Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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Treatment of Metaphyseal Pathologic Fractures of Long Bone Using Locking Compression Plate in Children

소아에서 잠김 금속판을 이용한 장관골 골간단부 병적 골절의 치료

Jung, Sung-Taek;Jeong, Kwang-Cheul;Kim, Hyun-Jong;Lee, Jin-Ho
정성택;정광철;김현종;이진호

  • Published : 20081000
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Abstract

Purpose: To evaluate the results of operative treatment for metaphyseal pathologic fracture of long bone in children using Locking Compression Plate (LCP). Materials and Methods: Six children were enrolled in this study. The locations of fracture were proximal femur in five children and distal femur in one child. Pathologic diagnosis was aneurysmal bone cyst, in three children and simple bone cyst, enchondroma, and nonossifying fibroma, in other three children. All six children were underwent curettage of bone lesion and bone grafting, then the fractures were internally fixed using LCP. Results: All fractures were united at six to ten weeks after operation. Healing of bone lesions except one case was observed. There were no mechanical complications, no loss of reduction and malunion. Also, we couldn't find any complication associated with physeal injury, such as leg length discrepancy of lower extremities. Conclusion: Internal fixation of metaphyseal pathologic fracture of long bone using LCP in children is technically easy and offers secure fixation despite anatomic and biologic characteristics of this type of fracture due to biologic and biomechanical advantages of LCP.

목 적: 소아에서 발생한 장관골 골간단부 병적 골절에 대한 잠김 금속판을 이용한수술적 치료의 결과를 평가하고자 하였다. 대상 및 방법: 6명의 환아를 대상으로 하였으며, 5예에서는 대퇴골 근위부에 1예에서는 대퇴골 원위부에 골절이 발생하였다. 기저 병변에 대한 조직학적 진단은 동맥류성 골 낭종이 3예, 단순 골 낭종, 내연골종, 비골화성 섬유종이 각각 1예였다. 기저 병변은 소파술 및 골 이식술을 시행하였으며, 골저른 잠김 금속판을 이용한 내고정 시행하였다. 결 과: 골 유합은 술 후 6-10주에 전 예에서 관찰 되었으며, 기저 병변은 전체 6예 중 5예에서는 병변의 치유 관찰 하였다. 전 예에서 금속판의 파단, 나사못의 이탈 등의 기계적 합병증은 관찰 되지 않았으며, 정복의 소실에 따른 부정 유합도 관찰할 수 없다. 또한 성장판 손상에 따른 하지 부동, 하지 정렬의 변화 등을 보인 예도 없었다. 결 론: 소아에서 양성 골 종양에 의한 하지의 골간단부의 병적 골절은 그 해부학적, 생물학적 특성에도 불구하고 압박 금속판의 생역학적 특징과 생물학적 장점을 적절히 이용함으로써 비교적 기술적으로도 쉬우면서 견고한 고정을 얻을 수 있을 것으로 생각된다.

Keywords

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