Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.131
Kyung-Jae Lee, B. Min, Eun-Seok Son, H. Seo, Jin-hyun Park
Purpose: We wanted to compare the clinical and radiological results of surgical treatment of acetabular both column fracture according to the fixation method. Materials and Methods: Between 1986 and 2008, 55 patients who underwent surgical treatment for acetabular both column fracture were clinically and radiologically evaluated after a minimum follow-up of one year. Of 55 patients, 29 cases were operated with a cerclage wire or cable (group I) and 26 cases were operated with a plate and screw (group II). The surgical approach, the intra- and post-operative complications and the reduction quality were compared between the two groups. The clinical and radiological results were analyzed according to the criteria reported by Matta. Results: There were 14 (48.3%)/20 (76.9%) cases of anatomical reduction, 12 (41.4%)/6 (23.1%) cases of imperfect reduction, 1/0 case of poor reduction and 2/0 cases of surgical secondary incongruence, respectively. Thirty three patients of 34 anatomically reduced patients showed excellent clinical results and the anterior and posterior combined approach was frequent in group I. There were no differences between the two groups for the complications, although intraoperative complication was more frequent in group II and postoperative complication was more frequent in group I. Conclusion: The clinical and radiological results of surgical treatment in patients with both column fracture were satisfactory in both groups. However, the concerns related to the surgical approach and complications will require a randomized prospective study.
{"title":"Comparative Results of Acetabular Both Column Fracture According to the Fixation Method","authors":"Kyung-Jae Lee, B. Min, Eun-Seok Son, H. Seo, Jin-hyun Park","doi":"10.5371/JKHS.2011.23.2.131","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.131","url":null,"abstract":"Purpose: We wanted to compare the clinical and radiological results of surgical treatment of acetabular both column fracture according to the fixation method. Materials and Methods: Between 1986 and 2008, 55 patients who underwent surgical treatment for acetabular both column fracture were clinically and radiologically evaluated after a minimum follow-up of one year. Of 55 patients, 29 cases were operated with a cerclage wire or cable (group I) and 26 cases were operated with a plate and screw (group II). The surgical approach, the intra- and post-operative complications and the reduction quality were compared between the two groups. The clinical and radiological results were analyzed according to the criteria reported by Matta. Results: There were 14 (48.3%)/20 (76.9%) cases of anatomical reduction, 12 (41.4%)/6 (23.1%) cases of imperfect reduction, 1/0 case of poor reduction and 2/0 cases of surgical secondary incongruence, respectively. Thirty three patients of 34 anatomically reduced patients showed excellent clinical results and the anterior and posterior combined approach was frequent in group I. There were no differences between the two groups for the complications, although intraoperative complication was more frequent in group II and postoperative complication was more frequent in group I. Conclusion: The clinical and radiological results of surgical treatment in patients with both column fracture were satisfactory in both groups. However, the concerns related to the surgical approach and complications will require a randomized prospective study.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125577087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.89
Jun-Shik Kim
고관절 전치환술 후 가장 심각한 합병증 중 하나가 관절의 탈구이다. 수술 후 3개월 이내에 발생하는 경우가 가장 많 으며, 수술 후 1년 이내에 0.5~4%의 빈도로 발생한다. 탈구를 유발하는 인자는 환자, 수술, 그리고 인공관절 삽 입물등 다양한 원인이 관계되므로 정확한 인과관계를 단 정짓기는 어렵다. 1년 동안 시행한 수술 경험이 많고 적음 의 차이가 탈구의 빈도에 영향을 미치기도 한다. 처음 탈구가 발생하였을 때 한번의 도수 정복과 그 이후 예방조치로 대부분 더 이상 발생하지 않으나, 탈구가 반복 하여 재발될 경우 수술적인 조치가 필요하게 되며, 환자는 물론 치료의사에게도 심리적인 부담을 갖게한다. 탈구를 유발시킬 수 있는 요인을 알고 수술 수기를 섬세하게 하는 것이 탈구의 빈도를 최소화할 수 있는 방법이라 할 수 있 다.고관절 전치환술 후 발생하는 탈구에 관계된 요인, 예 방과 치료에 대해 알아보고자 한다.
