Journal of Musculoskeletal Trauma

Evaluation of the Wearing Characteristics of Hip Protectors Based on Draping Pattern Design and Body Shape in Korean Elderly People: Eunjin Jeon, Heeeun Kim, Heecheon You, Seunghoon Lee, Giwook Kim, Sunjung Yoon; J Korean Fract Soc 2017;30(4):180-185. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.180

PURPOSE
The purpose of this study was to verify the new hip protector design with respect to the comfort and mobility. The new hip protector was developed based on a pattern of draping and body shape of Korean elderly individuals.
MATERIALS AND METHODS
An wearing characteristics evaluation was conducted on 101 elderly women wearing hip protector using a questionnaire of preference and ease of wearing. Hip protectors, with existing and newly developed belt and underwear types, which were previously preferred by the Korean elderly, were evaluated.
RESULTS
The newly developed belt type (65.0%) and newly developed underwear type (30.1%) hip protectors were preferred to the existing type (3.9%) and existing underwear type (1.0%) ones. The convenience of the newly developed belt type was greater than 4 out of 5 points (1 for strongly disagree and 5 for strongly agree) for all nine measures, including fit, allowance, mobility, pad placement, pad thickness, pad size, material, design, ease of dressing, and ease of undressing. The newly developed hip protectors showed less discomfort than the existing ones. In particular, the newly developed belt type and developed underwear type improved sitting convenience by 31.1% and 26.1%, respectively, compared with the existing ones.
CONCLUSION
The hip protectors developed in the present study is expected to provide better fit for the body shape of Korean elderly individuals and prevent hip fracture due to fall.

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Development and Evaluation of Fall Impact Protective Clothing for the Elderly Women
Jung Hyun Park, Jin Suk Lee, Jeong Ran Lee
Fashion & Textile Research Journal.2018; 20(5): 569. CrossRef
Development and Evaluation of Fall Impact Protection Pad
Jung Hyun Park, Jin Suk Lee, Jeong Ran Lee
Fashion & Textile Research Journal.2018; 20(4): 422. CrossRef

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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; J Korean Fract Soc 2012;25(1):8-12. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.8

Abstract PDF: PURPOSE
Although most peritrochanteric fractures in old age necessitates surgical treatment, daily life functions are still impaired after discharge. We assessed the types of peritrochanteric fracture, risk factors, and functional recovery in elderly patients who were over 65 years old. We also tried to determine factors for recovery to daily life.
MATERIALS AND METHODS
From January 2006 to December 2007, among 61 patients who were over 65 years old with the possibility of 1 year follow-up, 50 patients were selected through interviews. After verifying age, sex, mode, types of fracture, and method, we analyzed daily living activities with a functional recovery index and estimated recovery of daily life functions after surgery, assuming a score increase if functional recovery was good.
RESULTS
The mean age was 75.8 years, and females (31 patients, 62%) exceeded males. Slipping (27 patients, 54%) was the most common cause of fracture, and the intertrochanteric femur fracture was the most common fracture type (34, 68%). The average functional recovery index decreased 16.24% compared with the pre-operation value, having a tendency to decrease more in old age and female patients. Subtrochanteric femur fracture showed a 17.6% decrease in functional recovery index among the fracture types.
CONCLUSION
In elderly patients over 65 years, the functional recovery index after peritrochanteric fracture decreased 16.24% on average compared with the preoperation state. The largest decrease was in basic life ability. The functional recovery index decreased more in old age, females, and subtrochanteric femur fracture, which indicates these factors influence functional recovery.

