1.Orthopedic disease and sports medicine related to lower limbs.
Joon Ho WANG ; Ju Seon JEONG ; Won Hah PARK
Journal of the Korean Medical Association 2011;54(7):715-724
In this study, the cause, diagnosis, and treatment of common lower limb injuries during the sports activities were presented. Sports injuries of the lower limbs are the most common injuries in the sports medicine field due to the high level of use of the lower limbs during sports activities. The common causes of leg injuries in athletes are traumatic force over the critical limit of normal tissue, repetitive microtrauma, and overuse. Common hip and pelvis problems encountered by the authors include trochanteric bursitis, snapping hip syndrome, and labral tears. The anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, and meniscus have been most frequently involved in sports injuries affecting the knees. Lateral ankle sprain represents one of common injuries in the athletic population. Common overuse injuries are tendinopathies, stress fractures, chronic exertional compartment syndrome, and shin splints. Athletic activity provides a variety of positive benefits to participants' health. To safely continue those activities, an injury prevention program focusing on injuries that may occur in specific sports activities is recommended for participants. Early diagnosis and proper treatment are also important in promoting prompt recovery and preventing secondary injuries.
Animals
;
Ankle
;
Athletes
;
Athletic Injuries
;
Bursitis
;
Collateral Ligaments
;
Compartment Syndromes
;
Cumulative Trauma Disorders
;
Early Diagnosis
;
Femur
;
Fractures, Stress
;
Hip
;
Humans
;
Knee
;
Leg Injuries
;
Lower Extremity
;
Medial Tibial Stress Syndrome
;
Orthopedics
;
Pelvis
;
Posterior Cruciate Ligament
;
Sports
;
Sports Medicine
;
Sprains and Strains
;
Tendinopathy
2."Jammed Leg" Injury of Short-Fronted Vehicle Drivers in Frontal Collision Accidents.
Yong Min KIM ; Choong Hee WON ; Joong Bae SEO ; Ho Seung LEE ; Eui Sung CHOI ; Byoung Gwon BAE ; Sung Moon LIM
The Journal of the Korean Orthopaedic Association 2001;36(6):579-585
PURPOSE: To Investigate the patterns and to document the clinical and technical significances of the leg injuries of drivers of short-fronted vehicles in frontal collision accidents. MATERIALS AND METHODS: Twelve cases of jammed leg injury were chosen from hospitals in the Chungcheong Province area and investigated in terms of nature of the accident, distribution of injuries, methods and duration of treatment and final sequelae. RESULTS: The patients had multiple injuries on the lower extremities, such as, fractures of the femoral shaft, tibial shaft, foot and ankle and soft tissue injuries, requiring an average 8.3 surgical procedures and 7 months admission, and from which permanent sequlae resulted, though associated injuries of the head, chest, abdomen were not significant. CONCLUSION: "Jammed leg injury" seemed to be related with the design of short-fronted vehicles. As these injuries can cause considerable functional and socioeconomic loss with long treatment periods and permanent residual sequelae. Preventive measures appear to be necessary, possibly involving vehicle design modification.
Abdomen
;
Ankle
;
Foot
;
Head
;
Humans
;
Leg
;
Leg Injuries
;
Lower Extremity
;
Multiple Trauma
;
Soft Tissue Injuries
;
Thorax
3.Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles.
Ramesh-Kumar SEN ; Sujit-Kumar TRIPATHY ; Vibhu KRISHNAN ; Tarun GOYAL ; Vanyambadi JAGADEESH
Chinese Journal of Traumatology 2011;14(3):183-187
This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture-dislocations of the left hip (Pipkin's type IV) and knee (Moore II) joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.
Adult
;
Fractures, Open
;
surgery
;
Hip Dislocation
;
surgery
;
Humans
;
Knee Dislocation
;
surgery
;
Leg Injuries
;
surgery
;
Male
;
Tomography, X-Ray Computed
4.Fixation versus Excision of Osteochondral Fractures after Patellar Dislocations in Adolescent Patients: A Retrospective Cohort Study.
Hui KANG ; Jian LI ; Xu-Xu CHEN ; Tao WANG ; Shi-Chang LIU ; Hong-Chuan LI
Chinese Medical Journal 2018;131(11):1296-1301
BackgroundPatellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to compare the outcomes between fixation and excision of osteochondral fractures not involving the bearing surface in adolescent patients with patellar dislocations.
MethodsPatients who underwent surgery for osteochondral fracture following patellar dislocation in our institution from 2007 to 2014 were retrospectively evaluated. Visual analog scale (VAS) of pain and the International Knee Documentation Committee (IKDC) form were used to assess knee pain and function at follow-up. Patient satisfaction was evaluated. Differences in the values of variables among groups were assessed using t-test if equal variance or Mann-Whitney U-test if not equal variance. The Pearson's Chi-square test was applied for dichotomous variables if expected frequency was >5 or Fisher's exact test was applied if not. A value of P < 0.05 was considered statistically significant.