{"title":"Dislocation as a Complication after Total Hip Arthroplasty","authors":"Jun-Shik Kim","doi":"10.5371/JKHS.2011.23.2.89","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.89","url":null,"abstract":"고관절 전치환술 후 가장 심각한 합병증 중 하나가 관절의 탈구이다. 수술 후 3개월 이내에 발생하는 경우가 가장 많 으며, 수술 후 1년 이내에 0.5~4%의 빈도로 발생한다. 탈구를 유발하는 인자는 환자, 수술, 그리고 인공관절 삽 입물등 다양한 원인이 관계되므로 정확한 인과관계를 단 정짓기는 어렵다. 1년 동안 시행한 수술 경험이 많고 적음 의 차이가 탈구의 빈도에 영향을 미치기도 한다. 처음 탈구가 발생하였을 때 한번의 도수 정복과 그 이후 예방조치로 대부분 더 이상 발생하지 않으나, 탈구가 반복 하여 재발될 경우 수술적인 조치가 필요하게 되며, 환자는 물론 치료의사에게도 심리적인 부담을 갖게한다. 탈구를 유발시킬 수 있는 요인을 알고 수술 수기를 섬세하게 하는 것이 탈구의 빈도를 최소화할 수 있는 방법이라 할 수 있 다.고관절 전치환술 후 발생하는 탈구에 관계된 요인, 예 방과 치료에 대해 알아보고자 한다.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133411913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.137
P. Chung, Suk Kang, Jong Pil Kim, Y. S. Kim, H. M. Lee, Young Hwa Choi
노년층에서 고관절 골절은 작은 손상에서도 흔히 발생 하는 흔한 골절이고, 노인 인구의 급속한 증가로 이러한 골절 또한 증가하는 추세이다. 그리고 대부분의 고관절 골 절 환자가 고령이고 내과적 기존 질환이 있는 경우가 많아 골절 후 사망률이 매우 높다. 외국 문헌에 의하면 14~36% 정도로 보고되고 있으며 국내문헌에 의하면 12.8~21.6% 정도로 보고되고 있다. 그리고 노인에서 고 관절 골절 치료의 목적은 합병증을 최소화하면서 골절 전 의 활동력, 특히 보행 능력을 회복시켜 줄 수 있는 수술적 치료가 원칙이다. 노인장기요양보험의 기준이 65세이고, 미국의 사회보장제도에서도 65세 이상을 노인이라고 정 의하고 있기 때문에 본 연구에서 65세 이상의 환자를 대 상으로 하였다. 고관절 골절 후 수술적 치료를 받은 65세 이상의 환자를 대상으로 1년 내 사망률과 사망률에 영향 을 미치는 인자를 알아보고자 하였다.
{"title":"One-Year Mortality Rate of Patients over 65 Years Old with a Hip Fracture","authors":"P. Chung, Suk Kang, Jong Pil Kim, Y. S. Kim, H. M. Lee, Young Hwa Choi","doi":"10.5371/JKHS.2011.23.2.137","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.137","url":null,"abstract":"노년층에서 고관절 골절은 작은 손상에서도 흔히 발생 하는 흔한 골절이고, 노인 인구의 급속한 증가로 이러한 골절 또한 증가하는 추세이다. 그리고 대부분의 고관절 골 절 환자가 고령이고 내과적 기존 질환이 있는 경우가 많아 골절 후 사망률이 매우 높다. 외국 문헌에 의하면 14~36% 정도로 보고되고 있으며 국내문헌에 의하면 12.8~21.6% 정도로 보고되고 있다. 그리고 노인에서 고 관절 골절 치료의 목적은 합병증을 최소화하면서 골절 전 의 활동력, 특히 보행 능력을 회복시켜 줄 수 있는 수술적 치료가 원칙이다. 노인장기요양보험의 기준이 65세이고, 미국의 사회보장제도에서도 65세 이상을 노인이라고 정 의하고 있기 때문에 본 연구에서 65세 이상의 환자를 대 상으로 하였다. 고관절 골절 후 수술적 치료를 받은 65세 이상의 환자를 대상으로 1년 내 사망률과 사망률에 영향 을 미치는 인자를 알아보고자 하였다.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115166265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5371/JKHS.2011.23.2.124
S. Kweon
대퇴골 전자부 골절은 대부분의 경우 골다공증을 동반한 고령층에서 많이 발생하며, 평균 수명의 증가로 그 발생 빈 도가 증가 추세에 있다. 골절 치료의 목적은 정확한 정복 및 견고한 내고정을 통해 조기 보행을 시행함으로서 고령 환자에서 흔한 술 후 합병증을 예방하고 조기에 골유합을 얻는데 있다. 그러나 골다공증이 심하여 골절 양상이 분쇄 상이거나 불안정성을 보이는 전자부 골절의 경우 정복 및 내고정이 어려우며 술 후에도 내고정물의 실패와 골절부 위의 심한 함몰이 발생하는 합병증이 문제라고 할 수 있다. 지금까지 대퇴골 전자부 골절의 치료에 많은 기구들이 고안되어 왔다. 특히 골절 부위의 압박력을 얻을 수 있는 활강 압박 고나사와 생체 역학적인 장점이 있는 골수강 내 고정술이 대표적이다. 활강 압박 고나사는 전자부 골절의 치료에서 양호한 결과를 보고하고 있으나 불안정성 골절 에서는 과도한 활강으로 인한 정복 소실, 내반 및 외회전 변형, 지연 나사의 골두 내 천공 등 여러 가지 문제를 보고 하고 있다. 그래서 짧은 지렛대로 인한 생역학적 안정성 Submitted: Januarry 7, 2011 1st revision: February 11, 2011 2nd revision: April 13, 2011 3rd revision: April 26, 2011 Final acceptance: April 26,2011
