Journal of Musculoskeletal Trauma

Risk Factors of Periprosthetic Fracture after Total Knee Arthroplasty: Ju Young Shin, Hyung Jun Kim, Seung Han Cha, Dong Heon Kim; J Korean Fract Soc 2012;25(1):1-7. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.1

Abstract PDF: PURPOSE
To evaluate the incidence rate and risk factors for periprosthetic fracture after total knee replacement (TKR).
MATERIALS AND METHODS
We carried out a retrospective case-control study of 596 patients (951 knees) who underwent TKR between 1999 and 2006 and who were followed up over 36 months. We classified patients into group I (study group) and group II (control group). We subdivided risk factors as pre-operative, intra-operative, and post-operative factors. Age, osteoporosis, revision arthroplasty, CVA, and alcohol dependence were categorized as pre-operative factors; anterior femoral notching and prosthetic types (mobile, fixed, and load-bearing) were considered intra-operative factors; and post-operative activity level was classified as a post-operative factor. We obtained information from the patients' charts, X-ray film, and telephone interviews.
RESULTS
The overall incidence rate was 2.25%; 3 patients were male, and 18 were female (14.28% and 85.72%, respectively). Old age (p<0.01, odds ratio=1.14), osteoporosis (p=0.01, odds ratio=4.74), revision arthroplasty (p=0.01, odds ratio=7.46), CVA (p=0.02, odds ratio=8.55), and alcohol dependence (p=0.03, odds ratio=44.54) were statistically significant among the pre-operative factors. Among the intra-operative factors, anterior femoral notching (p<0.01, odds ratio=11.74) was significant, and continued heavy labor (p<0.01, odds ratio=8.14) was significant among the post-operative factors.
CONCLUSION
We concluded that old age, osteoporosis, revision arthroplasty, comorbidity related with falling down, anterior femoral notching, and continued heavy labor were associated with periprosthetic fracture after TKR.

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Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly: Duk Hwan Kho, Ki Hwan Kim, Hyeung Jun Kim, Dong Heon Kim; J Korean Fract Soc 2009;22(4):239-245. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.239

Abstract PDF: PURPOSE
To evaluate the results of the treatment of femoral basicervical fractures aged 75 years or older. MATERIALS AND METHODS: We reviewed the clinical records of 60 patients who were older than 75 years and who underwent bipolar hemiarthroplasty for femoral basicervical fractures using calcar replacement stem between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability and modified Harris hip score, the activities of daily living, the associated medical conditions and arthritis, and postoperative disgnosis. RESULTS: The mean Harris hip score were 87.2 (74~92). Walking ability was recovered in 91% (55 cases) and activity of daily living was achived in 91% (55 cases). Press-fit fixations were 56 cases and bony ingrowth fixations were 57 cases. Stress shields were 28% (17 cases). Thigh pains were 5% (3 cases) and revision rate was 3% (2/60 cases). CONCLUSION: We consider bipolar hemiarthroplasty using calcar replacement stem in femoral basicervical fractures in the Elderly with severe osteoporosis is the useful treatment in view of the stable and rigid fixation of femoral stem, early ambulation, and the low rate of complications and death, even if the operation is technically very difficult.

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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly: Duk Hwan Kho, Ki Hwan Kim, Hyeung June Kim, Dong Heon Kim; J Korean Fract Soc 2008;21(3):232-239. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.232

PURPOSE
To evaluate the results of bipolar hemiarthroplasty using calcar replacement stem for hip fractures in elderly patients.
MATERIALS AND METHODS
Between March 1995 and March 2005, the clinical records on 68 cases more than 75 years old who underwent the bipolar hemiarthroplasty using calcar replacement stem and followed minimum 2 years were reviewed. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, complications, osteoporosis and radiologic findings.
RESULTS
The mean postoperative modified Harris hip score was 88.3 (69~95) in femoral neck fractures and 83.5 (63~91) in femoral intertrochanteric fractures. Walking ability was recovered in 82.3% (56 cases) and activity of daily living was achived in 82.3% (56 cases). Complications were thigh pain, infection, femoral stem subsidence, stress shield, dislocation.
CONCLUSION
We consider bipolar hemiarthroplasty using calcar replacement stem for unstable hip fractures in elderly patients with severe osteoporosis is the useful treatment in view of the stable and rigid fixation, early ambulation and the low rate of complications, even if the operation is technically very difficult.

