Regional Bone Loss as a Risk Factor for Distal Radius Fracture in Women under 60 Years Old / 대한골다공증학회지

OBJECTIVES: Some studies have suggested that lumbar spine and hip bone mineral density (BMD) are not associated with distal radius fractures (DRF), and a few studies have investigated regional BMDs at the fracture site, not just the lumbar or hip. We correlated distal radius BMD with DRF in postmenopausal women or =50 years old with DRF were enrolled in the fracture group, and 72 women without fractures were included as a control group. We measured distal radius BMD in the distal radius contralateral to the fractured bone in the fracture group and that of the lumbar body 5 days after the trauma. BMDs at the distal radius of each group were compared in three age groups (50~59, 60~69, and > or =70 years). Age- and site-specific BMDs were analyzed in each group. RESULTS: No significant differences in the rate of osteoporosis at the distal radius or lumbar spine were observed in patients > or =60 years old. However, BMD and T-score values of the distal radius in female patients were lower than those in controls <60 years old. BMD and T-score values of the distal radius were lower than those of the lumbar spine in the fracture group <60 years old. BMD of the distal radius also carried a higher relative risk. CONCLUSIONS: Low BMD of the distal radius was an indicator of regional BMD and could be a sensitive risk factor for DRF in women <60 years.

Preserving Remnant Tissue in Arthroscopic ACL Reconstruction Using Achilles Tendon Allograft

PURPOSE: The purpose of this study was to determine the clinical usefulness of remnant preservation in anterior cruciate ligament (ACL) reconstruction using Achilles tendon graft. MATERIALS AND METHODS: Between April 2004 and June 2007, 26 patients who were followed up for at least 12 months after ACL reconstruction with Achilles tendon were included in this study. They were divided into two groups according to whether the remnant was preserved. The post-reconstruction state was evaluated using pivot-shift test, Telos anterior stress test, International Knee Documentation Committee (IKDC) scale, Lysolm score and single limb standing test. RESULTS: No statistically significant differences in mechanical stability and mean values of IKDC scale and Lysholm test between the two groups were present. In single limb standing test, the remnant-preserving group showed 1.1+/-0.8 cm and the remnant sacrificing group showed 1.8+/-1.2 cm (p=0.04). However, there were no significant differences between the injured knee and the intact knee in the group which the remnant was preserved. CONCLUSION: ACL reconstruction using allo Achilles graft showed satisfactory results in terms of stability and function. Preserving the tibial remnant seems to be helpful to restore knee joint proprioception.

The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients / 대한정형외과학회잡지

PURPOSE: The incidence of hip fracture associated with disability, pain and death increases in old age. The decreased bone mineral density, particularly due to osteoporosis, has been described as one of factors associated with the proximal femur fracture. Therefore, this study, measured the bone mineral density (BMD) of elderly patients with hip fractures to better understand the relationship between osteoporosis and proximal femur fractures. MATERIALS AND METHODS: The bone densities of the femoral neck and trochanteric region were measured by dual energy x-ray absorptiometry (DEXA) in 60 patients with femur neck fractures and 82 patients with intertrochanteric fractures. Individuals (158 subjects) who had their BMD checked in a Health promotion center without a proximal femoral fracture were selected as a control group. The patients were divided into subgroups according to gender and type of fracture. RESULTS: The BMD of the hip in the patients with proximal femur fractures was significantly lower than that of the control subjects. The intertrochanteric fracture group had a lower T-score than the femur neck fracture group. However the differences were not significant. No significant differences were found between the displaced and undisplaced femur neck fracture groups and between the stable and unstable intertrochanteric fracture groups. CONCLUSION: The BMD in elderly patients with proximal femur fracture was significantly lower than that of the control group. There was a poorer association between a decreased BMD and femur neck fractures in elderly males. There were no association between the BMD and location of the fracture or fracture type.

Analysis of the Mechanical Axis of the Lower Limb in Patients with Isolated Meniscal Tear

PURPOSE: We wanted to evaluate the relationship between meniscal tear and the alignment of the lower limb. MATERIALS AND METHODS: Between Oct 2006 and Jun 2008, 125 patients aged 55 year or less with isolated meniscal tear and who were examined arthroscopically were included in this study. The patients had no severe lesion (ulceration or defect) of cartilage or ligamentous injuries. 21 individuals who had no abnormal findings on MRI were selected as the control group. The patients were divided into the complete discoid lateral meniscus, incomplete discoid lateral meniscus, lateral semilunar meniscus and medial semilunar meniscus groups and they were subdivided according to gender and whether there was an obvious history of trauma. The varus percentage was defined as a percentage of the width from where the mechanical axis passes the level of the tibial articular surface to the middle of the tibial articular surface on the orthoroentgenogram of the lower leg. Each individual's varus percentage was expressed as the mean of the measurements taken by three observers. The comparisons were done using the Wilcox Signed Ranks Test and the Mann-Whitney Test. RESULTS: There was no significant difference between the involved knee and the contralateral normal knee in terms of the varus percentage in all the groups (p>0.05). There were no significant differences in each group according to the history of trauma, a complete discoid lateral meniscus, an incomplete discoid lateral meniscus, a lateral semilunar meniscus and a medial semilunar meniscus. However, there was a significantly greater varus percentage for the medial semilunar meniscus group without a history of trauma. CONCLUSION: There was a statistical relationship between tears on the medial semilunar meniscus without a history of trauma and genu varum. Tears on a complete discoid lateral meniscus, incomplete discoid lateral meniscus and lateral semilunar meniscus had a little relationship with the mechanical axis of the lower leg.