Journal of Musculoskeletal Trauma

Kyung-Jae Lee

4 Articles

Osteoporotic Hip Fracture: How We Make Better Results?: Byung-Chan Choi, Kyung-Jae Lee; J Korean Fract Soc 2024;37(1):52-59. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.52

Abstract PDF: The prevalence of osteoporosis and incidence of osteoporotic fractures is increasing gradually as life expectancy is prolonged and the aged population increases. Osteoporotic hip fractures (femoral neck fractures and femoral intertrochanteric fractures) have high mortality because the patients with these fractures are elderly and have several comorbidities. Thorough preparation and a multidisciplinary approach in the preoperative period are critical, and early surgery is recommended. There are also several principles to treat osteoporotic hip fractures and prevent fixation failures. Many studies have suggested various treatment methods for femoral neck fractures and femoral intertrochanteric fractures. Functional recovery treatment is essential based on the patient’s health and activity levels. Finally, aggressive management of osteoporosis and the prevention of falling is needed to treat osteoporotic hip fractures successfully.

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Risk Factors for Subsequent Contralateral Hip Fracture following Osteoporotic Hip Fracture Surgery: Kyung-Jae Lee, Jung-Hoon Choi, Hee-Uk Ye, Young-Hun Kim, Kyung-Hwan Lim; J Korean Fract Soc 2021;34(2):51-56. Published online April 30, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.2.51

Purpose
This study examined the risk factors contributing to subsequent hip fractures in patients with osteoporotic hip fractures.
Materials and Methods
Between March 2008 and February 2016, 68 patients sustained a subsequent contralateral hip fracture after surgery for a primary osteoporotic hip fracture (Study group). The patients were compared with 475 patients who had been followed up for a minimum of one year with a unilateral osteoporotic hip fracture (Control group). The demographic data, bone mineral density (BMD), osteoporosis medication, osteoporotic fracture history, comorbid disease, type of surgery, preoperative, postoperative ambulatory capacity, and postoperative delirium in the two groups were compared.
Results
The demographic data, BMD, osteoporosis medication history, comorbid disease, type of surgery, and postoperative delirium were similar in the two groups. At three months after the primary surgery, the poor ambulatory capacity was significantly higher in the study group than the control group (p<0.001).
Conclusion
The ambulatory capacity after primary surgery is an important risk factor in the occurrence of subsequent hip fractures after osteoporotic hip fracture. Cause analysis regarding the poor ambulatory capacity after surgery will be necessary, and the development of a functional recovery program and careful management of the walking ability recovery will be needed.

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Osteoporotic Hip Fracture: How We Make Better Results?
Byung-Chan Choi, Kyung-Jae Lee
Journal of the Korean Fracture Society.2024; 37(1): 52. CrossRef

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Clinical Outcomes and Radiologic Characteristics of Insufficiency Femoral Neck Fracture in Elderly Patients: Hee-Uk Ye, Kyung-Jae Lee, Byung-Woo Min, Kyung-Hwan Lim, Beom-Soo Kim, Young-Hoon Kim; J Korean Fract Soc 2021;34(1):1-7. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.1

Abstract PDF: Purpose
In elderly patients, femoral neck insufficiency fractures that occur without a history of trauma are difficult to diagnose and treat, so it is emphasized that early suspicion of fractures and additional diagnostic tests are conducted. Materials and Methods: Between December 2010 to December 2019, 12 femoral neck insufficiency fractures (group 1) were evaluated by comparing them with 50 traumatic femoral neck fractures of a similar age. Along with demographic data, neck cortical thickness, shaft cortical thickness, head diameter, neck width, trochanter width, shaft width, neck-shaft angle, hip axis length, femoral neck index on the simple radiographic image were compared. Results: Seven of the 12 cases were non-displaced fractures, and it took an average of 19.2 days to diagnose the fracture after the symptoms occurred. The height was smaller than the control group at 149.1 cm in group 1 and 157.2 cm in group 2 (p<0.001). The cortical thickness of the medial femoral neck showed significant differences between the two groups: 3.16 mm in group 1 and 4.11 mm in group 2 (p=0.004). There was no statistical difference in the other measurements. Conclusion: Femoral neck insufficiency fracture often has a delayed diagnosis because of the characteristics of the fracture. The cortical thickness of the medial femoral neck in simple radiographic images can help suspect femoral insufficiency fractures in elderly patients when considered with detailed medical history taking and a physical examination.

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Three-Dimensional Analysis of the Morphological Features in the Femur of Atypical Fracture and Practical Implications of Intramedullary Nailing: Yong Uk Kwon, Kyung-Jae Lee, Joo Young Choi, Gu-Hee Jung; J Korean Fract Soc 2020;33(2):87-95. Published online April 30, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.2.87

Abstract PDF: Purpose
This study analyzed the morphological features of the contralateral femur without an atypical fracture by constructing a three-dimensional model with an actual size medullary canal.
Materials and Methods
Lateral and anterior bowing of the shaft were measured for 21 models, and the shape of the medullary canal was analyzed. To eliminate the projection error, the anteroposterior (AP) femur was rotated internally to the extent that the centerline of the head and neck, which is the ideal position of cephalomedullary nail screw, was neutral, and the lateral femur matched the medial and lateral condyle exactly.
Results
The lateral bowing and anterior bowing was an average of 5.5° (range, 2.8°-10.7°; standard deviation [SD], 2.4°) and 13.1° (range, 6.2°-21.4°; SD, 3.2°), respectively. In the area where lateral bowing increased, the lateral cortex became thicker, and the medullary canal was straightened. On the lateral femur, the anterior angle was increased significantly, and the diameter of curvature averaged 1,370.2 mm (range, 896-1,996 mm; SD, 249.5 mm).
Conclusion
Even if the anterolateral bowing increases in the atypical femur, the medullary canal tends to be straightened in the AP direction. So, it might be considered as a reference to the modification of an intramedullary nail to increase the conformity.

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