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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

Abstract PDF

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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Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients: Woong Kyo Jeong, Sang Won Park, Soon Hyuck Lee, Jong Hoon Park, Suk Ha Lee, Ji Hoon Kang, Gi Won Choi, Won Noh; J Korean Fract Soc 2008;21(1):8-12. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.8

Abstract PDF: PURPOSE
To evaluate the clinical results of bipolar hemiarthroplasty in elderly patients more than 65 years of age with a femoral neck fracture.
MATERIALS AND METHODS
Forty-six bipolar hemiarthroplasties in 43 patients more than 65 years of age which could be followed more than 3 years were included in this study. The clinical outcomes were evaluated using Harris hip score, pain score and support score. The radiological results were analyzed by femoral stem loosening and bipolar cup migration.
RESULTS
The average Harris hip score was 88.7 (62~96) points. An excellent score was recorded in 34 cases, good in 7 cases, fair in 3 cases and poor in 2 cases. The average pain score was 39.3 points and there were no pain in 20 cases, slight pain in 17 cases, mild pain in 6 cases and moderate pain in 2 cases. The average support score was 9.6 points and 32 patients could walk without the use of any assistive devices. Two cases were converted to total hip arthroplasty due to femoral stem loosening with or without bipolar cup migration.
CONCLUSION
For the early ambulation and functional recovery of elderly patients with femoral neck fracture, bipolar hemiarthroplasty was considered as one of recommendable methods.

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Traumatic Simultaneous Bilateral Hip Dislocation in the Elderly Patient: A Case Report: Koing Woo Keon, Sang Bong Ko; J Korean Fract Soc 2007;20(4):335-338. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.335

Abstract PDF: Traumatic simultaneous bilateral hip dislocation is reported rarely, but the most of them are limited in young patients. The authors managed the elderly patients whose both hip was dislocated traumatically, simultaneously and who didn't have any other underlying disease and other associated fracture - femur, hip joint and pelvis, with a review of the relevant literature.

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Choice of Internal Fixatives for the Intertrochanteric Fractures of the Femur in the Elderly: Kyoung Duck Kwak, Chul Un Ko, Sang Min Ahn, Kee Baek Ahn; J Korean Fract Soc 2005;18(4):385-389. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.385

Abstract PDF

PURPOSE
To prepare the appropriate guideline in choosing the internal fixatives for the intertrochanteric fractures of the femur in the elderly.
MATERIALS AND METHODS
We reviewed 95 cases of intertrochanteric fractures of the femur from January, 1999 to December, 2003. We fixed the fracture with Proximal Femoral Nail in 37 cases (PFN group), Dynamic Hip Screw in 56 (DHS group), Dynamic Condylar Screw in 2 cases (DHS group). We reviewed operation time, blood loss during operation, changes in neck-shaft angle and sliding of lag screw.
RESULTS
There were no significant differences in the parameters between the 2 groups in stable fracture. In unstable fractures, operation time in PFN group and DHS group revealed 103.9 and 128.2 minutes respectively; mean amount of blood loss during operation revealed 523.2 and 573.1 ml respectively. Mean changes in the neck-shaft angle at final follow-up in PFN group and DHS group revealed 4.6 degrees and 4.1 degrees; sliding of lag screw averaged 3.4 and 6.5 mm respectively. Among the DHS group, cases of additional fixation with trochanteric supporting plate revealed 3.1 degrees of changes in neck-shaft angle and 4.2 mm of lag screw sliding.
CONCLUSION
In cases of stable fractures, any fixative might suffice. In cases of unstable fractures, there were no significant differences in results of treatment between these two groups, however, PFN group revealed shoter operation time and less blood loss during operation. It seemed to be necessary to apply additional fixation with trochanteric supporting plate when using DHS in unstable cases.

