Journal of Musculoskeletal Trauma

Computational Simulation of Multiple Cannulated Screw Fixation for Femoral Neck Fractures and the Anatomic Features for Clinical Applications: Jin Hoon Jeong, Gu Hee Jung; J Korean Fract Soc 2018;31(2):37-44. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.37

PURPOSE
To identify the anatomic features for clinical applications through a computational simulation of the fixation of three cannulated screws for a femoral neck fracture.
MATERIALS AND METHODS
Thirty cadaveric femurs underwent computed tomography and the images were transferred to the MimicsÂ® program, resulting in three-dimensional proximal femur models. A three-dimensional scan of the 7.0 mm cannulated screw was performed to enable computerized virtual fixation of multiple cannulated screws for femoral neck fractures. After positioning the screws definitively for cortical support, the intraosseous position of the cannulated screws was evaluated in the anteroposterior image and axial image direction.
RESULTS
Three cannulated screws located at the each ideal site showed an array of tilted triangles with anterior screw attachment and the shortest spacing between posterior and central screws. The central screw located at the lower side was placed in the mid-height of the lesser trochanter and slightly posterior, and directed toward the junction of femoral head and neck to achieve medial cortical support. All the posterior screws were limited in height by the trochanteric fossa and were located below the vastus ridge, but the anterior screws were located higher than the vastus ridge in 10 cases. To obtain the maximum spacing of the anterior and posterior screws on the axial plane, they should be positioned parallel to the cervical region nearest the cortical bone at a height not exceeding the vastus ridge.
CONCLUSION
The position of cannulated screws for cortical support were irregular triangular arrangements with the anterosuperior apex. The position of the ideal central screw in the anteroposterior view was at the mid-height of the lesser trochanter toward the junction of the femoral head and neck, and the anterior and posterior screws were parallel to the neck with a maximal spread just inferior to the vastus ridge.

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Computational Simulation of Femoral Neck System and Additional Cannulated Screws Fixation for Unstable Femoral Neck Fractures and the Biomechanical Features for Clinical Applications
Ju-Yeong Kim
Journal of the Korean Fracture Society.2023; 36(1): 1. CrossRef

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The Determination of Optimal Entry Point for Proximal Femoral Nail Antirotation-II by Fluoroscopic Simulation: A Cadaveric Study: Jin Hoon Jeong, Gu Hee Jung; J Korean Fract Soc 2017;30(4):173-179. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.173

Abstract PDF

PURPOSE
This study seeks to determine the anatomically optimal entry point of proximal femoral nail antirotation-II (PFNA-IIÂ®) according to geographic features of Korean cadaveric femoral trochanters for successful reduction of osteoporotic proximal femoral fractures.
MATERIALS AND METHODS
Forty-three adult cadaveric femurs without previous fractures or surgeries were included. Anteroposterior (AP) and lateral images of all femurs and PFNA-IIÂ® were taken with an image intensifier. Using the image synthesis process via the image editing program (Adobe Photoshop CS6), the optimal entry point was verified and compared with the tip of the greater trochanter (GT) and the cervicotro-chanteric junction on AP images, as well as the width of the trochanter and the neck on lateral images.
RESULTS
The optimal entry point of PFNA-IIÂ® was an average distance of 9.1 mm (range, 7â€“15 mm) medially from the tip of GT on AP images. The center of the nail was located at an average of 30% (range, 21%â€“44%) area from the posterior margin of the middle neck, which is an average area of 38% (range, 26%â€“48%) from the posterior cortex of the trochanter on lateral images. Furthermore, the ideal entry point was at the extended line of the cervico-trochanteric junction.
CONCLUSION
The optimal entry point, which was found to be medial to the tip of the GT and posterior to the center of the middle femoral neck and the trochanter, was at on the extended line of the cervicotrochanteric junction.

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Clinical Research through Computational Anatomy and Virtual Fixation
Ju Yeong Kim, Dong-Geun Kang, Gu-Hee Jung
Journal of the Korean Orthopaedic Association.2023; 58(4): 299. CrossRef
Does the Entry Point of Proximal Femoral Nail Antirotation Affect the Malalignment of Intertrochanteric Fracture? A Cadaveric Study
Chittawee Jiamton, Nonpawit Nimmankiatkul, Pongsakorn Rungchamrassopa, Wichan Kanchanatawan, Pariyut Chiarapatanakom, Wirat Kongcharoensombat
Journal of Southeast Asian Orthopaedics.2022;[Epub] CrossRef

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Breakage of Cephalomedullary Nail Used in the Treatment of Proximal Femur Fractures: Case Report: Seok Hyun Kweon, Chang Hyun Shin, Jin Sung Park, Byoung San Choi; J Korean Fract Soc 2016;29(1):42-49. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.42

Abstract PDF

Internal fixation using a cephalomedullary nail as treatment for proximal femur fracture has recently been popular for early ambulation and rehabilitation. However metal breakage at the lag screw insertion site was reported due to non-union, delayed-union, and early weight bearing. In our orthopedic department, we experienced 2 cases of nail breakage at the lag screw insertion site, therefore we report on evaluation of the cause of metal failure and prevention of complications with literature review.

