Journal of Musculoskeletal Trauma

Risk Factors of Fixation Failure in Femoral Neck Fractures: Sung Hyun Yoon, Kyu Beom Kim, Hyung Jun Lee, Kyung Wook Kim; J Korean Fract Soc 2023;36(4):118-124. Published online October 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.4.118

Abstract PDF: Purpose
Internal fixation after a femoral neck fracture (FNF) is one of the conventional treatment options for the young and active elderly patients. However, fixation failure of internal fixation is a probable complication. The treatment of fixation failure after a primary internal fixation of the FNF remains a challenge.
Materials and Methods
Between July 2002 and March 2017, 83 patients who underwent internal fixation after FNF were retrospectively analyzed. Radiological assessments, including Pauwels’ angle, fracture level, reduction quality, and bone union, were measured, preoperatively and postoperatively. Moreover, intraoperative variables such as time to surgery, surgical time, and estimated blood loss were also evaluated.
Results
The patients were divided into the fixation failure and the non-failure groups. Among the 83 patients, 17 cases (20.5%) of fixation failure after the primary internal fixation of the FNF were identi-fied. When comparing the two groups according to the radiographic data, Pauwels’ angle and the reduction quality based on Garden’s angle showed significant differences (p<0.001). Moreover, when comparing the intraoperative variables, unlike the surgical time and estimated blood loss, significant differences were noted in the time interval from injury to surgery and specifically in whether the surgery was performed within 12 hours after injury (p<0.001).
Conclusion
Pauwels’ angle, reduction quality, and time to surgery are the major factors that can predict the possibility of internal fixation failure of the FNF. Early and accurate anatomical reduction is needed to decrease complications after the internal fixation of the FNF.

134 View
4 Download

Insufficiency Fracture of Simultaneously Bilateral Femur Neck in Patient Treated with Long-Term Bisphosphonate Treatment - A Case Report -: Seong Kee Shin, Hyung Gon Ryu, Dae Won Shin, Beom Su Han; J Korean Fract Soc 2022;35(3):109-113. Published online July 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.3.109

Abstract PDF: Bisphosphonate is used widely for osteoporosis management. On the other hand, some studies have reported that prolonged use of bisphosphonate without a proper resting period can cause insufficiency fracture and, in rare cases, fractures on the femur neck. This paper reports a case of an elderly patient who suffered bilateral femur neck insufficiency fractures induced by non-stopped long-term bisphosphonate therapy. The patient complained of pain in her buttocks at the first visit. During the admission period, inguinal area pain newly developed. Both a femur neck insufficiency fracture was observed on the hip radiographic image. Hip pinning and postoperative parathyroid hormone treatment were performed. The patient was discharged without specific complications and reported improvement in symptoms on the last follow-up. Several authors have reported one-sided femoral neck insufficiency fractures due to bisphosphonate use, but the present case is uncommon in that it occurred simultaneously in both femur necks. In addition, in the case of bilateral femur fractures, the walking ability after surgery is lower than that of one-sided fracture cases, so active rehabilitation is necessary.

142 View
1 Download

Mortality-Related Risk Factors in Total Hip Arthroplasty for Femoral Neck Fractures in Elderly Patients: Jae Sung Suh, Hyung Gon Ryu, Young Ju Roh, Dae Won Shin; J Korean Fract Soc 2022;35(2):51-56. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.51