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Bipolar Hemiarthroplasty With a Calcar Stem for the Management of a Failed Proximal Femoral Nail Anti-rotation Asia (PFNA2) in a Case of Geriatric Unstable Intertrochanteric Femur Fracture
Mukesh O Phalak, Tushar Chaudhari, Ajinkya K Chaudhari
Cureus.2024;[Epub] CrossRef
Bipolar Hemarthroplasty Using Cementless Conical Stem for Treatment of Dorr Type B and C Femoral Neck Fracture
Jeong Hoon Kang, Sang Hong Lee, Sung Jung
Hip & Pelvis.2015; 27(4): 232. CrossRef
Assessment of the Clinical Features of Bilateral Sequential Hip Fractures in the Elderly
Duk-Hwan Kho, Ju-Yong Shin, Hyeung-June Kim, Dong-Heon Kim
The Journal of the Korean Orthopaedic Association.2009; 44(3): 369. CrossRef
Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly
Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-Jun Kim, Dong-Heon Kim
Journal of the Korean Fracture Society.2009; 22(4): 239. CrossRef

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Risk Factors of Postoperative Delirium in Elderly Patients with Hip Fractures: Ki Hwan Kim, Duk Hwan Kho, Ju Yong Shin, Jin Yong Choi, Eung Sik Kim, Dong Heon Kim; J Korean Fract Soc 2008;21(3):189-194. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.189

Abstract PDF

PURPOSE
To find out the relationship between various risk factors and post-operative delirium in elderly patients with hip fractures.
MATERIALS AND METHODS
Out of 135 patients older than 65 years old who underwent the surgery for hip fracture in our department, between the periods of March 2003 to March 2005, 14 patients (10.4%) developed post-operative delirium and 121 patients (89.6%) did not. We studied risk factors of post-operative delirium in two groups.
RESULTS
In chi-square test between delirium group and non-delirium group, the patients were more likely to develop post-operative delirium if they had previous episodes of delirium, abnormal cognitive function, low walking ability before admission, high dependency on ADL (Activities of Daily Living), other medical accompanying diseases, history of dementia, post-operative hypoxia, post-operative electrolyte imbalance, low post-operative hemoglobin and hematocrit, low post-operative albumin and were older than 75 years old (p<0.05). Sex, type of fracture, anesthesia and the time between admission and operation did not show much difference between the two groups.
CONCLUSION
The risk factors of postoperative delirium in elderly patients with hip fracture have a tendency to be multifactorial. Therefore, we conclude that being prepared by thorough understanding of the risk factors and their relationships will help prevent post-operative delirium and result in good postoperative prognosis.

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Increased Serum Neuropeptide Galanin Level Is a Predictor of Cognitive Dysfunction in Patients with Hip Fracture
Zichao Xue, Ke Zhang, Biao Luo, Long Fan, Ruizhe Zhao, Guangliang Hu, Yuzhen Xu
Disease Markers.2021; 2021: 1. CrossRef
Sleep Disturbance Strongly Related to the Development of Postoperative Delirium in Proximal Femoral Fracture Patients Aged 60 or Older
Myung-Rae Cho, Suk-Kyoon Song, Cheol-Hwan Ryu
Hip & Pelvis.2020; 32(2): 93. CrossRef
Incidence and Associated Factors of Delirium after Orthopedic Surgery
Si-Wook Lee, Chul-Hyun Cho, Ki-Cheor Bae, Kyung-Jae Lee, Eun-Seok Son, Sang-Hyun Um
Journal of the Korean Orthopaedic Association.2019; 54(2): 157. CrossRef
Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery
Jae-Lan Shim, Seon-Young Hwang
Journal of the Korea Academia-Industrial cooperation Society.2016; 17(2): 649. CrossRef
Relationship between Knowledge, Stress, and Nursing Performance about Care for Delirium in Geriatric Hospital Nurses
Eun-Hee Kim
Journal of Korean Clinical Health Science.2016; 4(2): 593. CrossRef
The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial
Kyoung-Ja Moon, Sun-Mi Lee
International Journal of Nursing Studies.2015; 52(9): 1423. CrossRef
Is Delirium an Unrecognized Threat to Patient Safety in Korean Intensive Care Units?
Kyoung-Ja Moon, Jinshi Piao, Yinji Jin, Sun-Mi Lee
Journal of Nursing Care Quality.2014; 29(1): 91. CrossRef
The Effects of Delirium Care Training Program for Nurses in Hospital Nursing Units
Moonja Kim, Haejung Lee
Korean Journal of Adult Nursing.2014; 26(5): 489. CrossRef
Knowledge, Performance and Stress about Care for Delirium in Orthopedic Hospital Nurses
Mi Young Kim, Young Eun
Journal of muscle and joint health.2013; 20(1): 72. CrossRef
The Experience of Delirium Care and Clinical Feasibility of the CAM-ICU in a Korean ICU
Joo-Hee Jung, Jung-Hye Lim, Eun-Jung Kim, Hyo-Chan An, Min-Kyung Kang, Jin Lee, Yu-Kyung Min, Eun-Zoo Park, Xiang-Hwa Song, Hye-Ryoung Kim, Sun-Mi Lee
Clinical Nursing Research.2013; 22(1): 95. CrossRef
Development and validation of the Korean Nursing Delirium Scale
Kyoung-Nam Kim, Cheol-Ho Kim, Kwang-Il Kim, Hyun-Jung Yoo, Si-Young Park, Yeon-Hwan Park
Journal of Korean Academy of Nursing.2012; 42(3): 414. CrossRef
Influencing Factors of the Incidence of Delirium in Elderly Patients with Arthroplasty
Young-Whee Lee, Hye-Bin Im, Eun-Jeong Jeong, Hee-Sun Ma
Korean Journal of Adult Nursing.2012; 24(4): 348. CrossRef
Delirium After Spinal Surgery in Korean Population
Jin Kyu Lee, Ye-Soo Park
Spine.2010; 35(18): 1729. CrossRef
The Incidence and Related Factors of Delirium in Elderly Patients with Hip Fracture after Surgery
Bo-Kyung Sohn, Yerl-Bo Sung, Eun-Jin Park, Dong-Woo Lee
Journal of the Korean Geriatrics Society.2010; 14(3): 162. CrossRef

