A decreased bone mineral density, such as osteoporosis, has been considered a factor closely associated with proximal femur fractures. We studied the relationship between osteoporosis and proximal femur fractures. Dual energy radiograph absorptiometry was used to measure the bone mineral density of 121 patients with a femur neck fracture and 134 patients with an intertrochanteric fracture. The bone density of the femoral neck, Ward's triangle, and the trochanteric region were measured. Two hundred seventeen normal patients who had undergone a bone mineral density test and were found to have no proximal femur fracture were used as the control group. Comparative analysis was performed after the patients were subdivided into different groups depending on sex and fracture type. The bone mineral density of the lumbar vertebra in patients with a proximal femur fracture was not significantly different from that of the control group, but the bone mineral density of the proximal femur in patients with a proximal femur fracture was significantly less than that of the control group. The bone mineral density of the group with an intertrochanteric fracture was lower than that of the femur neck fracture group. However, the difference was statistically insignificant. In bone mineral density comparisons, no significant differences were observed between the displaced and undisplaced femur neck fracture group and between the stable and the unstable intertrochanteric fracture group. The bone mineral density of elderly patients with a proximal femur fracture was significantly less than that of normal individuals. However, femur neck fractures in elderly men were less likely to be associated with a decreased bone mineral density. Little correlation between bone mineral densities of the proximal femur and fracture location (neck vs intertrochanter) and type (nondisplaced vs displaced neck, stable vs unstable intertrochanter) was found.
Purpose: To present our operative experiences with carpometacarpal (CMC) injuries, excluding thumb. Materials and Methods: Thirty four fracture and dislocations of CMC joint excluding thumb were reviewed retrospectively. Emphases were placed on injury mechanisms, anatomical location, times between diagnosis and surgery, treatment and complications. Results: The average age of patients was 31.5 years. 19 cases of axial loading by blow as an injury mechanism. The 5th CMC joint was found to be the most frequently involved single joint (18 cases of 34 cases). Dorsal dislocation of CMC joints was present in 12 cases. Comminution of the carpal or metacarpal bone was present in 18 cases. The average time to surgery was 6 days. Twenty-seven cases were operated upon by closed reduction and percutaneous pinning. Seven cases were treated by open reduction and internal fixation. In the last follow up period, a clinically full hand function was restored in 31 cases. Intermittent pain was present in 6 cases in which there was grip weakness in 4 cases and limitation of motion in 3 cases. However, all cases were able to activities of daily living. Conclusion: We obtained good outcomes in CMC joint injuries through the accurate diagnosis and proper operative treatment.
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