Abstract PDF: Purpose
Total hip arthroplasty (THA) using dual mobility components (DMC) is a reasonable surgical option for displaced femoral neck fractures in elderly patients, resulting in lower dislocation rates and improved stability. The purpose of this study was to investigate the clinical outcomes and risk factors responsible for mortality in elderly patients who were diagnosed with a displaced femoral neck fracture and had undergone DMC-THA.
Materials and Methods
Out of 147 cases of THA from December 2018 to June 2020, a total of 79 cases were enrolled in this study, with the following characteristics: (1) Garden stage III or IV, (2) over 75 years of age, and (3) over 1 year of follow-up. All the patients received DMC-THA surgery using the anterolateral approach.
Results
The mean follow-up period was 15.0±8.43 months and a total of one dislocation case was observed. The mortality rate was 17.7% (14/79), and it was especially higher in patients with a past medical history of malignancy (odds ratio [OR]=7.18, p=0.03) or a cognitive disorder such as dementia (OR=5.48, p=0.03). Preoperative low initial hemoglobin levels (OR=0.65, p=0.04) and low UCLA (Uni-versity of California at Los Angeles) score (OR=0.47, p=0.02) were also associated with mortality.
Conclusion
When considering THA as a treatment approach in elderly patients with a displaced femoral neck fracture, a high mortality rate is expected in patients with low preoperative hemoglobin levels or a history of malignancy or cognitive disorders. Hence, thorough monitoring and management should be undertaken before and after surgery.

69 View
3 Download

Simultaneous Bilateral Proximal Femoral Fracture associated with Generalized Tonic-Clonic Seizure: A Case Report: Sang Hoo Lee, Kyeong Seop Song, Seung Joo Jeon, Seong Hwan Hong; J Korean Fract Soc 2012;25(1):69-72. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.69

Abstract PDF: Simultaneous bilateral proximal femoral fractures are extremely rare, and a few have been reported in and outside the country. It may have various causes, and most cases were associated with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, and anti-epileptic medications. We experienced a case of simultaneous bilateral proximal femoral fractures after generalized tonic-clonic seizure in a 70-year-old female. Herein, we report it with a review of the literature.

91 View
0 Download

The Reliability of Proximal Femoral Shaft Fracture Classification: Sang Wook Lee, Sang Bong Ko, Myung Rae Cho, Ho Hyoung Lee; J Korean Fract Soc 2006;19(1):6-10. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.6

Abstract: PURPOSE
The Garden classification by which femur neck fracture is classified and the Boyd-Griffin classification by which trochanteric fracture is classified are studied on the reproducibility, repeatability, interobserver's and intraobserver's reliability and then reliability.
MATERIALS AND METHODS
56 cases in femoral neck fracture and 60 cases in trochanteric fracture who were operated from May 1999 to December 2003 were classified by three observers who are hip surgeon, orthopaedic surgeon and senior residentship doctors three times. Femur neck fracture was classified by Garden's method which used commonly and trochanteric fracture was classified by Boyd-Griffin method which is classified by the pattern of fracture and degree of comminution. We got the interobserver's and intraobserver's Kappa score using the Stata 7.0 statistically. The statistical analysis was made by Stata 7.0.
RESULTS
Garden classification in femur neck fracture showed moderate agreement in intraobserver reliability and fair agreement in interobserver reliability. Boyd-Griffin classification in trochanteric fracture showed substantial agreement in intraobserver reliability and moderate agreement in interobserver reliability.
CONCLUSION
Boyd-Griffin classification showed over moderate agreement but Garden classification showed fair agreement, so using Garden classification in femur neck fracture has some problem in reliability and application.

120 View
0 Download

Bilateral Femoral Neck Fractures in a Young Adult: A Case Report: Eea Sub Chung, Jae Kyu Park; J Korean Fract Soc 2005;18(4):478-480. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.478

Abstract PDF: Ipsilateral femur shaft and neck fractures are occurred by high energy trauma, usually in motor vehicle accidents or fall from a height. Simultaneous Ipsilateral femur shaft and neck fractures and contralateral femur neck fracture are not yet reported in Korea. Authors report a case of simultaneous bilateral femoral neck fractures combined with a ipsilateral femoral shaft fracture in a young adult treated with anatomical reduction, internal fixation and vascularized bone graft with a review of the literature.