大腿骨电子部骨折多发生在伴有骨质疏松症的高龄层，由于平均寿命的增加，其发生频率呈增加趋势。治疗骨折的目的是通过正确的征服及坚固的内固定，实行早期步行，预防高龄患者常见的术后并发症，早期得到骨愈合。但骨质疏松症严重，骨折情况粉碎性或表现不稳定的电子部骨折，很难征服或内固定，而且术后也会发生内固定物的失败和骨折部位严重下陷的并发症。到目前为止，治疗大腿骨电子部骨折的器具有很多。特别是具有获得骨折部位压迫力的滑降压迫枯死和生物力学上的优点的骨髓腔内固定术是代表性的。滑降压迫螺栓在电子部骨折的治疗上报告了良好的结果，而不稳定性骨折则报告了过度滑降导致的征服消失、内盘及外旋转变形、延迟螺丝的骨内穿孔等多种问题。因此，短杠杆的生物力学稳定性Submitted: Januarry 7, 2011 1st revision: February 11, 2011 2nd revision: April 13, 2011 3rd revision: April 26,2011 Final acceptance: April 26,2011 Final acceptance: April 26,2011 Final acceptance: April 26,2011 Final acceptance: April 26,2011 Final acceptance: April 26,2011
{"title":"Comparison of the Gamma Nail and the Dynamic Hip Screw for Peritrochanteric Fracture","authors":"S. Kweon","doi":"10.5371/JKHS.2011.23.2.124","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.2.124","url":null,"abstract":"대퇴골 전자부 골절은 대부분의 경우 골다공증을 동반한 고령층에서 많이 발생하며, 평균 수명의 증가로 그 발생 빈 도가 증가 추세에 있다. 골절 치료의 목적은 정확한 정복 및 견고한 내고정을 통해 조기 보행을 시행함으로서 고령 환자에서 흔한 술 후 합병증을 예방하고 조기에 골유합을 얻는데 있다. 그러나 골다공증이 심하여 골절 양상이 분쇄 상이거나 불안정성을 보이는 전자부 골절의 경우 정복 및 내고정이 어려우며 술 후에도 내고정물의 실패와 골절부 위의 심한 함몰이 발생하는 합병증이 문제라고 할 수 있다. 지금까지 대퇴골 전자부 골절의 치료에 많은 기구들이 고안되어 왔다. 특히 골절 부위의 압박력을 얻을 수 있는 활강 압박 고나사와 생체 역학적인 장점이 있는 골수강 내 고정술이 대표적이다. 활강 압박 고나사는 전자부 골절의 치료에서 양호한 결과를 보고하고 있으나 불안정성 골절 에서는 과도한 활강으로 인한 정복 소실, 내반 및 외회전 변형, 지연 나사의 골두 내 천공 등 여러 가지 문제를 보고 하고 있다. 그래서 짧은 지렛대로 인한 생역학적 안정성 Submitted: Januarry 7, 2011 1st revision: February 11, 2011 2nd revision: April 13, 2011 3rd revision: April 26, 2011 Final acceptance: April 26,2011","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123684159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.60
H. Kim, J. Yoo, Y. Park, Jin soo Park, K. Noh, K. Chung, Min-Young Jo, J. Hwang
Paget disease is a well-documented skeletal disease and it has an increased rate of tissue breakdown due to the excessive turnover of osteoblasts and osteclasts. Stress fracture is one of the most common complications in the late phase of Paget disease, but the clinical presentation of incomplete pathologic fracture is rare and this is an important clue to plan the treatment. We experienced a case of Paget’s disease in a 74 year old woman with a periprosthetic fracture from the undetected, imcomplete stress fracture in the proximal femur.