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Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients: Duk Hwan Kho, Ju Yong Shin, Ki Hwan Kim, Jun Hyuck Lee, Dong Heon Kim; J Korean Fract Soc 2007;20(2):129-134. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.129

Abstract PDF

PURPOSE
To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult.
MATERIALS AND METHODS
Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
RESULTS
The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
CONCLUSION
We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.

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Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
Injury.2017; 48: S72. CrossRef
Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
Hip & Pelvis.2013; 25(4): 274. CrossRef
Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim
Journal of the Korean Fracture Society.2009; 22(4): 232. CrossRef

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Treatment of the Hip Fracture in Elderly Patients with Cerebrovascular Accident (CVA): Ki Hwan Kim, Duk Hwan Kho, Ju Yong Shin, Dong Heon Kim, Jun Hyuck Lee; J Korean Fract Soc 2006;19(2):122-127. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.122

Abstract: PURPOSE
To evaluate the results of the treatment of the hip fractures in elderly hemiplegic CVA patients with disuse osteoporosis. Hemiplegic CVA patients have much difficulties in rehabilitation such as walking, daily activity of living and so forth.
MATERIALS AND METHODS
The clinical records on thirty-four CVA patients who had undergone the treatment in hip fracture and followed more than 12 months of period between March 1998 and March 2004 were retrospectively reviewed. The treatment methods were 22 cases of bipolar hemiarthroplasty, 6 cases of compression hip screw, 3 cases of ender nail, 3 cases of multiple cannulated screw. We compared the groups underwent bipolar hemiarthroplasty (Group I), internal fixation (Group II), fracture in ipsilateral (Group A), fracture in contralateral (Group B). We evaluated the results by modified Harris hip score, walker ambulation time, walking ability and activity of daily living.
RESULTS
The mean postoperative modified Harris hip score was decreased in Group I (11.7 points), Group II (9.6 points), Group A (10.0 points), Group B (12.3 points). Recovery of preoperative walking ability was achieved in total 21 cases (62%) that 7 cases (58%) were observed in Group I, 14 cases (64%) in Group II, 18 cases (67%) in Group A and 3 cases (43%) in Group B. Basic activity of daily living was possible in 18 cases (53%).
CONCLUSION
Hemiplegic CVA patients with hip fracture have much difficulties in rehabilitation. However, with appropriate treatment and confident positive attitude for rehabilitations of the patients, doctors and family members, we can expect more reliable results close to the pre-injury status in terms of walking ability and activity of daily living.

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Postoperative Mortality Rate of Hip Fracture in Elderly Patients: Duk Hwan Kho, Ki Hwan Kim, Ju Yong Shin, Jun Hyuck Lee, Dong Heon Kim; J Korean Fract Soc 2006;19(2):117-121. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.117

Abstract

PURPOSE
To evaluate the rate of mortality for the elderly patients after treatment of hip fractures and analyze the associated risk factors which might affect their mortality rate.
MATERIALS AND METHODS
About the clinical records on 305 patients who had undergone the treatment in hip fractures, we evaluated the mortality rate of the total number of 248 patients whose age between 70 and 103 who were followed more than 12 months of period between March 1994 and March 2003. The mean age was 81.3 years. The composition of each female and male were 176 and 72 cases respectively. 99 cases were femoral neck fractures, and 149 cases were femoral intertrochanteric fractures. The operation included bipolar hemiarthroplasty and internal fixation using multiple cannulated screws, compression hip screws and Ender nails. We compared and analyzed the relating factors for the mortality rate.
RESULTS
The mean postoperative mortality rate was 14.1% (35 cases). The highest mortality rate showed for the postoperative 3 months which was 57.1% (20 cases), between 4 and 6 months was 25.7% (9 cases), and 17.1% (6 cases) were presented for 7 and 12 months. The postoperative mortality rate within 1 year was affected by underlying diseases, ASA (American society of Anesthesiologists) and cemented bipolar hemiarthroplasty. but, there were no significant difference of the other factors such as the age, gender, osteoporosis and delayed operation.
CONCLUSION
The variable factors which affect the mortality rate of the hip fractures in the elderly patients whose age over 70 were mostly determined by underlying diseases, ASA grade, and cemented bipolar hemiarthroplasty. Further study should be necessary for the factors influencing on the mortality rate.