68 View
0 Download

Differences of Bone Mineral Density between Spine and Hip in Osteoporotic Patients: Gyu Min Kong, Sang Eon Lee, Dong Jun Kim, Tae Hyun Yoon; J Korean Fract Soc 2005;18(2):181-184. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.181

Abstract PDF

PURPOSE
To evaluate differences and correlations of spine and hip region BMD in osteoporotic patients with or without spine fracture.
MATERIALS AND METHODS
From January 1999 to December 2002, We measured and evaluated BMD of L3 and hip by DXA in 52 patients with spine fracture (fracture group) and 96 osteoporotic patients without spine fracture (non-fracture group) above 60 years.
RESULTS
The average age of patients with spine fracture is 72.1 years and without spine fracture is 66.9 years. There were no statistical significant differences of BMD of spine, neck of femur and trochanteric area between 2 groups. But the BMD of Ward triangle of fracture group decreased significantly in statistics. The correlation coefficient between the lumbar spine and trochanteric area were 0.674 in fracture group and 0.794 in non-fracture group. They had statistical significance (<0.01).
CONCLUSION
The BMD of Ward triangle of fracture group had lower value, but the BMD of lumbar spine had no differences between 2 groups. Therefore in these persons who have decreased BMD in Ward triangle should be concerned about high vertebral compression fracture risk vertebral compression fracture.

Citations

Citations to this article as recorded by

Comparison of vertebral and femoral bone mineral density in adult females
Han Seong Choe, Jae Hong Lee, Dong Ki Min, So Hong Shin
Journal of Physical Therapy Science.2016; 28(6): 1928. CrossRef
Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef
Comparison of Bone Mineral Density in Elderly Patients over 65 Years according to Presence and Types of Hip Fracture
Myung-Ho Kim, Moon-Jib Yoo, Joong-Bae Seo, Hyun-Yul Yoo, Sang-Young Moon
Journal of the Korean Fracture Society.2010; 23(3): 263. CrossRef
Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture
Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho
Journal of the Korean Fracture Society.2007; 20(3): 222. CrossRef

165 View
0 Download
4 Crossref

The Complications during Treatment of Femoral Neck Fracture in Children - Coxa Vara, SCFE and Avascular Necrosis: Myung Rae Cho, Won Jae Song, Jeong Hwan Son, Jeong Ho Park; J Korean Soc Fract 2002;15(1):1-6. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.1

Abstract PDF: Femur neck fractures in children are relatively rare by comparison with the incidence in adults and can occur by high-energy trauma. The common complications of femoral neck fracture are avascuar necrosis, coxa vara, premature physeal closure and nonunion. The femoral neck fracture by traffic accident in 7-years-old girl was reduced closely and fixed internally. After 1 year later, varus deformity, slipped capital femoral epiphysis and avascular necrosis occurred. Valgus osteotomy and epiphysiodesis were done. There are many series of complications after femoral neck fractures in children, but the case followed by varus deformity, slipped capital femoral epiphysis and avascular necrosis as complications is rare. We report the clinical and radiologic finding of this case with pertinent literature.

98 View
0 Download

The Effectiveness of Bone Scintigraphy of Femur neck fracture: Sang Won Park, Seung Beom Han, Soon Hyuck Lee, Woong Kyo Chung, Seung Yong Wang; J Korean Soc Fract 2001;14(3):323-330. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.323

Abstract PDF

PURPOSE
To evaluate the effectiveness of bone scintigraphy using 99mTc-methylene diphosphonate(99mTc-MDP) for prediction of viability of femoral head in femur neck fracture that have been treated with osteosynthesis.
MATERIALS AND METHOD
Thirty two patients were included in this study who underwent preoperative and postoperative bone scintigraphy using 99mTc-MDP following femur neck fracture. The uptake of istope was estimated visually as either normal or reduced compared with the opposite side. The complications as avascular necrosis and non-union were checked and compared with the preoperative and postoperative bone scintigraphy and the predictive values of positive and negative scintigraphy were calculated.
RESULTS
Among thirty-two patients, bone union occured in nineteen patients except 12 avascular necrosis and 1 non-union. Average bone union peried was 4.4 months and 50% was occured between 3 and 6 months. In seventeen patients who showed reduced isotope uptake, twelve patients developed complications and predictive value of positive scintigraphy was calculated as 0.76. In fifteen patients shown normal isotope uptake, none developed complications and predictive value of negative scintigraphy was calculated as 1.00.
CONCLUSION
Preoperative bone scintigraphy using 99mTc-MDP was useful method to evaluate the viability of femoral head following femur neck fracture and to choose the treatment modality of displaced femur neck fracture especially in elderly person.