{"title":"Undetected Incomplete Stress Fracture in the Proximal Femur of a Patient with Paget's Disease - A Case Report -","authors":"H. Kim, J. Yoo, Y. Park, Jin soo Park, K. Noh, K. Chung, Min-Young Jo, J. Hwang","doi":"10.5371/JKHS.2011.23.1.60","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.60","url":null,"abstract":"Paget disease is a well-documented skeletal disease and it has an increased rate of tissue breakdown due to the excessive turnover of osteoblasts and osteclasts. Stress fracture is one of the most common complications in the late phase of Paget disease, but the clinical presentation of incomplete pathologic fracture is rare and this is an important clue to plan the treatment. We experienced a case of Paget’s disease in a 74 year old woman with a periprosthetic fracture from the undetected, imcomplete stress fracture in the proximal femur.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123358163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.15
Pil-Sung Kim, D. Hwang, Chan Kang, Jung Bum Lee, Jun Yeong Park
� Purpose: We wanted to arthroscopically analyze the femoral osseous abnormalities (bumps) in hips with anterior femoroacetabular impingement (FAI) and the other radiologic abnormalities of the hip joint associated with this. Materials and Methods: We retrospectively reviewed the radiographs of 45 patients (51 hips) who underwent arthroscopic treatment under the impression of FAI from January to August, 2008. The indications for surgery included persistent hip pain, the absence of advanced osteoarthritis, physical examination or MRA findings consistent with an acetabualr labral tear. Preoperative and postoperative plain radiographs (pelvis AP, frog-leg lateral, cross table lateral and the false profile view) were taken. As the occasion demanded, 3D-CT or MRA were performed. Results: For the radiologic findings, a decreased head-neck offset (<8 mm) was seen in 15 hips. Femoral bumps were seen in 26 hips and among them, 11 hips were associated with acetabular retroversion, 5 hips were associated with a prominent acetabular rim and 13 hips were located on the flattening of the neck due to a decreased offset. Pistol grip deformity was found in 21 hips and acetabular retroversion was done in 32 hips. Regarding the secondary changes, spurs on the acetabulum of the femur were found in 14 hips and femoral bony cysts were found in 23 hips. Arthroscopically, all the hips had acetabular degenerative labral tear and the acetabular cartilage was injured in 32 hips (62.7%). Among them, 25 hips underwent acetabular retroversion. Conclusion: Femoral osseous abnormalities are seen in various locations and these abnormalities have various shapes. A considerable number were associated with pincer impingement and they could produce a 'kissing lesion' between the acetabulum and femur. Identification of these abnormalities on radiographs aids confirming FAI in hips with symptomatic early osteoarthritis.
