ABSTRACT
This study aimed to investigate the relationship between sarcopenia and change in bone mineral density (BMD) and functional outcome in hip arthroplasty patients. Methods: Among the 221 patients who had undergone hip arthroplasty, 147 patients were enrolled. All patients were divided into 2 groups according to presence of sarcopenia. Bone mineral density (BMD) at hospitalization and 1-year after surgery and Barthel index was measured at the time of before injury, hospitalization, 3 months and 1-year after surgery. Results: BMD at hospitalization showed .627 ± .082 (g/cm2) in Sarcopenia and .726 ± .059 (g/cm2) in Non-sarcopenia at femur (total) site (P < .001), .531 ± .085 (g/cm2) vs .629 ± .057 (g/cm2) at femur neck site (P=.002), .715 ± .084 (g/cm2) vs .807 ± .058 (g/cm2) at lumbar (L1-L4) site (P < .001). BMD at 1-year follow-up period, Sarcopenia showed .626 ± .082 (g/cm2) and Non-sarcopenia showed .725 ± .060 (g/cm2) at femur (total) site (P < .001), .530 ± .085 (g/cm2) vs .629 ± .058 (g/cm2) at femur neck site (P < .001), .715 ± .084 (g/cm2) vs .806 ± .058 (g/cm2) at lumbar (L1-L4) site (P < .001). Change of BMD showed -.01 ± .25% for Sarcopenia and -.15 ± .47% for Non-sarcopenia in femur (total) site (P=.089), -.08 ± .63% vs -.01 ± 1.01% in femur neck site (P = .058), .00 ± .09% vs -.12 ± .33% for each group in lumbar (L1-L4) site (P = .052). Barthel index score showed 79.94 ± 5.66 for Sarcopenia and 84.74 ± 5.36 for Non-sarcopenia at pre-injury status (P < .001), 33.89 ± 4.94 vs 33.87 ± 5.36 at the time of hospitalization (P = .977), 57.42 ± 7.19 vs 60.06 ± 5.39 at 3 months follow up (P = .015), 73.86 ± 5.94 vs 80.71 ± 4.81 for each group at 1-year follow up (P < .001). Conclusions: Our study found that the sarcopenia showed lower BMD than the non-sarcopenia, but there was no significant difference of BMD change in the follow-up period. In addition, the sarcopenia showed poor functional results at all points except at the time of hospitalization.
ABSTRACT
PURPOSE: To evaluate clinical-functional and radiologic outcomes of elderly patients with an unstable intertrochanteric femur fracture treated with a wedge wing in the lag screw. MATERIALS AND METHODS: Forty-eight patients treated with the Dyna Locking Trochanteric nail (DLT nail) to resolve an unstable intertrochanteric femur fracture were reviewed retrospectively. Based on AO/OTA classification, Fracture 31-A2 (34 cases) and 31-A3 (14 cases) were included in the analysis. We measured the femoral neck-shaft angle, tip-apex distance (TAD), Cleveland index, sliding distance of the lag screw, and time to the fracture union. The Harris Hip Score and Paker and Palmer's mobility score for clinical evaluation were used. RESULTS: The mean follow-up period was 21.4 months (range, 12-34 months). The postoperative state of reduction was good in 28 cases and acceptable in 20 cases. The mean TAD was 20.5 mm. The position of the lag screw was center-center in 30 cases and center-inferior in 18 cases. The mean sliding distance of the lag screw was 3.4 mm at the last follow-up. The mean union time was 4.5 months. Two cases had complications which included a cut-out (1 case) and non-union (1 case). The mean Harris Hip Score was 86.5±8.3 (range, 76-90). Walking ability in 34 of the cases (70.8%) at last follow-up was similar to that prior to fracture. CONCLUSION: Functional and radiological outcomes are satisfactory using the DLT nail in the treatment of elderly patients with unstable intertrochanteric fractures; however, wedge wing in the lag screw does not prevent implant-related complications.
ABSTRACT
This research aims to verify whether it is possible to explain the health-promoting behaviors based on sociodemographic characteristics by integrating the theory of planned behavior (TPB) proposed by Ajzen in 1988 and the transtheoretical model (TTM) proposed by Prochaska and DiClemente in 1983. In particular, the aim was to verify whether the variables of the TPB can properly distinguish the stages of change in exercise in the proposed integrated model and to figure out how attitude, subjective norm, perceived behavior control, influence, and intention-can explain the stages of change in exercise. Investigators who have taken previous training for the survey visited and interviewed 3658 people older than 30 years in the chosen town by multistage sampling method from July 27 to July 31, 2003. After the exclusion of inappropriate data out of 760 participants, only data from 584 participants were used for this research. chi2 test, t test, and 1-way analysis of variance were used to identify the difference between the distribution of the stages of change in exercise and the variables of the means. A discriminant analysis to verify the accuracy of the stages of change in exercise by means of the variables of the TPB and a path analysis to verify the fit of the integrated model were also used. The variables of the TPB were useful to satisfactorily distinguish and predict the stages of change in exercise. But to clarify the validity of this model, more diversified research should be conducted in the future, and the results must be accumulated.
