The bone mineral density (BMD) has been measured for evaluation of the osteoporosis. Of the various methods of measuring the BMD, dual energy X-ray absorptiometry (DEXA) has been known to be an accurate, objective, and easily reproducible method. The authors measured BMD in patients with intertrochanteric fracture of the femur for comparison with results in the normal control. The BMD was measured in thirty-two patients with intertrochanteric fracture by dual energy X-ray absorptiometry from March 1993 to March 1995. And the relationship between the severity of osteoporosis and intertrochanteric fracture of the femur was studied. The comparison of BMD between fracture patients and normal control was done in the population below 79 years old of age (23 fracture patients and 90 normal controls). The average BMD in the intertrochanteric fracture group was 0.558g/cm2 in the neck, 0.425g/cm2 in Ward's triangle and 0.568g/cm2 in the trochanter, while in the normal control group it was 0.870g/cm2 in the neck, 0.681g/cm2 in Ward s triangle and 0.772g/cm2 in the trochanter. In comparison with the normal control group, the BMD in fracture group was about 79% of the normal control group. The BMD in the proximal femur was decreased by about 14% with the age increasing decennially after 50 years. The BMD at Ward s triangle and trochanter was much lower in type III and IV of Tronzo classification than in type I and II .The BMD did not show significant correlation with the height and weight of the patients.
Absorptiometry, Photon ; Aged ; Bone Density* ; Classification ; Femur* ; Humans ; Neck ; Osteoporosis

PURPOSE: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. MATERIALS AND METHODS: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. RESULTS: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). CONCLUSION: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.
Early Ambulation ; Femur ; Fractures, Spontaneous ; Humans ; Lower Extremity ; Postoperative Complications ; Postoperative Hemorrhage ; Skeleton ; Tibia ; Walking ; Wheelchairs

The treatment of fractures of the dens is controversial and the major controversy has centered on type II fracture of Anderson and D'Alonzo classification because of its high incidence of nonunion when they were treated by external immobilization like halo apparatus. The posterior arthrodesis of atlas and axis which has been recommended by many authors results in the limitation of rotation of neck. In an attempt to promote bone union and to eliminate functional impairment, the authors have treated 7 consecutive cases of type II dens fracture by direct screw fixation with one or two screws. Minimum follow up period was 15 months(Av. 20mos.). Ages were varied between 23 to 68 years. Amounts of displacement on arrival were more than 4mm in all. Ambulation was started from the day after operation with the external support. Bone union was observed in 6 cases within 3 months without limitation of rotation. One nonunion with losening of screw and one transient dysphagia were observed. The authors believe that the procedure has the advantages in bone union and neck motion, but it requires surgeon's experience and the modification of implant for secure fixation.
Arthrodesis ; Classification ; Deglutition Disorders ; Follow-Up Studies ; Immobilization ; Incidence ; Neck ; Walking

Generally the clinical results of Legg-Calvé-Perthes disease were evaluated until the time of disease healing. However, it is well known that the deformities of the proximal femur progress to the period of skeletal maturity. The purpose of this study was to evaluate the progression of the deformities in the proximal femur. In a retrospective study of 60 patients with Legg-Calvé-Perthes disease, who visited Chonnam National University Hosipital 1974 and 1995 and who were followed until the skeletal maturity, the bony changes of the proximal femur were compared between disease healing stage and skeletal maturity. The results were as follow; 1. More bony deformities were identified in skeletal maturity than in disease healing. 2. The quotient of inferior border of medial femoral neck decreased from 60% in disease healing to 45% in skeletal maturity (P < 0.001). 3. The femoral shortening increased from 4.9mm in disease healing to 10mm in skeletal maturity (P < 0.001). 4. The femoral neck-shaft angle decreased from 128 degrees in disease healing to 125 degrees in skeletal maturity (P < 0.001). 5. The proximal migration of greater trochanter increased from 13.8mm in disease healing to 21.3mm in skeletal maturity (P < 0.001). 6. There were no significant statistical differences in clinical results between operative and conservative treatment groups. 7. The spherical quotient of femoral head and Stulberg rate revealed no differences between disease healing and skeletal maturity. These results revealed that there were considerable differences of the deformities in the proximal femur at the time of disease healing and skeletal maturity.
Congenital Abnormalities ; Femur Neck ; Femur ; Head ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Retrospective Studies