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Treatment of Unstable Pertrochanteric Fractures with a Long Intramedullary Nail
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Dae Jung Huh
Hip & Pelvis.2013; 25(1): 51. CrossRef
Treatment of the Intertrochanteric Femoral Fracture with Proximal Femoral Nail: Nailing Using the Provisional K-wire Fixation
Gu-Hee Jung
Journal of the Korean Fracture Society.2011; 24(3): 223. CrossRef

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Treatment of the Intertrochanteric Fractures of the Femur in Elderly Patients: Comparision of Wayne-County Reduction and Anatomical Reduction: Nam Yong Choi, Kee Ho Nah, Hyun Seok Song, Sang Il Seo, Jung Keun Choi, Suk Ku Han; J Korean Fract Soc 2004;17(4):301-307. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.301

Abstract PDF

PURPOSE
To compare the radiological and clinical results of Wayne-County reduction with anatomical reduction in treatment of the intertrochanteric fractures of the femur in elderly patients.
MATERIALS AND METHODS
Among one hundred-three of intertrochanteric fractures treated with 135- degree angled compression hip scresw, eighty three cases treated by Wayne-County reduction (Group 1, 42 cases) and anatomical reduction (Group 2, 41 cases) with at least 1 year follow-up were reviewed. The average pateint ages were 72.4 (65~92) in group 1, 71.6 (65~89) in group 2, respectively. 33 cases (75.2%) in group 1 and 31 cases (77.5%) displayed unstable fractures by Jensen classification. The radiological observation was included neck-shaft angle, penetrating length of lag screw into head, sliding length of lag screw and time of bony union. The clinical results were evaluated by Koval criteria, Kyle's functional evaluation, leg length inequality and complications.
RESULTS
There were no significant changes between group 1 and group 2 in stable fractures in the radiological and clinical results. In unstable fractures, the neck-shaft angle averaged 132.2 degree in group 1 and 129.4 degree in group 2 in the final follow-up films. The penetrating length of lag screw into head were 2.2 mm in group 1 and 3.1 mm in group 2 (p<005). But there were little differences in the sliding length of lag screw, the time of bony union and complication rates between groups. In post- operative evaluation of walking abilility by Koval, 31 patients (73.8%) in group 1 and 28 (68.3%) recovered the activity level before injury by the postoperative 1 year follow-up. Leg length discrepancy at final follow-up was 4.1+/-6 mm shortening in group 1 and 6.5+/-8 mm in group 2, respectively.
CONCLUSION
Both Wayne-County reduction and anatomical reduction had a favorable results after treatment of stable intertrochanteric fractures of the femur, but Wayne-County reduction may be a better method in treatment of unstable fractures, especially in elderly patients, in which it is difficult to obtain anatomical reduction.

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High Fixation Failure Rate of Cephalomedullary Nail Fixation in Patients with Low-Energy Basicervical Femoral Fractures: Do We Need Extramedullary Reduction?
Chang-Jin Yon, Ki-Cheor Bae, Young-Hun Kim, Kyung-Jae Lee
Medicina.2025; 61(1): 112. CrossRef
New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail
Junyoung Kim, Kihong Choi, Kyu Hyun Yang
Journal of the Korean Orthopaedic Association.2020; 55(3): 193. CrossRef
The Effect of Valgus Reduction on the Position of the Blade of the Proximal Femoral Nail Antirotation in Intertrochanteric Hip Fractures
Eui Yub Jung, In Taek Oh, Sang Yeup Shim, Byung Ho Yoon, Yerl Bo Sung
Clinics in Orthopedic Surgery.2019; 11(1): 36. CrossRef
Effectiveness of the Valgus Reduction Technique in Treatment of Intertrochanteric Fractures Using Proximal Femoral Nail Antirotation
Ji-Kang Park, Hyun-Chul Shon, Yong-Min Kim, Eui-Sung Choi, Dong-Soo Kim, Kyoung-Jin Park, Byung-Ki Cho, Jung-Kwon Cha, Sang-Woo Kang
Journal of the Korean Orthopaedic Association.2013; 48(6): 441. CrossRef

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Surgical Treatment of Fractures of the Distal Radius in Patients Older Than 65 Years: Jeung Tak Suh, Dae Woong Kim, Chong Il Yoo; J Korean Soc Fract 2003;16(4):563-569. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.563

Abstract PDF

PURPOSE
To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation. MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt).
RESULTS
According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05).
CONCLUSION
Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.