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Finite element modeling and simulation of hip joints in elderly women: for development of protective clothing against fracture
Jinhee Park, Yun Ja Nam
International Journal of Clothing Science and Technology.2020; 32(5): 661. CrossRef
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Dong Kyu Lee, Seunguk Bang, Sangseok Lee
Anesthesia and Pain Medicine.2019; 14(1): 8. CrossRef
The Influence of Stroke on Postoperative Prognosis of Femoral Intertrochanteric Fractures
Youn Soo Hwang, Kyu Pill Moon, Kyung Taek Kim, Won Seok Park, Joon Yeon Song, Jeong Hoon Chae
Journal of the Korean Orthopaedic Association.2016; 51(4): 273. CrossRef
Analysis of the Risk Factors and Clinical Outcomes of Femoral Intertrochanteric Fractures in Patients over 65 Years Old
Chul Hong Kim, Kyu Yeol Lee, Sung Soo Kim, Myung Jin Lee, Lih Wang, Hyeon Jun Kim, Jung Mo Kang
Hip & Pelvis.2013; 25(2): 127. CrossRef
Postoperative Mortality and the Associated Factors in Elderly Patients with Hip Fracture
You-Sung Suh, Yong-Beom Kim, Hyung-Suk Choi, Hong-Kee Yoon, Gi-Won Seo, Byung-Ill Lee
Journal of the Korean Orthopaedic Association.2012; 47(6): 445. CrossRef
Risk Factors for Cardiovascular Complications Following Hip Surgery
Kuen Tak Suh, Seung Joon Rhee, Jung Sub Lee, Jeung Il Kim
Hip & Pelvis.2012; 24(2): 71. CrossRef
Current Recommendations for Laboratory Testing and Use of Bone Turnover Markers in Management of Osteoporosis
Jehoon Lee, Samuel Vasikaran
Annals of Laboratory Medicine.2012; 32(2): 105. CrossRef
The Daily Life Functions of Elderly Peritrochanteric Fracture Patients after Surgical Treatment
Dae Moo Shim, Tae Kyun Kim, Jong Yun Kim, Duk Hwa Choi, Joung Suk Lee, Seong In Lee
Journal of the Korean Fracture Society.2012; 25(1): 8. CrossRef
One-Year Mortality Rate of Patients over 65 Years Old with a Hip Fracture
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Young Hwa Choi
Hip & Pelvis.2011; 23(2): 137. CrossRef
Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -
Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi
Journal of the Korean Fracture Society.2011; 24(1): 16. CrossRef
Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -
Jun-Dong Chang, Je-Hyun Yoo, Sang-Soo Lee, Tae-Young Kim, Kyu-Hak Jung, Yong-Kuk Kim
Hip & Pelvis.2010; 22(4): 283. CrossRef
Determination of an Applicable FRAX Model in Korean Women
Dong-Yun Lee, Seung-Jae Lim, Young-Wan Moon, Yong-Ki Min, DooSeok Choi, Byung-Koo Yoon, Youn-Soo Park
Journal of Korean Medical Science.2010; 25(11): 1657. CrossRef
Postoperative Mortality and the Associated Factors for Senile Hip Fracture Patients
Dong-Soo Kim, Hyun-Chul Shon, Yong-Min Kim, Eui-Sung Choi, Kyoung-Jin Park, Se-Hyuk Im
The Journal of the Korean Orthopaedic Association.2008; 43(4): 488. CrossRef

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Treatment of Intertrochanteric Fracture of the Femur with Ender Nail in the Elderly Patients with High Risk of Anesthesia: Ju yong Shin, Duk Hwan Kho, Dong Ok Kim, Dong Heon Kim; J Korean Fract Soc 2004;17(2):202-207. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.202

Abstract PDF: PURPOSE
To evaluate the usefulness of IM Ender nail in treating femoral intertrochanteric fractures with high risks including cardiovascular disease, pulmonary disease, liver cirrhosis, cerebrovascular disease, metastatic cancer, and skin problem at hip joint region.
MATERIALS AND METHODS
Thirty-five patients of pre-existing diseases and femoral intertrochanteric fractures treated with Ender nailing, January 1990 to November 1997. Under the c-arm guided, closed reduction and internal fixation were performed using Ender nails, We analized operation time, blood loss, bone union, ambulation time and complications RESULTS: Mean operation time was 55 minutes, mean blood loss was 120 ml, mean radiological bone union was 12 weeks and average of partial weight bearing was 6.9 days. Postoperative complications were gastrointestinal discomfort in 3 cases, superficial wound infection in 1 case, knee pain in 7 cases, inguinal pains in 5 cases, distal migration of nails in 3 cases, varus deformity in 2 cases, proximal migration of nail with nonunion in 1 case.
CONCLUSION
The intramedullary ender nail is useful method in treating femoral intertrochanteric fractures in high risk patients of anesthesia and blood loss or skin problem at hip joint region.

