Journal of the Korean Fracture Society (대한골절학회지)

The Korean Fracture Society (대한골절학회)
권호 표지

Intramedullary Nailing for the Fracture of Proximal Humerus

상완골 근위부 골절의 골수정 삽입술을 이용한 수술적 치료

Kang, Ho-Jung;Lee, Dae-Young;Sung, Seung-Yong;Hahn, Soo-Bong
강호정;이대영;성승용;한수봉

  • Published : 20040900
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Abstract

Purpose: To evaluate the clinical and radiological result of the treatment for the fracture of proximal humerus using intramedullary nail. Materials and Methods: Nine cases with fractures around the shoulder joint treated with Polarus IM nail from February 1999 to June 2002 was selected. There were 1 case with segmental fracture, 2 cases with nonunion after conservative treatment, 3 cases with nonunion after IM nail, 1 case with nonunion after pinning, 1 case with metal failure after plate fixation, and 1 case with fracture combined with shoulder dislocation. Bone union was evaluated with simple radiographic findings, and functional evaluation was done using Kona evaluation method. Results: The average follow up period after the operation was 16 months and the average duration of immobilization was 2 weeks. All cases showed radiographic union and the average duration until union was 3.1 months. On the functional evaluation using Kona evaluation method, 3 cases excellent, 3 cases good, 2 cases fair, and 1 case showed poor result. The cases with poor result had combined elbow, forearm, and hand fractures at the initial injury. The complication of periprosthetic fracture caused by repeated trauma was reported in 1 case. Conclusion: Polarus IM nailing can result in good clinical and functional results for the treatment of nonunion, plate failure, segmental fracture and fracture of proximal humerus with shoulder dislocation.

목 적: 상완골 경부를 포한한 근위부 골절의 치료로 골수정을 이용한 치료 방법의 임상적, 방사선학적 치료 결과를 알아보고자 하였다. 대상 및 방법: 1999년 2월부터 2002년 6월까지 상완골 경부를 포함한 근위부의 골절에 폴라루스 골수정 삽입술을 시행 받은 9예를 대상으로 하였다. 수술은 분절성 골절 1예, 보존적 치료 후 불유합 2예, 골수강내 금속정 사용 후 불유합 3예, 핀 고정술 후 불유합 1예, 금속판 고정실패 1예, 그리고 골절과 견관절 탈구가 동반된 경우 1예를 대상으로 시행하였다. 골유합은 방사선적 소견으로 판정하였으며 기능적 평가는 Kona 평가표를 이용하였다. 결 과: 술후 평균 추시 기간은 16개월이었으며, 평균 고정 기간은 2주였다. 전 예에서 방사선학적 골유합 소견을 보였으며, 골유합 시기는 평균 3.1개월 이었다. Kona 등의 평가표에 의한 기능 평가에서 3예에서 우수, 3예에서 양호, 2예에서 보통의 결과를 보였고 1예에서 불량 결과를 보였다. 불량 평가를 보였던 경우는 초기 손상 시 동반 손상으로 주관절, 전완부 및 수부 골절이 있었던 경우였다. 합병증은 넘어지면서 재손 상으로 인한 골수정 주위 골절이 1예 있었다. 결 론: 상완골 경부 골절에 폴라루스 골수정으로 불유합, 금속판 고정술의 실패, 분절 골절 그리고 견관절 탈구와 동반된 근위 상완골 골절을 치료함으로 골유합 및 임상적 기능 면에서 좋은 결과를 얻을 수 있다.

Keywords

References

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