The Relationship between Body Mass Index and Diabetic Foot Ulcer, Sensory, Blood Circulation of Foot on Type II Diabetes Mellitus Patients / 대한정형외과학회잡지

PURPOSE: Excessive weight bearing from obesity may induce pains in the lower extremity and resulting functional abnormality. Here we aimed to identify the relationship, it is intended to identity relationship obesity has with diabetic foot ulcer, sensory function, and blood circulation in diabetic patients. MATERIALS AND METHODS: We included patients who hospitalized or visited the department of orthopedic surgery for the treatment of diabetic foot ulcer, between January 2010 and December 2015. Among them, those aged over 30 years, diagnosed with diabetes with a progression of more than one year, and an HbA1c level of less than 7.5% were included for final analysis. For obesity, body mass index (BMI) was used, those with a BMI of over 18.5 kg/m2 were included. Using the Asian cut point of World Health Organization, patients were classified into normal, overweight, or obese. For foot ulcers, patients were classified using the Wagner ulcer classification. For sensory function, it was measured by scoring it with Semmes-Weinstein monofilament of International Working Group on the Diabetic Foot (IWGDF). Moreover for blood circulation, ankle-brachial index (ABI) was measured. RESULTS: For the sensory function, it was found that the overweight group obtained the highest score and the obesity group obtained the lowest score. For ABI, the overweight group scored the highest and the normal group scored the lowest. Moreover diabetic foot ulcer was the highest in the obesity group and the lowest in the normal group. From these results, it was considered that BMI had no relationship with sensory or blood circulation of the feet. However, the relationship between the diabetic foot ulcer and BMI showed statistical significance; according to the result of regression analysis, BMI of diabetic patients had a positive correlation with diabetic foot ulcer. CONCLUSION: This study showed that the sensory function and blood circulation of the feet had no relationship with diabetic foot ulcer; however, BMI appears to have a positive correlation with diabetic foot ulcer. Moreover, it seems to be a good index for determining the risk of diabetic foot ulcer.

Comparative Analysis of Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Intramedullary Nailing in Distal Tibial Metaphyseal Fractures

PURPOSE: To compare results between minimally invasive plate osteosynthesis using a periarticular plate and intramedullary nailing in distal tibial metaphyseal fractures in two treatment groups. MATERIALS AND METHODS: Sixty-one cases of distal tibial metaphyseal fractures from December 2008 to December 2009 were evaluated. The minimal follow-up period was 12 months. Thirty patients treated by minimally invasive plate osteosynthesis using a periarticular plate were Group A; 31 patients treated by intramedullary nailing were Group B. We compared and analyzed the results of each group by radiological and clinical assessments. RESULTS: The mean bony union time was 16.4 weeks in Group A and 17.2 weeks in Group B. The mean operation time was 45 minutes in Group A and 48 minutes in Group B. The mean radiation exposure times were 4.2 minutes and 4.8 minutes, respectively. VAS scores were 0.7 points and 0.5 points in each respective group. In Group A, the VAS score was 1.7 points when we applied pressure on the skin around the plate. The mean Olerud and Molander Ankle Score was 87.4 points and 86.3 points, respectively. A superficial wound infection occurred in 1 case in each group, and angular deformities more than 5 degrees occurred in 2 Group B cases. CONCLUSION: No significant differences in results were observed between the two groups. However, a higher incidence of angular deformity was seen in the intramedullary nailing group. Therefore, we must be careful during surgery.

Effect of Intravenous Administration of Bisphosphonate for Patients Operatively Treated for Osteoporotic Hip Fracture / 대한고관절학회지

PURPOSE: We evaluated changes in bone mineral density and biochemical bone turn over markers resulting from intravenous administration of zoledronic acid for the purpose of increasing bone mineral density and decreasing bone turnover rate in patients who had received operative treatment after hip fracture. MATERIALS AND METHODS: We carried out a retrospective study of 34 patients who had received injections of zoledronic acid after surgical treatment for hip fracture from January 2009 to June 2010, with a follow up period of more than one year. We evaluated pre and post T-scores of DXA in spine, proximal femur and femoral neck along with biochemical bone metabolic markers, and we then analyzed each factor. RESULTS: T score was enhanced in all cases with pre T-score -4.2 and post T-score -3.3 revealing statistical significance (P<0.05). In addition, two biochemical bone turnover markers were observed to decrease in most patients. Three days after drug administration, 7 patients(20.6%) had minor adverse effects. There were no serious complications such as atrial fibrillation. CONCLUSION: No major adverse effects were observed, only minor ones in patients who had been injected with zoledronic acid for the prevention of osteoporotic fracture after surgical treatment for hip fracture. We confirmed the affirmative effects on changes in bone mineral density and biochemical bone turn over markers associated with the use of this drug.

The Relationship between Stud Morphology and 5th Metatarsal Proximal Stress Fractures on Soccer Players / 대한스포츠의학회지

This research sets out to define the relationship between stud morphology of soccer shoes and 5th metatarsal proximal stress fractures on soccer players by comparison and analysis. After the pre-survey of 132 soccer players in Gwangju, 107 players who seem to have a 5th metatarsal fracture were selected. We investigated the shape of the studs and asked whether they had ever had a 5th metatarsal proximal stress fracture. We also asked them some questions on factors, which cause stress fracture, such as what position they play, how long they have been playing soccer as athletes and average playing time. And we analyzed correlation between these several factors and whether they had ever had stress fracture using chi-square (x2) test and Logistic regression analysis. We concluded that soccer players who wore bar type studs shoes had a much greater possibility of stress fracture than soccer players who wore the round type. Also we learned that soccer players who play mid-fielder have a much greater possibility of stress fracture than soccer players who play other positions. And the result of logistic regression analysis of relevance between soccer shoes stud morphology and stress fracture shows a statistically significant odd ratio, 6.840. It has been suggested that the morphology of the soccer shoes stud has relevance to the occurrence of stress fracture. Therefore, according to the result of this study, soccer shoes with the round shape are more helpful in preventing 5th metatarsal proximal stress fracture than soccer shoes with the bar shape.