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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Fractures in Elderly Patients: Duk Hwan Kho, Kyou Hyeun Kim, Ju Young Shin, Sin Woo Lim, Dong Heon Kim; J Korean Soc Fract 2003;16(1):22-28. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.22

Abstract PDF

PURPOSE
The purpose of this paper is to analyze the operating time, timing of ambulation, functional results and complications using the calcar replacement stem for the severely comminuted unstable intertrochanteric fractures in the elderly patients.
MATERIALS AND METHODS
From August 1991 through January 2001, 20 elderly patients over the 75 year old patients had undergone bipolar hemiarthroplasty with calcar replacement stem for the treatment of unstable intertrochanteric fractures.
RESULTS
The mean operating time was 45 minutes and mean Harris Hip Score was 84.7. Ambulation with walker was started at post-operative 8 days and full weight bearing was 6.9 weeks, each. Complications were 2 cases of wound infection, 1 case of severe thigh pain and 1 case of dislocation.
CONCLUSION
Early ambulation, functional restoration and decrease of the complications with bipolar hemiarthroplasty using calcar replacement stem for severely comminuted unstable intertrochanteric fractures in elderly patients, therefore this methods seems to be one of the effective treatments.

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Pre- and Perioperative Risk Factors of Post Hip Fracture Surgery Walking Failure in the Elderly
YoungJi Ko
Geriatric Orthopaedic Surgery & Rehabilitation.2019;[Epub] CrossRef
A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447. CrossRef
Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
Hip & Pelvis.2012; 24(1): 45. CrossRef

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Supracondylar Fracture of the Humerus in a Hemophiliac with Antibodies to Factor VIII - A Case Report: Duk Hwan Kho, Dong Heon Kim, Kyou Hyeun Kim, Sin Woo Lim; J Korean Soc Fract 2002;15(1):82-86. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.82

Abstract PDF: Fractures in hemophiliacs with antibodies to factor VIII are very rare, and the presence of antibodies to factor VIII in the patient`s blood makes antihemophilic replacement therapy and operative treatment extremely difficult. We treated one case of supracondylar fracture of the humerus in hemophiliac with antibodies to factor VIII surgically and present that case with a review of the literature.

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Treatment of intertrochanteric fractures with bipolar hemiarthroplasty in the elderly: Kyou hyeun Kim, Duk hwan Kho, Joon ho Yang, Dong heon Kim; J Korean Soc Fract 2001;14(2):174-180. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.174

Abstract PDF

PURPOSE
To compare the timing of ambulation, complications and functional results between the autogenous femoral head graft and the calcar replacement type stem in the severe comminuted fracture of the elderly patients with unstability.
MATERIALS AND METHODS
25 intertrochanteric femoral fracture patients who had bipolar hemiarthroplasty were followed for more than 1 year. 17 patients had autogenous femoral head graft and 8 patients had calcar replacement type stem.
RESULT
The mean operating time for autogenous femoral head graft was 1.7 hours, and calcar replacement type stem was 1.3 hours. Postoperative Harris functional score was 84.1 for the autogenous femoral head graft group and 82.2 for the calcar replacement type stem group.
Discussion
: Both autogenous femoral head graft augmentation and fixation using the calcar replacement type stem result in rigid fixation, which enables the patients to ambulate early and to have low complication rate. Both techniques seem to be effective for the treatment of intertrochanteric fractures.

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Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
Journal of the Korean Fracture Society.2024; 37(3): 144. CrossRef
Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
Hip & Pelvis.2013; 25(1): 44. CrossRef
Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -
Jun-Dong Chang, Je-Hyun Yoo, Sang-Soo Lee, Tae-Young Kim, Kyu-Hak Jung, Yong-Kuk Kim
Hip & Pelvis.2010; 22(4): 283. CrossRef

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Ischial Weight Bearing Brace after Skin Traction for Treatment of Femoral Shaft Fractures in Children: Dong Heon Kim, Jae Jin Oh, Joonho Yang; J Korean Soc Fract 2000;13(4):1038-1043. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1038

Abstract PDF: PURPOSE
Most of the pediatric femoral shaft fractures are treated conservatively such as traction therapy followed by cast fixation. At Konkuk University Hospital, for those pediatric femoral shaft fractures that managed well with skin traction without having to perform bone traction, we utilized skin traction until callus appear on the radiologic studies. At this time, they wore ischial weight bearing braces were and forced on early ambulation with satisfactory result. MATERIAL AND METHODS: The pediatric patients between 2 to 10 years of age with femoral shaft fractures during January 1993 to January 1997 were selected for the study. They were treated with skin traction followed by wearing ischial weight-bearing braces. From the 39 selected cases, we selected 32 cases with 1-year follow-ups. For each case, results from before and after the treatment were studied RESULTS: The average post-therapy angular changes were that the varus angle change was 10.2, anterior 10.6. There were 7 cases of malunion, 6 cases of anterior angle change, 1 case of varus angle change. The average duration of skin traction was 4.3 weeks and initiation of weight-bearing was 5.8 weeks. We observed 6 cases of limblength discrepancy, but no signs of claudication in any cases.
CONCLUSION
In pediatric femoral shaft fractures, if the alignment is maintained well, then we can utilize skin traction followed by ischial weight-bearing braces, which enables earlier ambulation than the cast fixation. Also skin traction and weight-bearing braces has less complication than the cast fixation.