{"title":"Arthroscopic Analysis of the Radiologic Abnormalities of the Hip Associated with Anterior Femoroacetabular Impingement","authors":"Pil-Sung Kim, D. Hwang, Chan Kang, Jung Bum Lee, Jun Yeong Park","doi":"10.5371/JKHS.2011.23.1.15","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.15","url":null,"abstract":"� Purpose: We wanted to arthroscopically analyze the femoral osseous abnormalities (bumps) in hips with anterior femoroacetabular impingement (FAI) and the other radiologic abnormalities of the hip joint associated with this. Materials and Methods: We retrospectively reviewed the radiographs of 45 patients (51 hips) who underwent arthroscopic treatment under the impression of FAI from January to August, 2008. The indications for surgery included persistent hip pain, the absence of advanced osteoarthritis, physical examination or MRA findings consistent with an acetabualr labral tear. Preoperative and postoperative plain radiographs (pelvis AP, frog-leg lateral, cross table lateral and the false profile view) were taken. As the occasion demanded, 3D-CT or MRA were performed. Results: For the radiologic findings, a decreased head-neck offset (<8 mm) was seen in 15 hips. Femoral bumps were seen in 26 hips and among them, 11 hips were associated with acetabular retroversion, 5 hips were associated with a prominent acetabular rim and 13 hips were located on the flattening of the neck due to a decreased offset. Pistol grip deformity was found in 21 hips and acetabular retroversion was done in 32 hips. Regarding the secondary changes, spurs on the acetabulum of the femur were found in 14 hips and femoral bony cysts were found in 23 hips. Arthroscopically, all the hips had acetabular degenerative labral tear and the acetabular cartilage was injured in 32 hips (62.7%). Among them, 25 hips underwent acetabular retroversion. Conclusion: Femoral osseous abnormalities are seen in various locations and these abnormalities have various shapes. A considerable number were associated with pincer impingement and they could produce a 'kissing lesion' between the acetabulum and femur. Identification of these abnormalities on radiographs aids confirming FAI in hips with symptomatic early osteoarthritis.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126215356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.54
M. Park, Do-Hyun Kim, Hong-Man Cho, Woochull Chung
� Purpose: We retrospectively evaluated performing curettage and bone grafting for the treatment of simple bone cyst in 21 patients with cysts in the proximal femur. The purpose of this study was to review the results with a minimum follow up of 24 months. Materials and Methods: We treated 21 cases of simple bone cysts with curettage and a bone graft from June 1995 to July 2008. 4 male and 17 female patients (age range: 14~62 years (mean age: 39.8 years) volunteered for this study. The range of the follow-up period was from 24 months to 6 years (mean follow-up: 63.7 months). We evaluated the effect of treatment by examining the simple follow-up radiographs according to Oppenheim's classification. We retrospectively reviewed the site of the cysts, the patients' ages at the time of the diagnosis, the incidence of pathologic fracture, the association with femoro-acetabular impingement (FAI) and the type of bone graft. Results: The investigation revealed that 20 out of 21 patients had better than improved results. 14 patients of the 15 patients who were treated with an autogenous bone graft had better than improved results and all 6 patients who received an autogenous and allergenic bone graft had better than improved results. Two patients had associated FAI. These cases were managed with arthroscopic labral trimming and curettage. There were no specific complications related to the bone cyst and the operative procedure. Conclusion: We believe curettage and bone grafting and stabilization with compression hip screws is a reasonable treatment for simple bone cysts in the proximal femur. The bone cyst in the femoral head neck junction in patients older than 50 years old is related with femoroacetabular impingement.
