Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.
Absorptiometry, Photon ; Alendronate ; Biomarkers ; Bone and Bones ; Bone Density ; Bone Remodeling ; Bone Resorption ; Calcitonin ; Diet ; Estrogens ; Etidronic Acid ; Female ; Humans ; Incidence ; Male ; Motor Activity ; Organ Specificity ; Osteogenesis ; Osteoporosis ; Public Health ; Raloxifene Hydrochloride ; Risk Factors ; Smoking Cessation ; Strontium ; Teriparatide ; Risedronate Sodium

From January 1985, to June 1986, 7 cases in which supracondylar and intercondylar fractures of the femur were treated at our orthopaedic department using the Extensile Approach for an anatomical reduction and firm internal fixstion, show successful results in follow up stuides. l. All 7 cases were type III fractures of Neers classification. 2. Among the 7 cases treated surgically using the Extensile Approach, 5 cases showed excellent and good results and the remaining 2 csses showed one fair and one failed results. 3. Probably due to the additional open proximal tibia and patella fracture and delayed surgery from trauma one case had a fair results. The case which failed wss due to ipsilsteral ligamentous injuries and a nerve injury in addition to the femur fracture and slso the impossibility of early knee joint exercise due to associated injuries. 4. None of the results of the 7 csses had any relationship with the patients age. 5. One case of postoperative skin necrosis developed around the tibial tuberosity and was treated successfully by a cross leg flap. 6. In comminuted supracondylar and intercondylar fractures of the femur, the Extensile Approach is thought to be an excellent surgical technique by means of a wide surgical field for an anatomical reduction and firm internal fixation with the repair of associated ligamentous injuries.
Adult ; Classification ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Leg ; Ligaments ; Necrosis ; Patella ; Skin ; Tibia

Congenital pseudarthrosis of the tibia was accepted as one of the most difficult disease in respect of the frequency and treatment for the orthopaedists. Since April, 1984, we experienced 3 cases of congenital pseudarthrosis of the tibia, one 2 year-old boy involved left tibia only and the other 4 year-old female involved bilaterally, obtained solid bony union in all which were treated by massive surgical management that contained vascularized bone graft and electric stimulation. Several complications were faced such as refracture, valgus deformities of the ankle, skin irritation sign, angular deformities. But refracture was healed without delayed or nonunion by simple plaster cast immobilization. The vascularized bone graft snd electric stimulation is thought to be more improved methods for the treatment of congenital pseudarthrosis of the tibia. Althought solid bony union was obtained in congenital pseudarthrosis of the tibia, periodic follow-up and adequste management must be mandatory up to the end of the bony growth.
Ankle ; Casts, Surgical ; Congenital Abnormalities ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Pseudarthrosis ; Skin ; Tibia ; Transplants

Although traumatic bowing of one or both bones of the forearm in children following acute trauma was reported by some authors, traumatic bowing of the ulna with dislocation of the radial head was described by only a few reports. We experienced one case of traumatic bowing of ulna associated with dislocation of the radial head and it was managed with open reduction of the dislocation of radial head and closed management of the bowing of the ulna. The result 1 year 10 months after treatment was very good, so we report this a case with related literatures.
Child ; Dislocations ; Forearm ; Head ; Humans ; Ulna

Although several histopathological changes have been developed in frozen shoulder, frozen shoulder is mostly accompanied by the changes of the rotator cuff which has the most important function in movement and has a role in stabilizing the shoulder joint. The changes of the rotator cuff in frozen shoulder have not been reported in Korea yet, but Simon reported that there was an attenuation of the rotator cuff in frozn shoulder. Accordingly, we observed the changes of the rotator cuff in frozen shoulder by ultrasonography, which has no rsdiation exposure and is non-invasive. The authors practiced the shoulder ultrasonography on 36 patients with a pain and limitation of motion in shoulder at the Dept. of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University, from March in 1988 to August in 1988. The results are as follows ;1) Ultrasonography is thought to contribute a great deal in detection of the changes of the rotator cuff, especially of the thickness of the rotstor cuff. 2) Among 36 patients, the thickness of the rotator cuff of 35 patients was 6.494+1.008 mm (M+SD) in the affected shoulder and 6.475+1.052 mm(M+SD) in the unaffected shoulder. In only one pstient, the thickness of the rotator cuff was 1.68+0.58 mm(M+SD) in the affected shoulder and 553+1.16mm(M+SD) in the unaffected shoulder. Theres no significant change in the thickness of the rotator cuff measured by ultrasonography in frozen shoulder. 3) Ultrasonography is an excellent diagnostic method in detecting the rupture of the rotator cuff in frozen shoulder.
Bursitis ; Heart ; Humans ; Korea ; Methods ; Orthopedics ; Rotator Cuff ; Rupture ; Shoulder ; Shoulder Joint ; Ultrasonography