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Osteoporotic Distal Radius Fracture-conservative Treatment
Seok-Whan Song
Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef

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Primary Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fracture of the femur in Elderly patients: Jong Min Sohn, Ju Hae Jahng, Nan Kyung Ha, Seong Tae Cho, Kwang Young Choi; J Korean Soc Fract 2003;16(1):37-44. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.37

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the effectiveness and advantage of bipolar hemiarthroplasty in treatment of unstable femoral intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
We reviewed 93 patients and followed up more than one year. Group I(n=34, Singh index <3 with more than 70 year old) were treated by bipolar hemiarthroplasty. Group II(n=20) with same condition were treated by compression hip screw. Group III(n=39, Singh index >4 with more than 70 year old) were treated by compression hip screw.
RESULTS
Group I and III patients showed satisfactory result over than good by merle D 'Aubigne hip rating scale. Among Group II(n=20), 16 cases showed under 'poor 'according to functional scale. Complication was 1 cases in group I, 19 cases in group II and 8 cases in group III.
CONCLUSION
We suggest bipolar hemiarthroplasty as first choice of treatment for osteoporotic elderly patients with unstable intertrochanteric fracture, especially who have combined medical problems or poor general condition.

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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

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The Study for the Factors Affecting the Radiological Outcome of the Displaced Ankle Fracture over the Elderly: Hong Gi Park, Lee Hyuk Jung; J Korean Soc Fract 2002;15(4):465-469. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.465

Abstract PDF: OBJECT: This study investigated to know the factors affecting the radiological results of the ankle fracture after open reduction and internal fixation over the age 60 years. PATIENTS & METHOD: Open reduction and internal fixation on patient with closed displacement ankle fracture over the age 60 years were studied in 51 cases. Statistical analysis by t-test was used to assess the factors affecting to the post-operation radiological results among the age, sex, classification of fracture, the degree of fracture displacement, bone fragility between anatomical reduction group and non-anatomical reduction group in average 16 months, RESULTS: There are statistical significance(p<0.05) of the sex and bone fragility in post-operation radiological results.
CONCLUSION
The radiological results in old age with ankle fracture is affected by sex and bone fragility in open reduction & internal fixation.

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Morbidity and Mortality of Bilateral Hip Fractures in Elderly Patients: Suk Ku Han, Nam Yong Choi, Seong Jin Park, Seong Keun Lee, Chan Woong Moon; J Korean Soc Fract 2000;13(4):788-794. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.788

Abstract PDF

PURPOSE
The purpose of this study was to estimate the morbidity and mortality rate of bilateral hip fractures in elderly patients compared to that in unilateral hip fractures and to evaluate it's related risk factors.
MATERIALS AND METHODS
Twenty-two cases of bilateral hip fractures in patients who were older than 70 years with at least two year follow-up were included in our study. We analysed the risk factors of bilateral hip fractures by comparing with age, sex and diagnosis matched 22 cases of ipsilateral hip fractures including onset of secondary fracture, injury mechanism and the rate of morbidity and mortality, respectively.
RESULTS
The onset of secondary fracture and death were mostly within 1 year after operation for the first hip fracture. Comorbidity of cardiovascular, neurologic, urologic or history of previous fracture and decreased ambulation ability were related with the occurrence of bilateral hip fractures. The rate of morbidity and mortality of bilateral hip fractures were about two- fold than that of ipsilateral hip fractures. High mortality rate was noted in patients who had operation delay from injury. But no significant relationship between nutrition, body weight or bone mineral density and the development of secondary hip fractures.
CONCLUSION
To prevent the occurence of bilateral hip fractures which had more serious results than that of ipsilateral hip fractures, more aggressive rehabilitation to improve walking ability and appropriate environmental circumstances to avoid falls were important, especially in older patients.