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Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes
Asep Santoso, Ik-Sun Choi, Kyung-Soon Park, Taek-Rim Yoon
Hip & Pelvis.2017; 29(3): 199. CrossRef

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Insufficiency Fracture of Proximal Femur Shaft without Bisphosphonate Therapy: Report of Three Cases: Suk Kyu Choo, Dae Yeon Jo, Hyoung Keun Oh; J Korean Fract Soc 2013;26(3):217-220. Published online July 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.3.217

Abstract PDF: There is a growing interest in the factors related to insufficiency fractures. We are going to report three insufficiency fracture cases which are considered to be caused by osteoporosis, rheumatoid arthritis, steroid use and femoral shaft bowing among the patients not taking bisphosphonate. All cases are caused by low energy trauma and among these cases, one patient is being presented with a prodromal symptom and another patient complains of both prodromal symptoms and bilateral lesions.

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Clinical Outcome of Surgical Treatment for Fracture of the Femoral Shaft with Ipsilateral Fracture of the Proximal Femur: Hee Gon Park, Jae Sung Yoo; J Korean Fract Soc 2011;24(4):307-312. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.307

Abstract PDF: PURPOSE
To analyze diagnostic process and clinical data in cases of fracture of the femoral shaft with fracture of the proximal femur.
MATERIALS AND METHODS
We reviewed 24 cases of patient who undergone surgery for fracture of the femoral shaft with ipsilateral fracture of the proximal femur and more than 1 year of examination of follow up was available. Age, sex.location and classification of the fracture, the time of diagnosis and operation, the method of operation, the associated injuries, the time of bony union and complication were investigated, postoperative function was evaluated on Friedman and Wyman criteria.
RESULTS
Bony union showed significant difference in the displacement and comminution of fracture, postoperative function revealed significant difference according to the associated injuries. The 6 cases (25%) out of 24 cases are failed early diagnosis, 4 cases out of 6 cases was detected during operation and 2cases was found after surgery. 21 cases out of 24 cases of femoral shaft fractures showed union, 23 cases out of 24 cases of femoral neck fractures showed union. There were eleven good, eleven fair, and two poor functional result according to Friedman and Wyman criteria.
CONCLUSION
Precious clinical and radiologic examination is needed not to miss the diagnosis of proximal femur fractures in ipsilateral femoral shaft fractures with proximal femur fractures. Anatomical reduction and rigid fixation of proximal femur are important to reduce avascular necrosis of femoral head and nonunion of proximal femoral fractures.

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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; J Korean Fract Soc 2010;23(3):263-269. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.263

Abstract PDF

PURPOSE
We measured the BMD of elderly patients with osteoporotic hip fracture in order to understand the relationship between BMD of each sites and hip fracture occurrence or the types, and also to suggest a reference point for starting an osteoporosis treatment program.
MATERIALS AND METHODS
From July 2007 to February 2010, we investigated total 147 elderly osteoporotic hip fracture patients over 65 years. For control group, 80 patients who were over 65-year-old and did not have any fracture were selected. BMD was compared at each site between each groups statistically.
RESULTS
In the comparison of femur intertrochanter and neck fracture groups, BMD of femur neck and trochanter areas and L2, L3 areas were significantly less in intertrochanteric fracture group. In the analysis according to the classification of intertrochanteric fracture, BMD of intertrochanter and Ward's triangle area were significantly less in unstable fracture group than stable one. Each of the fracture threshold of intertrochanteric and neck fracture group was -1.10 and -1.36 of the T-score in proximal femur, and -1.40 and -1.40 of the T-score in lumbar vertebrae.
CONCLUSION
To examine the BMD of both proximal femur and lumbar vertebrae areas is helpful to predict the hip fracture occurrence and the type of hip fracture. And for the prevention of hip fracture in elderly patients over 65 years, we propose that the aggressive treatment of osteoporosis should be started to prevent fracture for patients with a T-score less than -1.40.

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Risk factors affecting hip fracture patterns in an elderly Korean patient population
Sug Hun Che, Myung-Rae Cho, Patrick Michael Quinn, Suk-Kyoon Song
Medicine.2023; 102(33): e34573. CrossRef
Does Fracture Severity of Intertrochanteric Fracture in Elderly Caused by Low-Energy Trauma Affected by Gluteus Muscle Volume?
Byung-Kook Kim, Suk Han Jung, Donghun Han
Hip & Pelvis.2022; 34(1): 18. CrossRef

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Correlation Analysis of BMD in Proximal Femur and Spine: Jun Young Yang, Young Mo Kim; J Korean Soc Fract 2003;16(4):570-576. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.570

Abstract PDF

PURPOSE
To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine.
MATERIALS AND METHODS
It is based on 59 cases who visited the out-patient department. They were classified into two groups by age, group I (55~59 yr) and II (60~64 yr). Then we evaluated the average and the degree of correlation between the two groups and analyzed the correlation of the two sites according to the T & Z-score through the regression analysis.
RESULTS
In T-score, the correlation between L (independent variable, lumbar) and H (dependent variable, femur) indicated that L = 0.751 xH -0.195 for group I and L = 0.912 xH+0.31 for group II. In Z-score, the correlation was L = 0.647 xH -0.656 for group I and L = 0.897 xH -0.481 for group II.
CONCLUSION
It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

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A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography
Kwanmoon Jeong, Hoon Ko, Chang-Hoon Lee, Myeung Lee, Kwon-Ha Yoon, Jinseok Lee
Applied Sciences.2016; 6(4): 113. CrossRef
The Correlation Analysis and Correction factor of BMD in Forearm and Lumbar with DXA
Man-Seok Han
The Journal of Digital Policy and Management.2013; 11(12): 551. CrossRef
The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry
Man-Seok Han, Dong-Heon Cho
Journal of the Korea Society of Computer and Information.2012; 17(9): 165. CrossRef

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