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The Clinical Resuts of Bipolar Hemiarthroplasty in Old Age-Femoral Neck Fracture vs. Intertrochanteric Fracture-: Dong Heon Kim, Kyu Cheol Shin, Byeong Chun Chang, Dae Sul Kang; J Korean Soc Fract 1999;12(3):509-515. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.509

Abstract PDF: The peritrochanteric fracture remains one of the most common and potentially devastating injuries in the geriatric population. The goal of treatment is early ambulation to prevent the complications such as pressure sore, pneumonia, deep vein thrombosis, pulmonary embolism and long time hospitalization by open reduction and internal fixation or closed reduction and internal rotation. In femoral neck fracture, many surgeons agree on the bipolar hemiarthroplasty but there is controversy about that treatment in intertrochanteric fracture. We have tried to assess the clinical outcome of bipolar hemiarthroplasty for the intertrochanteric fracture as compared with femoral neck fracture in old age. Ninty-five bipolar hemiarthroplasties were performed at our hospital, between January 1991 and February 1996. We selected 65 patients who had been followed for at least one year. Forty of sixty-five patients had femoral neck fractures and twenty-five of them intertrochanteric fractures. The results were as follows: 1. Regardless of using the cement, the partial weight bearing ambulation time after operation was 10.3 days in femoral neck fracture, 19.5 days in intertrichanteric fracture. 2. At one year follow-up the average Modified Harris Hip Score was 88.9 in femoral neck fracture, and 87.5 in intertrochanteric fracture. 3. Postoperative complications in case of femoral neck fracture included thigh pain in 4 patients, heterotopic ossification in 1, intraoperative fractures of the femoral shaft in 2, leg length inequality in 1 and dislocations after bipolar hemiarthroplasties in 3. And those in case of intertrochanteric fractures were thigh pain in 2 patients, heterotopic ossifications in 2, intraoperative fractures of the femoral shaft in 2 and dislocation after bipolar hemiarthroplasty in 1. 4. There were no statistically significant differences in the clinical functional score and complications between intertrochanteric and femoral neck fracture groups, therefore bipolar hemiarthroplasty can be recommended as one of the treatment of intertrochanteric fracture as well as femoral neck fracture in the elderly patient.

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The Treatment of the Proximal Tibia Fracture -Comparison of the Variable Method of Fixation-: Dong Heon Kim, Kyu cheol Shin, Kyeong Soon Kim, Byeong Chun Chang, Dae Sul Kang; J Korean Soc Fract 1998;11(2):442-448. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.442

Abstract PDF: The treatment of proximal tibial fracture is an area of great controversy. Because open and comminuted fractures are common, selection of fixation method of the proximal tibial fracture is more difficult than any other fractures. Many authors reported high rate of malunion and loss of reduction. The purpose of this study is to compare the results of the proximal tibial fractures depending on the fixation method. We evaluated the records of 35 patients (36 fractures) who had been treated with intramedullary nailing, plate and screws and external fixation from January 1989 to January 1996. The mean period of follow-up was 12months. Of the 36 fractures, 8 fractures were with intramedullary nailing, 12 fractures with plate and screws, 16 fractures with external fixator. In intramedullary nailing groupp, the average time of bony union was nineteen weeks (16-27), in plate and screws fixation group twenty three weeks (18-31) and in external fixation group 22 weeks (19-29). The complications of intramedullary nailing group were 3 nonunions, 1 delayed union, 1 varus deformity, 2 anterior angulations and 2 cases of deep wound infection. The complications of plate and screws group were 1 nonunion, 3 delayed union, 1 deep wound infection, 2 superficial infections and in most fractures partial stiffiness of knee joint. The complications of external fixator group were 1 nonunion, 1 delayed union, 1 deep wound infection, 6 pin tract infections and 3 cases of knee joint stiffness. In our cases, if there is open wound higher than Gustilo grade III-B and severe comminuted fracture initially, the external fixation is more preferred for wound management and also more advantageous method for the patients who got a multiple trauma in abdomen, chest and head injuries. In closed fractures and Gustilo grade I, II open fractures, intramedullary nailing is considered to be more preferable method. But the anatomy of proximal tibia made nailing these fractures technically difficult. In conclusion, we consider each method of fixation is useful fixation method of the proximal tibial fractures, but each method should be selected advertently depending on the severity of soft tissue injury and the degree of comminution of the fractures.