{"title":"Results of Operative Treatment for a Bone Cyst in the Proximal Femur","authors":"M. Park, Do-Hyun Kim, Hong-Man Cho, Woochull Chung","doi":"10.5371/JKHS.2011.23.1.54","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.54","url":null,"abstract":"� Purpose: We retrospectively evaluated performing curettage and bone grafting for the treatment of simple bone cyst in 21 patients with cysts in the proximal femur. The purpose of this study was to review the results with a minimum follow up of 24 months. Materials and Methods: We treated 21 cases of simple bone cysts with curettage and a bone graft from June 1995 to July 2008. 4 male and 17 female patients (age range: 14~62 years (mean age: 39.8 years) volunteered for this study. The range of the follow-up period was from 24 months to 6 years (mean follow-up: 63.7 months). We evaluated the effect of treatment by examining the simple follow-up radiographs according to Oppenheim's classification. We retrospectively reviewed the site of the cysts, the patients' ages at the time of the diagnosis, the incidence of pathologic fracture, the association with femoro-acetabular impingement (FAI) and the type of bone graft. Results: The investigation revealed that 20 out of 21 patients had better than improved results. 14 patients of the 15 patients who were treated with an autogenous bone graft had better than improved results and all 6 patients who received an autogenous and allergenic bone graft had better than improved results. Two patients had associated FAI. These cases were managed with arthroscopic labral trimming and curettage. There were no specific complications related to the bone cyst and the operative procedure. Conclusion: We believe curettage and bone grafting and stabilization with compression hip screws is a reasonable treatment for simple bone cysts in the proximal femur. The bone cyst in the femoral head neck junction in patients older than 50 years old is related with femoroacetabular impingement.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"156 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122612000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.66
T. Yoon, Kyung-Soon Park, K. Thevarajan, N. Cho
Periprosthetic fracture of the femur is an uncommon complication after total hip arthroplasty (THA), but it appears to be increasing in incidence as a result of the aging population demographics and the increased number of THAs that are being performed. Much interest has been generated regarding low energy fractures in the elderly, but repeated periprosthetic fractures in the same femur are uncommon. The authors present here the case of a 71 year old patient who sustained repeated low energy ipsilateral periprosthetic femur fractures. The initial injury was caused by a road traffic accident, but the subsequent fractures were all caused by low energy falls. The patient sustained proximal and distal femur fractures with implants in situ. The probable causes of such fractures was a combination of systemic and local host factors, such as osteoporosis, cortical stress risers, local osteopenia secondary to bed rest, quiescent infection and altered fracture site vascularity due to the internal fixation devices and multiple re-operations.
{"title":"Surgical Management of Repeated Low-Energy Periprosthetic Femur Fractures - A Case Report -","authors":"T. Yoon, Kyung-Soon Park, K. Thevarajan, N. Cho","doi":"10.5371/JKHS.2011.23.1.66","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.66","url":null,"abstract":"Periprosthetic fracture of the femur is an uncommon complication after total hip arthroplasty (THA), but it appears to be increasing in incidence as a result of the aging population demographics and the increased number of THAs that are being performed. Much interest has been generated regarding low energy fractures in the elderly, but repeated periprosthetic fractures in the same femur are uncommon. The authors present here the case of a 71 year old patient who sustained repeated low energy ipsilateral periprosthetic femur fractures. The initial injury was caused by a road traffic accident, but the subsequent fractures were all caused by low energy falls. The patient sustained proximal and distal femur fractures with implants in situ. The probable causes of such fractures was a combination of systemic and local host factors, such as osteoporosis, cortical stress risers, local osteopenia secondary to bed rest, quiescent infection and altered fracture site vascularity due to the internal fixation devices and multiple re-operations.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116165775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.7
Ki-Choul Kim, Young-Kyun Lee, Y. Ha, K. Koo
� Osteonecrosis of the femoral head mainly occurs in young patients, and the hip joint with osteonecrosis of the femoral head can be preserved by adequate joint-preserving surgery. This review article includes the information, surgical technique, pitfalls and results of several types of joint preserving surgeries.
