• Title/Summary/Keyword: limb fracture

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National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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Osteocutaneous Turn-Up Fillet Flaps: A Spare-Parts Orthoplastic Surgery Option for a Functional Posttraumatic Below-Knee Amputation

  • Harry Burton;Alexios Dimitrios Iliadis;Neil Jones;Aaron Saini;Nicola Bystrzonowski;Alexandros Vris;Georgios Pafitanis
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.501-506
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    • 2023
  • This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Ulnar Radial Nonunion Fracture Treated with Recombinant Human Bone Morphogenetic Protein-2 in a Dog (개의 요.척골유합부전의 Recombinant Human Bone Morphogenetic Protein-2 적용 치료례)

  • 홍성혁
    • Journal of Veterinary Clinics
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    • v.18 no.2
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    • pp.156-159
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    • 2001
  • A 6-year-old male mongrel dog with a 7-month history of ulnar-radial nonunion fracture was treated with implantation of recombinant human bone morphogenetic protein-2 (rhBMP-2). The dog had received surgical correction three times prior to the admission but radiography of the affected limb revealed a typical figure of nonunion fracture. Glossly, the fractured ends were sclerotic and the area between the ends was filled with fibrous tissue. After debridement the shaft was fixed by an 10-hole plate. rhBMP-2 at a total dose of 256 micrograms was implanted with a synthetic carrier into the 10-mm defect formed by the debridement. Callus formation responding to rhBMP-2 was radiographically observed at 4 weeks after implantation and the defect bridged both fracture ends by 8 weeks after implantation. The plate was removed at 12 months after implantation. Any complications were not observed for 5 months after removal of the plate.

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The pattern of accidental bone fractures in Thoroughbred foals (Thoroughbred 망아지의 중 골절사고 유형)

  • Yang, Jae-hyuk;Yang, Young-jin;Cho, Gil-jae;Cheong, Jong-tae;Lim, Yoon-kyu
    • Korean Journal of Veterinary Research
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    • v.42 no.1
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    • pp.115-121
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    • 2002
  • The present study was conducted to investigate the pattern of fracture of 50 Thoroughbred foals in Jeju from January 1997 to August 2001. A total 50 Thoroughbred foals were investigated to figure out the relationship between breeding condition and fracture. The fracture was diagnosed by physical and radiological examinations after lameness test. Most sites of fracture were limb, skull and vertebrae. Age analyzed that the most popular is the 1-year-old foals. Most places of the occurrence of the fracture were pasture, paddock, track and stable. Main cause of the fracture were play, training and foal's dam. These results suggest that there were the 1-year-old foals have a lot of fracture during play at pasture in winter.

Treatment of Diabetic Charcot Arthropathy (당뇨병성 샤콧 관절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.243-250
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    • 2013
  • Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

Clinical observation on a case of patient with Atlanto-Axial Fracture-Dislocation (Atlanto-Axial Fracture-Dislocation (환축추 골절 및 탈구) 환자 1례(例)에 대한 증례보고)

  • Lim, Hyi-Jeong;Lee, Hae-Bok;Choi, Sung-Gwan
    • Journal of Acupuncture Research
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    • v.18 no.5
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    • pp.185-194
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    • 2001
  • Objective : By process of treatment for a case which diagnosed as Atlanto-Axial Fracture-Dislocation and admitted from the 2nd, December, 2000 to the 18th, December, 2000, the results are as follows. Methods : Clinical observation and analysis about a case of Atlanto-Axial Fracture-Dislocation was done, who visited Dong-in-dang Oriental Medicine Hospital. This case is managed by integrated therapy of oriental medicine. This patient was diagnosed as stagnation of Ki and stasis of blood(氣滯血瘀), deficiency of Um of the liver and kidneys(肝腎陰虛) and medicated gamisekyung-tang(加味舒經湯) and kanghwalsokdan-tang(羌話續斷湯). As acupucture treatments, we could get the effective results by providing the patient with acupuncture on the nape, shoulder, Lt upper limb and Rt distant point Conclusion : We could get the effective results that case of Atlanto-Axial Fracture-Dislocation with severe rigid neck and Motor disturb of neck, was treated with oriental medicine and acupuncture therapy.

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The Subclavian Artery Thrombosis after Open Reduction and Internal Fixation of Clavicular Fracture - A Case Report - (쇄골 골절의 관혈적 정복 및 내 고정술 후 발생한 쇄골하 동맥의 혈전증 - 증례 보고 -)

  • Moon, Eun-Sun;Kim, Myung-Sun;Jeong, Kwang-Cheul;Lim, Keun-Young
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.211-215
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    • 2006
  • Reported in this article is a case report of a patients who developed limb threatening ischemia as a consequence of a subclavian artery thrombosis resulting from screws. The subclavian artery thrombosis after open reduction and internal fixation of clavicle fracture, when it occurs, should be treated promptly by plate removal and claviculectomy. It can be prevented by placing screws in locations away from the underlying neurovascular structures.