There have been a few repots that serum immunoglobulins are increased in Perthes' disease suggesting possible immunological involvement in the pathophysiology of the disease. Joseph(1991) suggested that the raised IgM concentrations might be related to complications of Perthes' disease such as striking reduction of movement, fixed deformities and striking reduction of movement, fixed deformities and chondrolysis and that immunological mechanisms might be implicated in the mediation of some of the changes in Perthes' disease. More studies are necessary to prove the results. The purpose of this study is to detect if there is a true increase of serum immunoglobulins in Perthes' disease.
Congenital Abnormalities ; Immunoglobulin M ; Immunoglobulins ; Negotiating ; Strikes, Employee

No abstract available.
Adult* ; Female* ; Humans

Erdheim Chester disease (ECD) is very rare non-Langerhans cell histiocytosis (LCH) which occurs in the skeletal system and multiple organs. As it is progressive, sometimes it causes fatal results. However, it is often misdiagnosed as LCH or multiple bone metastasis and, thus, is very difficult to diagnose. In Korea, only 10 cases were first reported in 1999. In particular, there have been a few orthopedic approaches or reports in English-speaking literatures, and no report has been issued in Korea. The authors performed bone biopsy in patients with knee and lower extremity pain who were referred for the integrated treatment. We attempts to report this diagnosis experience with literature review.
Biopsy ; Erdheim-Chester Disease ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Knee ; Korea ; Lower Extremity ; Neoplasm Metastasis ; Orthopedics

The main goals of treatment of malignant bone tumor are the prolongation of life survival and the improvement of quality of life. In growing children, however, leg length discrepancy (LLD) is one of major problem in the treatment of malignant bone tumors. Therefore, the precise understanding of growth in children is essential, and the prediction of LLD is critical in deciding the time and options of surgery. In addition, to use the adequate method of growth expectation, periodic follow-up and collaboration with patient's parents are needed.
Child ; Cooperative Behavior ; Humans ; Leg ; Life Support Care ; Parents ; Quality of Life

For the nonunion of humeral shaft, there have been many methods of treatment. We are aimed to analyse the causes of nonunion of humeral shaft fracture and present the direction of treatment. We reviewed total 21 cases which were diagnosed as delayed or nonunion of humeral shaft and analysed the causes. l. Initial method of treatment was surgical in 19 out of 21 cases. Among these 19 cases, 14 cases were operated with internal fixation with plate and screw. 2. The most common cause of nonunion was inadequate internal fixation in 26 cases(81%) in which were unstable fixation in 13 cases, choice of inadequate internal fixator in 11 cases, and failure of operative technique in 2 cases. Other causes were distraction between fracture fragments in 4 cases(13%) and open comminuted fracture in 2 cases. 3. Eighteen cases of established nonunion due to inadequate internal fixation were treated by rigid fixation with longer and broader plate and bone graft, and 1 case interlocking IM nailing, 1 case Ender nailing and 1 case bone graft only. 4. Union was obtained in all cases at least in 5 months. And there were no specific complications. In conclusion, surgeons should contemplate the operative indication and principles in primary treatment. In treatment of nonunion, surgeons should treat by more longer and broder internal fixator and additional bone graft.
Fractures, Comminuted ; Humerus ; Internal Fixators ; Methods ; Surgeons ; Transplants

To study the relationship between the bone mineral density measured by DEXA and QCT methods and to study the factors influencing on the value, bone mineral density in 208 patients with low back pain were measured by the two methods and compared statistically. Ages were varied between 17 to 79(Av. 46.7) years and male and female were 86 and 122. The results of this are as follows; 1. The values of DEXA and QCT showed statistically significant relationship(γ=0.58) as a whole. And bone mineral density in L2, L3 and L4 showed no difference in both groups. 2. Bone loss by aging(per year) in male and female was 0.99% and 1.06% by DEXA, 0,99% and 1.41% by QCT. 3. Body height and weight showed no significant influence of the value in two methods. 4. In body mass index over 27.5, the value measured by QCT was influenced to be diminished while that of DEXA was not influenced. 5. The value by QCT was influenced to be diminished by the increase of age especially over 50 years old in both sex. While the value by DEXA was influenced to be lowered than expected in female over 50 years old. It is concluded that the methods of measurement of bone mineral density have their limitation depend on the age, sex and mass index.
Body Height ; Body Mass Index ; Bone Density ; Female ; Humans ; Low Back Pain ; Male ; Spine