{"title":"Joint Preserving Operations for Femoral Head Osteonecrosis","authors":"Ki-Choul Kim, Young-Kyun Lee, Y. Ha, K. Koo","doi":"10.5371/JKHS.2011.23.1.7","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.7","url":null,"abstract":"� Osteonecrosis of the femoral head mainly occurs in young patients, and the hip joint with osteonecrosis of the femoral head can be preserved by adequate joint-preserving surgery. This review article includes the information, surgical technique, pitfalls and results of several types of joint preserving surgeries.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114794820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5371/JKHS.2011.23.1.32
S. Choo, H. Oh, Jong-In Kim, H. Lee, G. Jang
Purpose: We wanted to investigate the radiographic and clinical results of internal fixation with cannulated screws in elderly patients with femoral neck fracture. Materials and Methods: We reviewed the results of 47 cases of elderly patients with femoral neck fractures that were treated by osteosynthesis from May 2000 and March 2009 and these patients could be followed up for more than one year. There were 11 males and 36 females with a median age of 72 years (65~85 years). They were classified by the Garden stage. The number of stage I and II fractures was 34 and 16, respectively. The postoperative follow up period was 24 months (12~84 months). The union time, horizontal shortening and complications were investigated. Walking ability was evaluated by Koval’s scoring system and the quality of life was measured by the Korean EQ-5D. Results: The average union time was 4.4 months. The complications were one case of nonunion, 6 cases of avascular necrosis and one case of subtrochanteric fracture. The average of the horizontal shortening was 6.815 mm (0~20 mm) in the fracture site. The walking ability was on average 1 step down and it was possible to walk independently using a walker for 69% of the patients. The Korean EQ-5D quality of life was reduced from 0.856 to 0.561 (P <0.01). Conclusion: In elderly patients with femur neck fracture, the decreased abductor moment arm may reduce the quality of life and walking ability after cannulated screw fixation.
目的:探讨空心螺钉内固定治疗老年股骨颈骨折的影像学和临床效果。材料与方法:回顾性分析2000年5月至2009年3月间行骨融合术治疗的老年股骨颈骨折患者47例，随访1年以上。男性11例，女性36例，中位年龄72岁(65~85岁)。他们被划分为花园阶段。I期骨折34例，II期骨折16例。术后随访24个月(12~84个月)。观察愈合时间、水平缩短及并发症。行走能力采用Koval评分系统评估，生活质量采用韩国EQ-5D量表评估。结果:平均愈合时间4.4个月。并发症为骨不连1例，无血管坏死6例，转子下骨折1例。断裂部位水平缩短量平均为6.815 mm (0~20 mm)。行走能力平均下降1级，69%的患者可以使用助行器独立行走。韩国人的EQ-5D生活质量由0.856降至0.561 (P <0.01)。结论:老年股骨颈骨折患者行空心螺钉固定后，外展力臂减小可能会降低患者的生活质量和行走能力。
{"title":"The Result of Osteosynthesis for Femur Neck Fracture in Old Age Patients","authors":"S. Choo, H. Oh, Jong-In Kim, H. Lee, G. Jang","doi":"10.5371/JKHS.2011.23.1.32","DOIUrl":"https://doi.org/10.5371/JKHS.2011.23.1.32","url":null,"abstract":"Purpose: We wanted to investigate the radiographic and clinical results of internal fixation with cannulated screws in elderly patients with femoral neck fracture. Materials and Methods: We reviewed the results of 47 cases of elderly patients with femoral neck fractures that were treated by osteosynthesis from May 2000 and March 2009 and these patients could be followed up for more than one year. There were 11 males and 36 females with a median age of 72 years (65~85 years). They were classified by the Garden stage. The number of stage I and II fractures was 34 and 16, respectively. The postoperative follow up period was 24 months (12~84 months). The union time, horizontal shortening and complications were investigated. Walking ability was evaluated by Koval’s scoring system and the quality of life was measured by the Korean EQ-5D. Results: The average union time was 4.4 months. The complications were one case of nonunion, 6 cases of avascular necrosis and one case of subtrochanteric fracture. The average of the horizontal shortening was 6.815 mm (0~20 mm) in the fracture site. The walking ability was on average 1 step down and it was possible to walk independently using a walker for 69% of the patients. The Korean EQ-5D quality of life was reduced from 0.856 to 0.561 (P <0.01). Conclusion: In elderly patients with femur neck fracture, the decreased abductor moment arm may reduce the quality of life and walking ability after cannulated screw fixation.","PeriodicalId":410202,"journal":{"name":"The Journal of the Korean Hip Society","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134638359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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