period, and ambulation status, greater trochanter (GT) migration and stem subsidence were performed. And the incidence of complications was examined. Results: Operative time was 73.60±14.56 minutes in the PLA group and 79.80±8.89 minutes in the DAA group (P<0.05). However, after experiencing 20 cases using DAA, there was no statistically difference in operative time between two groups (P=0.331). Blood loss was 380.76±180.67 mL in the PLA group and 318.14± 138.51 mL in the DAA group (P<0.05). The hospitalization was 23.76±11.89 days in the PLA group and 21.45 ±4.18 days in the DAA group (P=0.207). In both groups, there were no progressive GT migration, intraoperative fractures or dislocations, although there was one case of infection in the PLA group. Conclusion: Although use of the DAA in performance of bipolar hemiarthroplasty required slightly more time in the beginning compared with the PLA, the DAA may well be an alternative, safe surgical technique as a muscle preserving procedure in elderly patients with intertrochanteric fractures.

질화규소-지르코니아 복합체의 기계적 및 내마모 특성 (Mechanical and tribological characterization of $Si_{3}N_{4}-ZrO_{2}$ composites)

  • 김성호;이수완;엄호성;정용선
    • 한국결정성장학회지
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    • 제9권2호
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    • pp.217-223
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    • 1999
  • 본 연구에서는 질화규소에 지르코니아 첨가량에 따른 효과를 조사하였다. 0 wt%~40 wt%의 지르코니아를 포함하는 세라믹 복합체 재료를 토대로 하는 질화규소를 $1750^{\circ}C$에서 172 MPa의 질소가스압으로 한 시간동안 유지하는 조건으로 hot isostatic pressing (HIP)하였다. 소결된 시편의 기계적 특성과 마모 특성을 조사하였다. 질화 규소-지르코니아 복합체는 지르코니아 양이 증가함에 따라 경도와 굽힘강도는 감소하였으나 밀도는 증가하였다. 그리고, 지르코니아 첨가량이 증가함에 따른 공기 중에서의 마모량은 감소하였으며, 공기 중에서의 마모 거동은 microcracking에 유관하였다.

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Diagnosis of Coxofemoral Joint Luxation in a Whooper Swan (Cygnus Cygnus) Using Computed Tomography and Radiography

  • Jinho Jang;Jong-pil Seo;Hyohoon Jeong;Seyoung Lee;YoungMin Yun
    • 한국임상수의학회지
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    • 제41권2호
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    • pp.139-142
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    • 2024
  • A wild Whooper swan (Cygnus Cygnus) with limping due to an injured left pelvic limb in an accident was rescued on the seashore and transferred to the Jeju Wildlife Rescue Center on November 23rd, 2020. On physical examination, its body condition score was 1 out of 5 due to starvation and dehydration. The left coxofemoral joint was also examined by careful palpating and estimating the damage. Moderated soft tissue swelling and crepitus surrounding the hip joint were confirmed. Radiography and computed tomography (CT) were used together for an accurate diagnosis of the joint. By radiographs readings, it was difficult to accurately confirm the condition of the proximal femur due to superimposition of the synsacrum and internal organs. However, signs such as avulsion fracture of the femoral head and a few fragments around the joint were revealed by CT imaging. Besides, through three-dimensional (3D) image analysis of CT, the dislocated area and condition of the left hip joint could be accurately and easily confirmed. The diagnostic process showing in this paper could be used as a good reference for diagnosing coxofemoral joint luxation in wild swan.

Comparative Study for Osteosynthesis of Femoral Neck Fractures: Cannulated Screws versus Femoral Neck System

  • Youngho Cho;Jae-uk Shin;Sangwoo Kim
    • Hip & pelvis
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    • 제35권1호
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    • pp.47-53
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    • 2023
  • Purpose: The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures. Materials and Methods: A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated. Results: The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation. Conclusion: A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.

인공고관절 치환술 후 세라믹 대퇴골두에서 발생하는 응력분포 예측 (Prediction of Stress Distribution in the Ceramic Femoral Head after Total Hip Replacement)

  • 한성민;추준욱;송강일;박성희;최재봉;김정성;서준교;최귀원;윤인찬
    • 한국정밀공학회지
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    • 제29권6호
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    • pp.680-685
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    • 2012
  • Ceramic femoral heads are now widely used in Total Hip Replacement (THR). Due to their high biocompatibility and low ductility, ceramic femoral heads are considered to be suitable for young and active patients. However, as in testing the mechanical stability of the femoral head, the conventional proof test (standard ISO 7206-10) has its limit of showing axisymmetric stress distribution on the contact surface, while non-uniformed stress distribution is expected after THR. Since non-uniformed stress distribution can result in the increased probability of ceramic femoral head fracture, it is considerable to evaluate the stress distribution in vivo-like conditions. Therefore, this study simulated the ceramic femoral heads under in vivo-like conditions using finite element method. The maximum stress decreased when increasing the size of the femoral head and stress distribution was concentrated on superior contact surface of the taper region.

고관절 치환술 후 삽입물의 안정성 판단과 대퇴 삽입물 주위 골절의 치료 원칙 (Decision-Making and Principle of Management in Periprosthetic Femoral Fracture after Total Hip Arthroplasty)

  • 김범수;이경재;민병우
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.200-207
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    • 2021
  • 대퇴 삽입물 주위 골절은 고관절 치환술 후 발생하는 가장 치료하기 어려운 합병증 중 하나이며, 만족스러운 치료 결과를 얻으려면 면밀한 임상 및 방사선 사진 평가, 정확한 분류 및 치료 원칙에 대한 이해가 필수적이다. Vancouver 분류 시스템은 이러한 삽입물 주위 골절의 치료를 계획하기 위한 간단하고 효과적인 방법이다. 대퇴 스템이 안정된 골절은 견고한 내고정으로 효과적으로 치료할 수 있지만 대퇴 스템 해리가 동반된 경우 삽입물 주위 대퇴 골절은 재치환술이 필요하다. 고관절 치환술 후 발생할 수 있는 삽입물 주위 대퇴 골절 환자의 치료 원리와 대퇴 스템의 안정성을 평가하는 방법에 대해 설명하고자 한다.

An Intraosseous Schwannoma Combined with a Subchondral Fracture of the Femoral Head: a Case Report and Literature Review

  • Kim, Hyun Young;Ryu, Kyung Nam;Park, Yong Koo;Han, Jung Soo;Park, Ji Seon
    • Investigative Magnetic Resonance Imaging
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    • 제21권3호
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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.