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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

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Primary Bipolar Hemiarthroplasty for the Treatment of Unstable Intertrochanteric Fractures in Elderly Patients: You Sung Suh, Sung Tae Kim, Soo Jae Yim, Yon Il Kim, Soo Kyoon Rah, Chang Uk Choi; J Korean Soc Fract 2000;13(2):222-229. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.222

Abstract PDF

PURPOSE
: The purpose of this paper was to present the clinical and roentgenographic results were obtained with bipolar hemiarthroplasty as a primary treatment for comminuted unstable intertrochanteric fracture in elderly patients with severe osteoporosis. The goal of this treatment is early ambulation with early weight bearing to prevent the complications such as a deep vein thrombosis, pulmonary embolism, pneumonia or atelectasis, and pressure sore.
MATERIALS AND METHODS
: Twenty consecutive patients who were more than seventy years old with severe osteopotosis and had an comminuted unstable intertrochanteric fractures were treated by primary bipolar hemiarthtoplasty from January 1995 through January 1998 at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital. If there were fractured at the lesser or the greater, a circlage wire or Dall-Miles system (trochanter cable grip system) was passed through the lesser and the greater trochnater to permit its subsequent fixation to the medial and the lateral side of the femoral component. The functional results were judged according to the hip rating scale of Merle d' Aubigne.
RESULTS
: The mean age at operation was 79.8(70 to 92) years old. The most common type according to the Evans classification system was I -d(10 cases, 50%). Singh index was case(5%) of Grade I , 7 cases(35%) of Grade II, 10 cases(50%) of Grade III and 2 cases(10%) of Grade IV. The mean bone mineral density(BMD) was -4.24(-6.95 - -3.17). The functional results in 75% of the patients were rated as excellent, very good, or good and in 25% as fair, poor, or bad.
CONCLUSION
: Primary bipolar hemiarthroplasty for the treatment of comminuted unstable intertrochanteric fractures in elderly patients with severe osteoporosis could return these patients to their pre-injury level of activity quickly, thus obviating the postoperative complications caused by immobilization.

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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

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T-plate Fixation of Distal Radius Fractures in the Elderly: Ik Su Choi, Woo Il Kim, Su In Roh, Hong Ju Ha, Jin Goo Kang, Seung Chan Ko; J Korean Soc Fract 1999;12(2):452-460. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.452

Abstract PDF: Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Especially, there are several problems, including joint stiffness and skin necrosis due to a long term immobilization, radial shortening and collapse due to the loss of reduction in the elderly. Thus, the anatomical reduction and rigid internal fixation and early rehabilitation were recommanded. We analyzed 16 patients with distal radius fractures in the elderly, who were treated with open reduction and internal fixation with T-plate from January, 1991 to June, 1997 and were followed up for more than 12 months. The results were as follows ; 1. According to the Fernandez classification, 3 cases were type I, 3 cases were type II, 7 cases were type III, 1 case was type IV and 2 cases were type V. 2. As complications, there were 2 cases of arthritic change, 3 cases of radial shortening, and 1 case of screw loosening. 3. Anatomically satisfactory results were obtained in 75%(12 cases). 4. Functionally and clinically satisfactory results were obtained in 87%(14 cases). 5. In the treatment of distal radius fractures in the elderly, three dimensional structure and recovery of joint congruency were related to the clinical prognosis.