Citations

Citations to this article as recorded by

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
Journal of the Korean Fracture Society.2008; 21(1): 8. CrossRef

120 View
1 Download
1 Crossref

The Prognosis of Undisplaced Abduction Fracture of the Neck of the Femur: Young Bok Jung, Eui Chan Jang, Suk Kee Tea, Whui Jae Jin, Jung Nam Han, Jung Il Lim, Cheol Kyoung Park; J Korean Soc Fract 2001;14(2):159-165. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.159

Abstract PDF: PURPOSE
The aim of this study was to analyze frequencies, types, and treatment results of the undisplaced abduction fracture of the neck of the femur for the prediction of the prognosis. MATERIALS & METHODS: From February 1984 to February 1999, the population was selected from those who were admitted in our hospital with the diagnosis of the fracture of the neck of the femur(96 cases). Among them 34 cases of undisplaced abduction fracture who could be followed minimum 2 years were chosen. The types of initial injury, the degrees of the rotation into valgus, union and the incidences of avascular necrosis of the femur head were analyzed by plain radiographs and medical records.
RESULTS
The undisplaced abduction fracture of the neck of the femur were 34 cases(35%) of the whole 96 cases and 33 cases of them had been operated. In all the 34 cases we were able to see the bone union, however in 7 cases(20.6%) the avascular necrosis of the femur head were happened. The incidences of the avascular necrosis is related with the degrees of the rotation into valgus(p=0.004).
CONCLUSION
The undisplaced abduction fracture of the neck of the femur is known to the result in good prognosis. According to this study, not a few avascular necrosis of the femur head happened. As a results, although undisplaced abduction fracture regained to be paid intention to the incidences of the avascular necrosis and careful follow-up should be accompanied.

63 View
0 Download

Treatment of Femoral Neck Fracture (Comparison of Knowles Pin and Cannulated Screw Fixation): Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Shin Pyo Kang; J Korean Soc Fract 2000;13(4):809-816. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.809

Abstract PDF: PURPOSE
The authors have analyzed clinical and radiological results of the femoral neck fractures to evaluate the difference Knowles pin and cannulated screw fixation group.
MATERIALS AND METHODS
The patients were devided into two group retrospectively, Group I included 35 cases that were treated with Knowles pin fixation for femoral neck fracture and Group II included 30 cases that were treated with cannuled screw fixation for femoral neck fracture. Clinical information included operation time, total blood loss and functional outcome. Postoperative X-ray information included Garden alignment index, duration of union and complication(P>0.05).
RESULTS
There was no difference between the two fixation group regarding duration of union, functional outcome by Lanceford's method and complication(P>0.05).
CONCLUSION
Knowles pin fixation and cannulated screw fixation were considered to be proper as a fixaton method in a fracture of the femur neck.

126 View
2 Download

Treatment of femur neck fracture : Attributing factor of postoperative collapse & avascular necrosis: Do Hyun Moon, Kee Chul Ko; J Korean Soc Fract 1999;12(4):780-785. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.780

Abstract PDF

We have experienced some difficulties in anatomical reduction and osteosynthesis of femoral neck fracture due to its specific anatomical structuret. The purpose of this study are to analyse attribilting factors of postoperative collapse and aseptic necrosis in femoral neck fractures. We studied 62 cases of femoral neck fracture treated with the internal fixation from February 1995 to August 1997 at Gil General Hospital. Average follow up period was 1.6years. We analyzed age, sex, operation interval, Garden stage, Pauwel angle, Singh index, fracture site and the fixation method. The results obtained were as follows : Increased incidence of collapse and aseptic necrosis was noted with higher Garden stage(Garden stage 4), wider Pauwel angle(over type 2), under 40 year or over 60 year old age, woman and larger operative interval.