ResultsForty-three patients were included, with the average age of 14.1 ± 2.3 (range, 9.0-17.0) years. Nineteen underwent fixation of osteochondral fractures and 24 did not. The average follow-up time was 28 ± 10 months. There was no significant difference in age, gender, follow-up time, causes of injury, times of dislocation, and location of osteochondral fracture between fixation and excision groups. The fixation group had a significantly longer surgery time (82 ± 14 min) and larger size of osteochondral fracture (2.30 ± 0.70 cm) than the excision group (43 ± 10 min, 1.88 ± 0.62 cm, respectively, t = 10.77, P < 0.01 and t = 0.84, P < 0.05). At the last follow-up, the average IKDC score in the fixation group (82.52 ± 8.71) was significantly lower than that in the excision group (89.51 ± 7.19, t = 2.65, P < 0.01). There was no significant difference in VAS of pain and patients' satisfaction. There were 7 (16%) patients with recurrent dislocation.
ConclusionExcision of osteochondral fractures has equivalent or better outcomes compared to fixation in adolescent patients with patellar dislocations when these fractures do not involve the bearing surface.
Adolescent ; Child ; Female ; Femoral Fractures ; surgery ; Humans ; Knee Injuries ; surgery ; Male ; Patellar Dislocation ; surgery ; Retrospective Studies
5.A mathematical model of determining the knee joint injury.
Journal of Biomedical Engineering 2004;21(5):737-740
A mathematical model of determining the injury of human knee joint was established by using structural dynamics method. The results showvered the corresponding shearing displacement and bending angle of the knee joint on the occasion of ligament avulsion, and the shearing force and bending moment which caused tibial condylar fractures under purest shearing and bending condition. The calculated results consisted with the experimental results greatly, suggesting that using mathematical method to determine the injury is feasible and this kind of method can do good to lots of subjects, such as pedestrian protection, athletic medicine and rehabilitation engineering.
Humans
;
Knee Injuries
;
Leg Injuries
;
Models, Theoretical
;
Multiple Trauma
;
Tibial Fractures
6.The Treatment of Ipsilateral Fracture of the Femur and Tibia
Dae Kyung BAE ; Sang Eun LEE ; Young Soo KIM ; Young Woo KIM
The Journal of the Korean Orthopaedic Association 1990;25(3):702-710
Fractures of the femur and tibia on the same leg encountered with forceful trauma. In these fractures, the treatment was difficult and the functional result was poor in most cases. Authors treated 22 fractures of femur and tibia on the same leg and analysed it. And the results were as follows. 1. The most common location of fractures was mid-third in both femur and tibia. 2. The shape of fractures was transverse or comminuted in most cases in femur and tibia. 3. Among the method of treatment of femoral fractures, the results were better in intramedullary-nailing group than plate and screw fixation group. There were three poor results in intramedullary-nailing group. These were attributed to the severity of combined tibial fractures. 4. Among the method of treatment of tibial fractures, the results were better in external fixation group which minimized the soft tissue injury than plate and screw fixation group. 5. According to the criteria of Karlstrom and Olerud, the final results were relatively good in 54% of cases. For the better results, it seemed to be needed initial careful planning and attention for the treatment.
Femoral Fractures
;
Femur
;
Leg
;
Methods
;
Soft Tissue Injuries
;
Tibia
;
Tibial Fractures
7.Vein Injury and Wound Complications Associated with Techniques of Saphenous Vein Harvest.
Jong Bum CHOI ; Kwon Jae PARK ; Hyun Woong YANG ; Sam Youn LEE ; Soon Ho CHOI
The Korean Journal of Thoracic and Cardiovascular Surgery 2003;36(7):504-509
BACKGROUND: Although arterial grafts are widely used due to the advantage of long-term patency in coronary bypass surgery, greater saphenous vein is still an important additional conduit. It was reported that preservation of the adventitia of vein graft and the adjacent tissues may bring the improved long-term graft patency. The aim of this study is to look for a harvest technique that can reduce vein injury and wound complications. MATERIAL AND METHOD: In thirty-four patients that vein grafts were used for coronary bypass surgery, 50 harvest sites were included for the study. In 25 harvest sites in calf below knee (group 1), vein was exposed through a long incision and then clearly dissected from the adjacent tissue. Ten endoscopic vein harvests were performed in the thighs (group 2). Fifteen other vein grafts that were bluntly dissected were harvested from the thighs through three separate incisions (group 3). RESULT: Vein harvest time was longest in endoscopic harvest group (44.7+/-9.8 minutes) and shortest in group 3 (24.2+/-5.9 minutes) (p=0.000). Most avulsion injuries of vein branches happened in the endoscopic group. Sequential grafting numbers per vein were 1.72+/-0.98 with thigh vein graft and 1.16+/-0.37 with calf vein (p=0.02). Swelling of foot and/or leg, which was the most common wound complication after vein harvest, was most commonly presented in group 1 (20/25 sites; p=0.000). Tingling, the most common neurologic complication, was also most prevalent in group 1 (7/25 sites; p=0.013). The risk factor of the wound complication was vein harvest from calf, and the vein harvest technique was not a risk for wound complication. CONCLUSION: Vein harvest technique through three separate incisions from thigh presented shorter harvest time and less vein injury and wound complication compared with the endoscopic harvest technique from thigh or the harvest through a long incision from calf.