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Experience with Bipolar Hemiarthroplasty in Femoral Neck Fracture in the Elderly Patients: Correlation Between Preoperative Medical Conditions and Postoperative Functional Results of Hip: Kwang Hee Lee, Se Dong Kim, Dong Chul Lee, Duk Seop Shin; J Korean Soc Fract 1998;11(1):143-152. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.143

Abstract PDF

The displaced femoral neck fracture remains a major challenge to orthopedic surgeons, as the elderly population is increasing. Elderly patients with femoral neck fractures often have other medical conditions, fragile bones, and poor compliance. Thus, for elderly patients who need early ambulation and funtional recovery, bipolar prosthesis is accepted as an appropriate treatment. We report a study of 58 cases of bipolar hemiarthroplasty with a femoral neck fracture and a physiologic age older than 65 years from January 1991 to May 1996. The purpose of this study is to evaluate the functional outcome of bipolar hemiarthroplasty and correlation between preoperative medical conditions and Harris hip score in femoral neck fractures in the elderly patients. The results obtained were as followings. 1. 90% of patients had uncontrolled medical conditions. Cardiovascular and pulmonary disease were main preexisting medical conditions. 2. The preoperative medical conditions were important deteminants for the functional results after bipolar hemiarthroplasty. 3. Dislocated bipolar prosthesis needed open reduction or revision to total hip arthroplast due to disassembly of the prosthesis caused by attempted closed reduction.

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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

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Ambulatory Ability & Mortality Study after Intertrochanteric Fractures of the Femur in Geriatric Patients: Bong Gee Park, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Young Gue Go; J Korean Soc Fract 1997;10(4):755-760. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.755

Abstract PDF: Intertrochanteric fractures are common in older age group. But still many patients suffer from high morbidity and mortality and decreased ambulation levels, because of accompanying general weak- ness and various senile diseases. From January 1991 to February 1995, we treated 46 patients older than 65 years with intertrochanteric fractures of femur. A retrospective study was performed to determine which Pre- and postinjury factors were predictive of mortality and ambulatory capacity 1 year after operation. Potential causative factors included age, gender, prefracture ambulatory ability, postoperative ambulatory ability, associated medical problem, fracture type, degree of osteoporosis, American. Society of Anesthesiologists rating of operative risk, interval between injury and operatiorl. This retrospective study were analyEed with following results ; 1. Mortality was releated to prefracture ambulatory ability, postoperative ambulatory ability, ASA risk, interval between injury and operation, which were statistically significant. 2. Eighteen(39%) patients maintained their prerfacture ambulatory ability at a poslinjury 1 year ; Twenty-eight(61%) patients lost some degree of ambulatory ability.

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Comparison of Hemiarthroplasty and Compression Hip Screw on Elderly Unstable Intertrochanteric Fractures: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Ki Woong Lee; J Korean Soc Fract 1997;10(4):738-745. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.738

Abstract PDF

Intertrochanteric fractures of the femur usually occur in the elderly and osteoporotic patients. These appear to be increasing in frefuence and are usually unstable. Sixthy two cases were treated ai our hospital from September 1993 through October 1995. 29 elderly patients underwent bipolar hemiarthroplasty and 33 patients underwent internal fixation with compression hip screw(C.H.S). The results were as follows ; 1. Functional results according to hip rating scale of Merle D,Aubiigne was superior in bipolar group. 2. The incidence of postoperative complications was much fewer in bipolar group than in compression hip screw group. 3. In casees of definite osteoporosis with Singhs index below 3 and Evans unstable type frartures, the incidence of mechanical complications was increased, especially in compression hip screw group. 4. There was no siginificant difference between 2 groups in operative time and blood loss.

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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
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
Hip Arthroplasty Using Collarless Polished Tapered Stem -Minimum 2 Years Follow-up Results-
Yerl-Bo Sung, Jung-Yun Choi, Su-Chan Oh
Hip & Pelvis.2012; 24(1): 18. 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
Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -
Sung Kwan Hwang, Dong Hyun Kang, Tae Yeon Cho, Chang Ho Yi
Hip & Pelvis.2010; 22(3): 209. CrossRef

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Evaluation of Quality of Life after Treatment of Femoral Neek Fracture in Elderly Patieno: Kweon Jae Roh, Jae Doo Yoo; J Korean Soc Fract 1996;9(4):869-875. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.869