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Treatment of Open Segmental Fracture of the Tibia: Kyeong Soon Kim, Kyu Chul Shin, Dong Hyeuk Kim, Dong Heon Kim; J Korean Soc Fract 1998;11(1):205-213. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.205

Abstract PDF: Tibial segmental fractures are considered special type of lesion and pose many problems and the results often are unsatisfactory. We performed retrospective study of the 17 cases of open tibial segmental fracture which were treated from January 1990 to December 1995 and evaluated the efficacy of the external fixation and intramedullary nailing. The segmental fracture were classified according to the Melis classification and open fracture were classified according to the Gustilo-Anderson classification. After average follow-up of 16 months (range, 12 to 24 months), all of the fractures had healded except one. The results were as follows: 1. The average time of union was 22.5 weeks in the case of intramedullary nailing (Endernail; 26 weeks, Interlocking IM nailing; 21 weeks) and 31 weeks in the case of external fixation (Monofixator; 28 weeks, Ilizarov external fixator; 34 weeks). 2. Nonunion and osteomyelitis was developed in one case of Ilizarov external fixation and 5 cases of pin tract infection were also developed. Among 8 cases of external fixation group, 4 cases of delayed union and one case of malunion were developed. 3. In intramedullary nailing, delayed union was developed in 4 cases. 4. The functional results by Tile rating system were showed good in 6 cases, acceptable in 8 and poor 3. In concla\usion, intramedullary nailing provided better ressults thanexternal fixator in open segmantal tibial fractures, but we consider fixation device should be selected depending on the fracture type, degree of comminution and condition of the soft tissue.

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Ender Nailing of Humeral Shaft Fractures: DONG HEON KIM, KYU CHUL SHIN, KYEONG SOON KIM, SANG HAK LEE; J Korean Soc Fract 1997;10(3):614-620. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.614

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Most humeral shaft fractures are treated conservatively. However, in the event of failure of closed reduction, pathologic fractures, multiple fracture, multiple associated injury and severe neurologic disorder, operative treatment may be indicated. The purpose of this article is to evaluate the effectiveness of Ender nailing for the humeral shaft fracture of the patients who have multiple fracture, multiple associated injury and pathologic fractures. Authors treated 56 patients with humeral shaft fractures by flexible intramedu-llary stabilization- Ender nail or Ender nail with Rush pin 47 cases were treated closed method, 9 cases were treated by open method. Period of follow-up was average 16 weeks. Fractures were united by an average 12 weeks(range : 9 to 20 weeks). There were no non-union, infection and malunion. No backing out of nails occured. In conclusion, Ender nailing is effective treatment for the humeral shaft fracture to decrease hospital stay, to permit early range of motion of the shoulder and elbow joint.

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Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture
Tae-Soo Park, Joon-Hwan Lee, Tai-Seung Kim, Kwang-Hyun Lee, Ki-Chul Park
Journal of the Korean Fracture Society.2008; 21(4): 292. CrossRef

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Treatment of Femoral Shaft Fracture with Intramedullary Nailing: A Comparison of Ender Nailing with Interlocking Intramedullary Nailing: Sung Tae Lee, In whan Jeong, Dong Heon Kim, Kyu Cheol Shin, Moon Koo Lee; J Korean Soc Fract 1996;9(2):409-415. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.409

Abstract PDF: The rigid internal fixation of the femoral shaft fracture with intramedullary nailing enables early joint motion and reduces morbidity. The authors reviewed the results of 38 patients treated with Ender nailing(22 casses) and interlocking intramedullary nailing(16 cases) between March 1989 and March 1994. The resuls were as follows. 1. The average bony union time in Ender nailing(18.9 weeks) was similar to interlocking intramedullary nailing(18.7 weeks). 2. The average time to acHieve full range of motion of the knee was shorter in intramedullary nailing (10.2 weeks) than in Ender nailing(13.5 weeks). 3. Interlocking intramedullary nailing required shorter time to achieve full weight Ender nailing. 4. The average operation time was shorter in Ender nailing(55 mins.) than in interlocking intramedullary nailing(100 mins). Interlocking intramedullary nailing is thought to be a better option than Ender nailing in fixa lion of femur shaft fracture by our study. However, in elderly patients or multiple injured patieilts, Ender nailing can be used advantageously for shorter operation time and technical sim plicity.

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Treatment of Nonunion of the Tibia Fracture: Dong Heon Kim, Kyu Cheol Shin, Hee Cheol Park, Ju Yong Shin; J Korean Soc Fract 1996;9(1):112-118. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.112

Abstract PDF: Nonunion after tibia fracture is a relatively common problem. The cases of nonunion have been known open and comunited fracture, extensive soft tissue injury, interposition of the soft tissue, distarbance of the blood supply and inadequate fixation. A number of methods stimulating union have born described. These include fibular osteotomy followed by weight-bearing in a cast, autogenous boone graft with or without additional stabilization, internal or external fixation with compression, open or closed IM nailing and even electromagetic stimulation. In this paper we carried out retrospective study of the 24 nonunion of the tibia fracture which were treated at the Department of Orthopeadic Surgery, Kon-Kuk University Hospital from March 1990 to March 1995. The results were as follows: 1. Among 24 cases of monunions, 16cases(66.6%) were communited fractures and 18cases(75%) were open fractures. 2. Hypervascular nonunion were 12cases and avascular nonunion were 12cases. Previous methods of treatinent were conservative treatment in 6cases of closed fracture and were treated with Ender nailing, multiple K-wire fixation, Ilizarolr external fixation, monofixator external fixation in 1 Bcases of open fractures. 3. The average duration from injury to dignosis of nonunion was 7 months tweets.(Range 5 months to 24months) 4. Tibial nonunion were treated with plate and screw with bone graft(Bcases), Interlocking IM nail ing(14cases), and nizarov external fixation with bone graft(teases). 5. The average time of union was 23weeks in all patients: 24 weeks in the case of plate and screw with bone graft. 20 weeks in the case of interlocking IM nailing. 28 weeks in the case Ilizarov external fixation with bone graft. 6. The main complications were joint stiffness due to long-term cast irnrnobiliBation in the case of plate and screw with bone graft, LROM of joint contracture and external pin site in the case of Ilizarov external fixation with bone graft, deep infection Icase and knee joint pain teases due to proximal nail protrusion in the case of Interlocking IM nailing.