Citations

Citations to this article as recorded by

Hidden osteonecrosis of the femoral head after healed femoral neck fractures: magnetic resonance imaging study of 58 consecutive patients
Chul-Ho Kim, Minkyu Shin, Dongkeun Lee, Se Jin Choi, Dou Hyun Moon
Archives of Orthopaedic and Trauma Surgery.2022; 142(7): 1443. CrossRef

125 View
0 Download
1 Crossref

Cemented Hemiarthroplasty in Femoral Neck Fractures over 70 Years : A Matched-Pair Analysis of unipolar and Bipolar Hemiarthroplasty: Kang Sup Yoon, Seung Baik Kang, Ji Ho Lee, Jin Soo Tark, Hyeok Rhyou; J Korean Soc Fract 1999;12(4):773-779. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.773

Abstract PDF

PURPOSE
: The goal of treatment in elderly patients with hip fractures is restoration of function We analysed the clinical efficacy of the cemented unipolar hemiarthroplasty and bipolar hemiarthroplalty for the treatment of femoral neck fractures in elderly patients over 70 years. Twenty-four pairs of patients who had a cemented hemiarthroplasty were studied with a retrospective and matched-pair analysis. Half of the patients had received a cemented bipolar hemiarthroplasty and the other half, a cemented unipolar hemiarthroplasty The patients were matched for age, sex, femoral head size, physical status and the ability to walk. At one year follow-up, the frequency of the pain and the limp were 41.7% and 54.2%, respectively, in the unipolar group and 45.8% and 45.8%, respertively, in the bipolar group. The ability to live independently was 66.7% in the unipolar group and 79.2% in the bipolar group. None of these differences were statistically significant. The frequency of the return to the level of function before injury was 37.5% in unipolar group and 45.8% in the bipolar group, which was also not significantly different. Flexion of the hip joint was 96.7+/-6.9 in unipolar group and 101.5+/-7.3 in the bipolar group(p=0.02). Abduction and rotational motion was not significantly different in two groups. There were no revisions in either group. Cemented bipolar hemiarthroplasty did not show better clinical results than cemented unipolar group.

Citations

Citations to this article as recorded by

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
Journal of the Korean Fracture Society.2008; 21(1): 8. CrossRef

122 View
0 Download
1 Crossref

Treatment of Femoral Neck Fracture with Multiple Pinning: Sang Won Park, Jong Ryoon Baek, Sang Seok Han; J Korean Soc Fract 1999;12(2):220-230. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.220

Abstract PDF

The incidence of femoral neck fracture is increasing because of the lengthening of human life span and a rising incidence of industrial trauma. Despite of the advance in treatment, femoral neck fracture presents poor prognosis and high rate of complications such as avascular necrosis or non- union due to anatomical consideration. It still remains one of the unsolved fracture as far as treatments and results are concerned. The purpose of this paper is to study the clinical results and factors predisposing to complication after multiple pin pixation of femoral neck fracture. The authors reviewed 50 cases of femoral neck fracture treated by multiple pin fixation at the Department of Orthopedic Surgery, Korea University Hospital from January 1989 to December 1996 with followed up period of more than 1 year and analyzed the relationship between the clinical results and age, degree of displacement, degree of osteoporosis, interval between onset of injury and operation, reducibility and complications. The results obtained were as follows: 1. The functional results by Lunceford criteria were excellent in 15 cases (30%), good in 13 cases(26%), fair in 9 cases(18%), and poor in 13 cases(26%) 2. Union occurred in 36 cases (72%) and the mean duration of union was 6.1 months. 3. There were 12 cases (24%) of avascular necrosis, 2 cases(4%) of non- union, 2 cases (4%) of malunion and 1 case of traumatic osteoarthritis. 4. Poor results were noted in cases of displaced fracture, osteoporotic bone under the Singh index 3, reduced in varus or valgus. Above results suggest that there was a relationship between the prognosis and bone density, degree of displacement and type of reduction, but the interval between the onset and operation within one month, and age distribution did not influence the end result.