Comparison of the circumference, skinfold thickness and leg strength of normal limb with those of casted limb following removal of leg cast (하지 석고붕대제거후 정상측과 석고붕대 적용측의 상하지의 둘레, 피부두겹두께 및 하지근력의 비교)

  • 최명애;박미정
    • Journal of Korean Academy of Nursing
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    • v.23 no.1
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    • pp.56-67
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    • 1993
  • The purpose of this study was to compare the circumference and skinfold thickness of upper and lower limb and the leg strength of the casted limb with those of the normal limb after removal of a leg cast. The subjects for the study were orthopedic patients who had had long and short leg casts or splints due to tibial, fibulal, metatarsal, calcaneus fracture or ankle sprains. The subjects were divided into two groups, those who had the cast on for less than 40 days and those for over 41 days. Circumference and skinfold thickness of the upper and lower limb on the side on which the cast was ap-plied were compared with those of the contralateral side after removal of the cast. Circumference and skinfold thickness of the upper and lower limb, and leg strength for those in a cast for under 40 days were compared with those of over 41 days for both the side to which cast was applied and the contralateral side. Measurements were made after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and lower extremity strength was determined with flat foot pressing on an electronic digital health meter in the sitting position. The results can be summarized as follows : 1. The circumference of the upper and lower leg on the side on which the cast was applied, when measured after the cast was removed, were significantly less than those of the normal side, 93.88%, 93.11% each. 2. Skinfold thickness of the quadriceps and gastrocnemius on the side on which the cast was applied were significantly less than those of the normal side when measured after removal of the cast, 85.98%, 82.85% respectively. 3. Leg strength on the side where the cast was applied was significantly 1ss than that on the normal side, 60.20%. 4. There was no difference in the circumference of upper and lower limbs, skinfold thickness or leg strength on the side where the cast was applied between the group which had the cast applied for under 40 days and the group that had it applied for over 41 days. 5. The circumference of the upper arm and lower leg on the normal side for the group that had the cast applied for over 41 days was significantly greater than the group that had the cast application for under 40 days. T ere was no difference between the two groups in the circumference of the forearm and upper leg, skinfold thickness and leg strength in the normal side. From these results, it may be concluded that muscle atrophy was apparent in the casted limb compared to the normal limb, and the circumference of the upper arm and lower leg, and leg strength on the normal side increased after removal of the cast in the group which had the cast on for more than 41 days.

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A Study of the Effects of Casting on Lower Limbs -Comparison of Casted and Noncasted Limb- (하지석고붕대 적용에 의한 활동저하가 석고붕대 적용하지와 비적용하지의 둘레, 피부두겹두께 및 근력에 미치는 효과)

  • 최명애;박미정;채영란
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.517-528
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    • 1994
  • The purpose of this study was to compare the circumference, skinfold thickness and strength of the normal and casted lower limb prior to casting and following removal of the cast. The subjects for the study were nine orthopedic patients who had had long and short leg casts due to a tibial, fibula, or calcaneus fracture, or to a lateral collateral ligament rupture. Circumference, skinfold thickness, and strength of the normal and casted lower limb following removal of the cast were compared with those prior to the application of the cast. Measurements were made before cast application and after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and strength was determined by measuring the length of time the leg was held elevated at 45$^{\circ}$. The results can be summarized as follows 1. There was no change in the normal limb in the circumference of the midthigh and midcalf after casting as compared to before cast application. 2. In the casted limb the circumference of the midthigh decreased by 3.23% and that of the midcalf decreased significantly by 7.49% during the period of casting. 3. In the normal limb skinfold thickness of the quadriceps decreased and that of gastrocnemius increased by 20.63% during the period of cast application. 4. In the casted limb skinfold thickness of the quadriceps decreased significantly by 12.37% and that of gastrocnemius decreased by 10% during the period of cast application. 5. Strength of the normal lower extremity decreased significantly by 48.37% and that of casted lower extremity decreased remarkably by 73.07% during the period of cast application. 6. Circumference of the midthigh and the midcalf decreased significantly by 7.6% and 9.4% respectively on the casted side as compared to the normal side. Skinfold thickness of the quadriceps and the gastrocnemius on the casted side decreased by 6.12% and 18.55% respectively as compared to the normal side and strength in the lower extremity on the casted side decreased significantly by 44.32% as compared to the nor-mal side. From these results, it may be concluded that muscle atrophy occurs in the casted lower limb and muscle strength of the normal lower limb are also reduced during the period of application of a leg cast.

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