Abstract PDF: In the elderly patients, we evaluated the results of treatments for the femoral neck fractures in the respect of quality of life. We used the Rosser index to generate quality of life score(QoL). Rosser index composed of two dimensions with distress and disability. Seventy-nine patients aged over 65 years with femoral neck fracture have been evaluated. Forty-nine cases were treated with bipolar hemiarthroplasty and thirty cases were treated with internal fixation such as compression hip screw. Knowles pin, cannulated hip screws. At one-year after operation, the median score of quality of life was 0.990 in bipolar hemiarthroplasty patients and 0.988 in the internal fixation patients. There was significant difference between the two groups(P<0.05). Patients treated with bipolar hemiarthrol)lasty had better QoL score than the patients treated with internal fixation. The elderly patients treated with bipolar hemiarthroplasty has lesser diability and was able to get early weight bearing.

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Treatment of Unstable Intertrochanteric fracture of the femur in Elderly Patients: Deuk Soo Hwang, Cheol Se Ahn, Sang Yong Lee; J Korean Soc Fract 1996;9(2):376-383. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.376

Abstract PDF: Intertrochanteric fractrures in elderly are a frequent problem and are becoming more common as the population of elderly people in the population increase. The treatment of unstable intertrochanteric fracture present a challenging problem. Severe comminution in elderly osteoporotic patients renders internal fixation difficult and precipitate varus malpositioning after internal fixation. We analysed 48 unstable intertrochanteric fractures in 48 elderly patient (58 to 91 yeared, mean age : 78 years) with advanced osteoporosis (grade III or more by Singh et al., and by BMD) between May, 1990 to March, 1995 ; Nineteen had been treated with an anatomical reduction with dynamic hip screw(DHS). In addition to DHS fixation, additional circumferential wiring was done in 1 cases, adjunctive methylmethacrylate bone cement fixation in head and neck was done 2 cases. We classified lag screw fixation alone group as DHS , lag screw fixation and additional oircurnferential wire reinforcement group as DHS II. Twenty had been treated with an anatomical reduction with gamma nail. Another nine that had severe comminuted fracture had been treated with bipolar hemiarthroplasty. In DHS II and gamma nailing group, operation time was longer and amount of transfusion after postoperative period was much than DHS I group. In DHS fixation group, lag screw fixation and additional tircurnferential wire reinforcement of posteromedial fracture fragment group was more favor result than lag screw fixation alone. Nonunion developed in two cases of adjunctive methylmethacrylate fixation with DHS, and malunion(external rotation) developed in two cases of DHS fixation group. We concluded that better result are obtained when posteromedial fracture fragment reduced with circumferential wiring with DHS. In addition to anatomical reduction of fragment, encouraging early postoperative ambulation also contribute to good prognosis. A number of the patients who had fear for weight bearing after 3 month postoperatively compromise ambulation on further follow up. In severely commented fracture that was not able to get stable reduction or in patient necessary for early weight bearing, hemiarthroplasty permit to early ambulation, but it also have many disadvantage.

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Bipolar Hemiarthroplasty for the Treatment of Femoral Neck Fracture in Elderly Patients: Kwon Jae Roh, Dong Wook Kim; J Korean Soc Fract 1995;8(4):747-752. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.747