Citations

Citations to this article as recorded by

Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi
Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef
Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years
Ui-Seoung Yoon, Jin-Soo Kim, Hak-Jin Min, Jae-Seong Seo, Jong-Pil Yoon, Joo-Young Chung
Journal of the Korean Fracture Society.2010; 23(1): 1. CrossRef

103 View
0 Download
2 Crossref

Ipsilateral Fracture of the Femoral Neck and Shaft: Chong Kwan Kim, Jeong Hwan Kim, Dae Young Kim; J Korean Soc Fract 1998;11(4):738-744. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.738

Abstract PDF: Ipsilateral femoral neck and shaft fractures are uncommon and have difficulty in diagnosis. The injury results from high energy trauma. From January, 1990 to March, 1995, 10 cases of ipsilateral femur neck and shaft fractures had been treated. Follow up period varied from 10 months to 3 years (average 1 year 10 month). The purpose of this study is to evaluate the fracture pattern of neck, complications due to delayed operation, and efficient methods of fixation. The neck fractures were minimally displaced or not displaced in 8 cases. The femur shaft fractures were usually comminuted and located at midshaft. The timing of operation was often determined by the patient's status as a multiple trauma victim, but a delay of days to cases, diagnosis was delayed, but there was no complication, like as avascular necrosis and nonunion. There was one case of nonunion of femur shaft, and which was treated with bone graft. We could not find the difference in complication rate among the fixation methods. Anatomic reduction and stable fixation seem to be more important than the method of fixation and timing of operation.

112 View
0 Download

A Clinical Comparision of Multiple Pinning With Bipolar Endoprosthesis of the Femoral Neck Fractures in the Elderly Patients: Jae Ik Lee, Myung Hwan Son, Jae Hong Park, Kang Hoon Kim; J Korean Soc Fract 1998;11(2):321-327. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.321

Abstract PDF: The goal of the treatment of femoral neck fractures is early ambulation to prevent the complications such as pneumoniae or atelectasis, deep vein thrombosis, pulmonary embolism, bed sore, general weakness. The authors have tried to asess the outcome and complication of multiple pinning (28 cases) and biploar endoprosthesis (35 cases) for femoral neck fractures in average 18 momths with the range of 12 months to 5 years from May 1990 to May 1996. The results were asessed by interval from injury to operation, post operative complication and mortality rate, weight bearing time, Lunceford hip grading method. The results were as folllows: 1. Post operative complications rate were 43% in multiple pinning, and 26% in bipolar group. 2. The mortality rate was 14.2% in multiple pinning group and 11.4% in bipolar endoprosthesis group. 3. The functional results evaluated by Lunceford's methods were satisfactory in 64% of multiple pinning group and 71% in bipolar endoprosthesis group. We concluded that displaced fractures, subcapital fracture, severe osteoporosis, old fracture over 3 weeks in elderly patients, bipolar endoprosthesis gave a more reliable results.

70 View
0 Download

Clinical Results of Cemented Bipolar Arthroplasty in Femur Neck Fractures over 70 Years: Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Jong Wha Yi; J Korean Soc Fract 1998;11(2):313-320. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.313

Abstract PDF: There have been much controversy about prosthetic replacement or internal fixation for patients over 70 years old. Authors reviewed and analyzed 45 cases of cemented bipolar hemiarthroplasty in patient over 70 years treated at the Department of Orthopedic Surgery, Sung-Ae General hospital from January 1988 to July 1995. The purpose of this study was to analyse the clinical and radiological results and to detect the motion study of bipolar cup. Follow up period was average 26.1 months, ranged from 24 months to 37 months. The following results were obtained. 1. In clinical evaluation, excellent & good result were in 31 cases(68.6%). 2. In radiologic evaluation, acetabular erosion were in 2 cases and loosening of the femoral component was in 1 case. 3. With time elapsed, the amount of the inner bearing motion was decreasing with preservation of the total joint motion. 4. Complications were idiopathic pain 7 cases, nerve paresis 2 cases, superficial infection 2 cases, intraoperative fracture 1 case, dislocation 1 case, losening 1 case.