BACKGROUND: With the rapid increase in the elderly population and the ensuing increase in osteoporosis and subsequent fractures, there has been a rise in socioeconomic costs. This study evaluated the relationship between osteoporosis and physical function in 66-year-old Korean women. METHODS: All of the 193 Korean women aged 66 years were recruited from life-transition health examinations from May to December, 2007. Background information was collected through a self-administered questionnaire; and height, weight, and waist circumference were measured. Bone mineral density of the lumbar spine was measured with the Dual Energy X-ray Absorptiometry and the 'timed up and go (TUG)' and 'one-leg balance (OLB)' tests were administered. Risk factors for osteoporosis were analyzed by correlation coefficients and binary logistic regression analysis. RESULTS: The prevalence of osteoporosis for 66-year-old women was 25.9%. A short stature and lower body mass index (BMI) were associated with osteoporosis of the lumbar spine. A longer time to complete the TUG test (>10 second) was associated with a 4-time higher prevalence of lumbar osteoporosis, which was not observed with the OLB test. CONCLUSIONS: One out of four 66-year-old Korean women had osteoporosis. A longer TUG time, short stature, and lower BMI were associated with osteoporosis.
Absorptiometry, Photon ; Aged ; Body Mass Index ; Bone Density ; Female ; Humans ; Korea ; Logistic Models ; Osteoporosis ; Prevalence ; Risk Factors ; Spine ; Waist Circumference

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

Rhabdomyosarcoma which was first described by Weber has generally been considered asan uncommon tumor. Pack and Eberhart were of the opinion that rhabdomyosarcoma represented 13.9 percent of soft tissue sarcomata. Recently it was classified as four types such as pleomorphic, embryonal, botryoid and alveolar type by many authors. We have experienced two cases of embryonal rhabdomyosarcoma, one arised within left leg and the other within right foot. The former(3 months old, female) showed tumor mass at birth, the latter(13 months old, male) showed at 1 month after birth.
Chungcheongnam-do ; Foot ; Leg ; Parturition ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal

Severe injuries of hands frequently expose the bone and joint due to the defect of crushing of soft tissues. Although the several methods are introduced, the treatment of bone and joint exposure of finger and hand is very difficult to control satisfactorily. From October 1986 to February 1988, we performed the pedicled skin flap in 11 cases; 9 abdominal skin flaps and 2 pectoral skin flaps. Follow up stuides showed good results. The successful surviving of flaps was accomplished in all cases and the dead bones were regenerated by the creeping substitution. Therefore this pedicled skin flap operation can be considered to be a simple and effective method in treating the bone and joint exposure of fingers.
Fingers ; Follow-Up Studies ; Hand ; Joints ; Methods ; Skin

Synovial chondromatosis is an uncommon benign lesion characterized by multiple cartilagenous and osteocartilagenous nodules of the synovium and loose bodies. The affection is monoarticular and most commonly involves the knee and has an unknown etiology. Of the five cases of synovial chondromatosis experienced by the authors, both knee joints were involved in a case, two the elbow joint, and one the proximal phalanx of the left middle finger. The diagnosis of synovial chondromatosis was made by the histopathological findings of the excised masses.
Chondromatosis, Synovial ; Diagnosis ; Elbow Joint ; Fingers ; Knee ; Knee Joint ; Synovial Membrane