Abstract PDF: Displaced intracapsular fracture of the hip remains a formidable problem in orthopaedic management despite advances in surgical technique and hardware. Advances in internal fixation have lowered the morbidity from prolonged bed rest and shortened the time of mobilization , however, the incidence of nonunion End avascular necrosis remains high. As a result, prosthetic replacement has been advocated as a solution to this problem. But, sepsis, dislocation and late loosening remain real concoern. So we reviewed the follow-up(range, twelve to sixty months) results of forty bipolar hemiarthroplasty for the displaced femoral neck fracture in elderly patients. The average age of the patients was seventy-four and the common cause of injury was slipped down. In the type of fracture, anatomically subcapital(21), Garden stage IV(19), and Pauwel typeII (21) was the most common. The associated medical conditions were chronic lung disease(10), chronic heart disease(8), diabetes mellitus(7), chronic liver disease(5). Two patients died of hepatoma and liver cirrhosis during the follow-up periods. The results were followed; 1. The most common used prosthesis was Centralign and cement was used in 32 cases. 2. Above 80% wereexcellent or goodin Luncefords criteria and Harris hip score. 3. The complications were transient peroneal nerve palsy(2), intractable thigh pain(2), deep wound infection(1), proximal femoral fracture(1). In conclusion, bipolar hemiarthroplasty seems to be a good alternative to the internal fixation in elderly patients with a displaced femoral neck fracture.

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Treatment of Intertrochanteric Fractures of Femur in Elderly Patients over 65 Years Old: Young Sun Koh, Chang Moo Yu, Suk Ha Lee, Sung Jong Lee, Taik Sun Kim, Jae lk Shim; J Korean Soc Fract 1995;8(1):46-53. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.46

Abstract PDF: The incidence of intertrochanteric fracture of femur is increasing because of increasing number of old-aged people. The goal in the treatment of an elderly patient with an intertrochanteric fracture is to restore the patient to his prefracture activity as soon as possible. The purpose of this report is to review of the difficulty of treating the intertrochanteric fracture of femur in elderly patients. The authors treated 213 cases of intertrochanteric fracture from Jan,1980 to Dec.1993. We analyzed the clinical result of 73 cases intertrochanteric fracture with minimum 1 year follow up retrospectively. The results were as follows. 1. The degrees of osteoporosis by Singh index were 27 cases in Grade III, 22 Cases in Grade II,14 cases in grade IV,5 cases in Grade I and 5 cases in Grade V. 2. By Tronzo classification of fracture, the most common type was 38 cases in type III, 17 cases in type II and 8 casesintype V. 3. The operation method were compression hip screw(38 cases), Jewett nail (12 cases), Ender nail(17 cases), multiple pinning (5 cases), and primary kerniarthoplasty(3 cases). 4. Average bony union time was 13.2 weeks in compression hip screw group, 14.5 weeks in Jewett nail group,14.7 weeks in Ender nail group and 15.4 weeks in multiple pinning group.

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Treatment of Intertrochanterie fracture of the Femur with Ender Nails in the Elderly Patients: Seong Taek Kim, Ki Soo Kim, Yeub Kim, Seung Hee Koh, Yong Soo Choi, Sang Tae Park; J Korean Soc Fract 1992;5(2):300-308. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.300

Abstract PDF: The incidence of intertrochanteric fracture of the femur in the elderly patient has been increased progresslvely due to the prolongation of Korean average life span and improvement of the medical survice. The mortality. however, in these elderly patients is relatively high. Rigid internal fixation of intertrochanteric fracture with early mobilization of the patient has in recent years reduced the mortality and morbidity. From September 1984 to August 1991, the authors had treated with Ender nails for 126 cases of intertrochanteric fracture. From 109 cases followed more than six months, the clincal results were as follows. 1. The average age was 74.8 years. 2. 73 cases (67%) were unstable fractures and 36 cases (33%) were stable fractures by Evans classification. The most common type was type 3 (35.8%) by the Tronzo classification, A2 type(55.1%) by the AO classification. 3. The main indication were stable fracture, unstable fracture over 70 years old, high anesthe tic resk, severe osteoporosis and wound at greater trochanter. 4. Intraoperatlve complications were experienced in 37 cases(33.9%). The improper entry hole site was most common. 5. Postoperative complications occured in 57 cases(52.3%) and more frequently in unstable fractures(57.5%). The most common complication was knee joint pain in 45 cases (41.3%) 6. Recently, patients who had Ender nails with Knowles pins showed good results in the presence of severe osteoporosis or unstable fracture.

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