53 View
0 Download

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.

Citations

Citations to this article as recorded by

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

110 View
0 Download
1 Crossref

Bipolar Hemiarthroplasty Inserted with Cement for the femoral Neck Fractures in Elderly Patients: Sang Won Park, Young Soo Byun, Gyou Hyouk Lee, Jong Won Kim; J Korean Soc Fract 1997;10(3):509-515. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.509

Abstract PDF: Elderly patients with femoral neck fracture often have other medical diseases, poor bone quality and poor compliance which make it more difficult to obtain satisfactory results after internal fixation. Therefore, prosthetic replacement is accepted as an appropriate treatment for elderly patients. The purpose of this study was to analize clinical results of cemented bipolar hemiarthroplasty in the femoral neck fractures of elderly patients. The authors analyzed thrity-seven patients with 38 fractures of the femoral neck older than 65 years of age who were treated with cemented bipolar hemiarthroplasty from Jan. 1991 to Dec. 1995. The average follow-up period was three years, ranged from one to five years. The functional results were evaluated according to the criteria of the Harris hip score The results obtained were as follows : 1. The average Harris hip score was 84.6 points, ranged from 61 to 97 points. 2. The average pain score was 40.3 points. Twelve cases did not complain of pain, slight pain in 26 cases and mild pain in 2 cases. 3. The average limping gait score was 8.9 points. Twelve cases had no limping gait, slight limping in 25 cases and moderate limping in one case. 4. The average support score was 8.4 points. Seventeen cases could be walked without support, sixteen cases did use cane for long walk, two cases did use cane at full time, and three cases did use crutch. 5. Intraoperative complications were partial fracture of greater trochanter in 2 cases and one non-displaced calcar fracture. 6. Postoperative complications were heterotopic ossification in 2 cases, dislocatioin of bipolar cup with proximal migration in 1 case and ipsilateral femur fracture below the tip of femoral stem in 1 case. Above results suggest that the cemented bipolar hemiarthroplasty for femoral neck fracture in elderly patients appears to be a method of treatment better than internal fixation for early ambulation and functioinal recovery.

57 View
0 Download

Femur Neck Fracture during Closed Nailing of Femur Shaft Fracture: Keun Woe Kim, Ui Seong Yoon, Yong Hoon Kim, Hak Jin Min, Jin Sup Yeom, Young Ho Lee; J Korean Soc Fract 1996;9(4):936-942. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.936

Abstract PDF

Closed intramedullary nailing has become increasingly popular in the management of fractures of the femur because of a high rate of union, a low rate of infection, and excellent return of function. But it requires good availability of equipment and surgeons skill and experience. Iatrogenic femur neck fracture can occur as a complication of closed intramedullary nailing of femur shaft fracture. The authors report five cases of this complication and analyze these five cases in the viewpoint of causal technical errors and suggest some technical points to avoid this complication.

Citations

Citations to this article as recorded by

Some Series of Honey-Comb Spaces
Elena Barbieri, Alberto Cavicchioli, Fulvia Spaggiari
Rocky Mountain Journal of Mathematics.2009;[Epub] CrossRef

101 View
0 Download
1 Crossref

Treatment of Femur Neck and Intertrochanteric Fractures in the Elderly with primary Hemiarthroplasty: Myung Chul Yoo, Ki Tack Kim, Yoon Je Cho, Seung Duk Sun, Gyoung Chean Park; J Korean Soc Fract 1994;7(2):412-421. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.412