Adventitia
;
Foot
;
Humans
;
Knee
;
Leg
;
Risk Factors
;
Saphenous Vein*
;
Thigh
;
Transplants
;
Veins*
;
Wounds and Injuries*
8.Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report -.
Bong Ju PARK ; Hong Man CHO ; Ju Han KIM ; Woo Jin SIN
Journal of the Korean Fracture Society 2013;26(2):151-155
Proximal femoral nail anti-rotation (PFNA) with a lag screw that is shaped like a spiral blade shape is an orthopedic implant to fix trochanteric fractures of the proximal femur. In addition the reason of the biomechanical advantages, PFNA widely been used recently. We report an 83-year-old man with excessive sliding of the helical blade and a femoral neck fracture after AO/OTA type A2 intertrochanteric fracture, which was fixed with a PFNA.
Femoral Neck Fractures
;
Femur
;
Femur Neck
;
Hip Fractures
;
Nails
;
Orthopedics
9.Evaluating the results of partial hip replacement for patients with femoral neck fracture
Journal of Practical Medicine 2005;10():48-51
Retrospective 104 patients with a femoral neck fracture had been underwent partial hip replacement in Viet Duc Hospital for 5 year (1/1998-4/2003): 61 male, 43 female, average age 70.71 (43-89), 72 patients used cement prostheses and 32 patients had prostheses without cement; 69 cases inserted with Austin Moore, 2 with Thompson, 1 with Monk and were followed for an average of 28.18 months. The results: 6 patients died; four prostheses had been changed to a total hip replacement. 65 patients were reexamined: joint function was excellent or good in about 61.98%; fair or unsatisfactory in 30.77%, and 46.15% patients had painful prostheses; 29.41% erosion of acetabulum; 21.56% with a radiolucent zone around the femoral stem were found.
Femoral Neck Fractures
;
Arthroplasty, Replacement, Hip
10.Research progress on evaluation methods for head-neck nail position in femoral intertrochanteric fractures.
Lincong FEI ; Xuzhou ZHENG ; Xuepeng XU ; Junwu YE
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(9):1149-1155
OBJECTIVE:
To summarize the research progress on the evaluation methods of head-neck nail positions in femoral intertrochanteric fractures.
METHODS:
The literature about the evaluation methods of head-neck nail positions for femoral intertrochanteric fractures in recent years was extensively reviewed, and research progress in the aspects of evaluation methods, clinical applications, and limitations were summarized.
RESULTS:
The position of head-neck nails in femoral intertrochanteric fractures is closely related to postoperative complications of head-neck nail cutting. Currently, the tip-apex distance (TAD) and femoral head zoning are widely used to evaluate the position of head-neck nails. The main opinion in the literature is that the use of TAD and femoral head zoning can effectively reduce the incidence of head-neck nails cutting. Parker's ratio, as one of the evaluation methods, has been controversial in subsequent studies and has not been widely used in clinical practice. The TAD as referenced to the calcar (CalTAD), which was modified based on TAD, has been gradually accepted by the clinic, but whether it is better than the TAD has not yet been conclusively determined. In recent years, new evaluation methods have been proposed to supplement the previous evaluation methods, such as the tip-neck distance ratio (TNDR) and the standardized TAD (STAD) to avoid the limitations of the TAD and the CalTAD by the volume of the femoral head, and the axis-blade angle (ABA) to supplement the direction of the head-neck nails channel, but at present the clinical application is relatively underutilized, and the validity of the method needs to be further verified.
CONCLUSION
Currently, there are many methods for evaluating the position of head-neck nails in femoral intertrochanteric fractures, TAD<25 mm combined with head-neck nails placed in the middle-middle quadrant or lower-middle quadrant of the femoral head division is currently a highly recognized assessment in the literature, but the optimal assessment is still controversial, and further research needs to be studied.
Humans
;
Nails
;
Head
;
Neck
;
Femoral Fractures
;
Hip Fractures/surgery*