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The Treatment of Volar Iunate Dislocation and Perilunar Dislocation: Kyu Cheol Shin, Dong Heon Kim, Ju Yong Shin; J Korean Soc Fract 1995;8(4):902-913. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.902

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The treatment methods of volar lunate dislocation and dorsal perilunar dislocation were introduced variably. We treated 7 cases of volar lunate and dorsal perilunar dislocation by closed reduction and K-wire fixation, open reduction and isolated lunate excision. The 1 case of trans-scaphoid dorsal perilunar dislocation was treated by closed reduction and Herbert screw fixation. The result were as followed: 1. The early diagnosis and early treatment is the most improtant. 2. The closed reduction and percutaneous pinning has advatage of maintenance of reduction and stability of wrist joint. 3. The advantage of Herbert screw fixation is anatomical reduction of the scaphoid fracture but disadvantage is technical difficulty. 4. In open reduction, we must choose the approach that minimiBe the vascular damage to the lunate from the volar side. 5. The isolated lunate excision is not advised.

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Carpal Tunnel Syndrome and Rupture of Flexor Tendon Associated from Neglected Anterior Lunate Dislocation
Young Yool Chung, Young Jae Jang
Journal of the Korean Society for Surgery of the Hand.2015; 20(1): 33. CrossRef
Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo-Hong Han, Jin-Myoung Dan, Dong-Hoon Lee, Young-Woong Kim
Journal of the Korean Fracture Society.2011; 24(4): 347. CrossRef
Combined Lunate and Triquetrum Fracture: A Case Report
Joo-Hak Kim, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Seung-Do Cha, Joong-Hyo Lee, Jai-Hyung Park
Journal of the Korean Fracture Society.2008; 21(4): 320. CrossRef

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Treatment of Ipsilateral Fracture of the Femur and Tibia: Dong Heon Kim, Kyu Cheol Shin, Bo Hyeon Kim; J Korean Soc Fract 1995;8(3):620-627. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.620

Abstract PDF: The floating knee describes the fail knee joint segment resulting from fractures of the shafts or adjacent metaphyses of the ipsilateral femu. and tibia. It usually is associated with majo. soft tissue damages, open fractures, and other site injuries. The methods of treatment have been controversal. The key point of the treatment is focussed to the early restoration of the knee function. The floating knee in 24 patients were treated by surgical management from March 1988 to December 1994. The results were follows: 1. Average bone union time in femur was 20 weeks and in tibia was 18 weeks. Difference of the result of the treatment between the interlocking nail and Ender nail was not significant. 2. At the last follow up, the excellent and good results were 83% by Karlstrom and Olerud criteria, and the first group using the intrarneduallary nail achieved best result. 3. The most common complication was loss of the range of motion of the knee and loss of the range of motion of the knee was 0 to 45 degrees(the average 1 degrees).

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Comparision of Ender Nailing with Sliding Screw Plate Fixation in Intertrochanteric Fracture: Dong Heon Kim, Young Roon Kim, Kyeong Soon Kim; J Korean Soc Fract 1994;7(2):545-552. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.545

Abstract PDF: A sliding screw plate is the most commonly used device for the fixation of intertrochanteric hip fractures, providing secure fxation and controlled impaction but several complications, such as penentration of lag screw, back out of lag screw, wide skin incision and relatively long operation time, have been reported. An intramedullary device has been introduced as an alternative method. Ender nailng for intertrochanteric fracture of femur has many advantages such as minimal operative trauma and blood loss, short operation time, low incidence of infection, good stability of fracture and early ambulation. The authors have treated 45 cases of intertrochateric fracture from March 1988 to July 1994 with sliding screw plate(25 cases) or Ender nailing(20 cases). The results are as follows : 1. The ratio between men and women was 1 : 1.5 and the average age was 69 years old. 2. The most common causes were slip down injury followed by traffic accident and fall down injury. 3. Follow-up period was 16 to 34 monthes(average 23 monthes). 4. The most common type of fractures was Tronzo type III. 5. The average bony union time was about 14.2 weeks in sliding screw plate group and 15.1 weeks in Ender nailing group. 6. The most common complications were progressive varus deformity in SSP group and pain & limited ROM of knee joint in Ender nailing group. 7. The outcome was satisfactory in both group.

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