Abstract PDF

From January 1982 through December 1992, 102 hips in 100 patients had a primary hemiarthroplasty for the treatment of femur neck and intertrochanteric fractures in the elderly who had severe comminuted fractures or poor bone quality and poor genenral condition. Of these, we reviewed 62 hips in 62 patients with a minimum follow-up over one year. 1. The average age at operation was 71.7 years(50-96 years). 2. The most common cause of injury was slip down in 56 cases(90.4%). 3. Bone quality was evaluated with Singh index radiologically and 42 cases(67.8%) were classified to below grade III. 4. Most patients were possible to sit and start wheel chair ambulation within a week and the average period of time from operation to partial weight bearing was 12.9 days. 5. In clinical evaluation, the average Harris hip score was 75.9 in the femoral neck fractures and 71.9 in intertrochanteric fractures and 73.2 in the unipolar endoprosthesis group and 69.5 in the bipolar endoprosthesis at the final follow up. 6. Postoperatively, 13 hips(21%) had only mild discomfort, 6 hips(10%) had moderate pain, one hip(1.6%) had severe pain on the ipsilateral hip or thigh, or knee. 7. The most common early postoperative complications were superficial wound infection(3 cases, 6.4%). 8. In the radiological evaluation, the most common late postoperative complications were leg length discrepancy(L.L.D) in 6 cases(9.7%) and acetabular erosion in 5 cases(8.1%). 9. In the analysis of the relationship between prosthetic head size compared to acetabular size and acetabular erosion, more proper size of prosthetic head raised less acetabular erosion, 1 case(2.5%), and large size of prosthetic head raised more acetabular erosion, 2 cases(28%). There was no significant difference in the incidence of the acetabular erosion between the unipolar and bipolar endoprosthesis group. In this study, most of the patients had relatively good results and lower incidence of local or general complictions. Therefore, hemiarthroplasty can be suggested for one of primary treatment method of intertrochanteric fractures and femur neck fractures in elderly patients who had fevere comminuted fractures or poor bone quality and poor general condition.

Citations

Citations to this article as recorded by

The Efficacy of Suture Fixation of the Greater Trochanter in Unstable Intertrochanteric Fractures
Ki-Choul Kim, Hee-Gon Park, Jae-Wook Park
Clinics in Orthopedic Surgery.2021; 13(4): 468. CrossRef
Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients
Han-Jun Lee, Jong Won Kim, Jae-Sung Lee, Jae June Yang, Woo-Young Hwang
Journal of the Korean Fracture Society.2010; 23(3): 276. CrossRef

84 View
0 Download
2 Crossref

A Cliniral Experience of Quadratus Femoris Muscle Pedicle Bone Graft in Nonunion and PatHologic Fracture of the Neck of Femur: C U Choi, S K Rah, Y S Seo, S Y Choi, D Y Kim; J Korean Soc Fract 1992;5(2):383-393. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.383

Abstract PDF: In spite of the improvement for the treatment of femoral neck fracture, the incidence of noinion is more than 15%. There are several surgical methods for treating the nonunion of femoral neck fracture, they are:osteosynthesis, osteotomy, prosthetic replacement, total hip arthroplasty, hanging hip and arthrodesis and so forth. The muscle pedicle bone graft method fof the nonunion in femoral neck fracture was designed by Judet (1962) initially. This method is also applied for the patients with nonunion, possibility of nonunion, or avascular necrosis of femoral head. In this paper, the authors reported the results of muscle pedicle bone graft for the three cases of the nonunion in femoral neck fracture, and one case of pathologic fracture at SoonChunHyang Hospital during from April 1988 to August 1990. Two out of the three cases of femoral neck fracture were treated by Richard hip screw and the other was applied by multiple pinning.The cause of nonunion was inaccurate reduction and inadequate position of implant. Mean fracture, 4 days after injury, curretage and muscle pedicle bone grafting were performed. The complication were found leg length shortening and limitation of hip motion but painful walking was not noted. Clinical and radiological, bone union was obtainef at 6 months after the operation In according to Lunceford s assessment, all four cases showed satisfaGtory results.

39 View
0 Download

Search