Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
권호 표지
DOI QR코드

DOI QR Code

상완골 경부 이분 골절에서 T형 금속판을 이용한 치료

Treatment of Two-Part Fracture of Humerus Neck Using T Plate Fixation

  • 남일현 (포항성모병원 정형외과) ;
  • 안길영 (포항성모병원 정형외과) ;
  • 윤호현 (포항성모병원 정형외과) ;
  • 김재철 (포항성모병원 정형외과) ;
  • 문기혁 (포항성모병원 정형외과)
  • Nam, Il-Hyun (Department of Orthopaedic Surgery, Pohang St. Mary's Hospital) ;
  • Ahn, Gil-Yeong (Department of Orthopaedic Surgery, Pohang St. Mary's Hospital) ;
  • Yun, Ho-Hyun (Department of Orthopaedic Surgery, Pohang St. Mary's Hospital) ;
  • Kim, Jae-Cheol (Department of Orthopaedic Surgery, Pohang St. Mary's Hospital) ;
  • Moon, Gi-Hyuk (Department of Orthopaedic Surgery, Pohang St. Mary's Hospital)
  • 발행 : 2006.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study is to analyze the result and complications of internal fixation with T-plate for two-part fracture of the neck of the humerus. Materials and Methods: The clinical results of fourteen patients who had been performed with this method mentioned above were reviewed. Their average age was 49.6. Postoperative mean follow up period was 24.1 months. Radiological evaluation was done by Kronberg's and shoulder function by Neer's. Results: By Kronberg evaluation, nine cases were good, two cases acceptable and three cases poor. By Neer's, mean score of shoulder function was 77.6 and 4 cases were excellent, one satisfactory, five unsatisfactory and four failure. The complications were the sfiff shoulder, loss of reduction and avascular necrosis of humeral head. Conclusion: In this study, there were differences according to the age. And we obtained an unsatisfactory result in patients over 50 years old. We consider that in patients over 50 years old, the differences were due to the muscle weakness through wide surgical approaches, postoperative implant loosening or the stiffness caused by poor rehabilitation.

키워드

참고문헌

  1. 김영규, 장영훈, 김건범: 상완골 근위부 불안정성 골절의 수술적 치료. 대한견주관절학회지, 1: 198-204, 1998.
  2. 박진영, 안진우, 이성철: 상완골 근위부 골절에 시행한 긴장 대 봉합을 동반한 관혈적 골수강내 고정술. 대한견주관절학회지, 6:149-160, 2003. https://doi.org/10.5397/CiSE.2003.6.2.149
  3. Baron JA, Karagas M and Barrett J: Basic epidemiology of fractures of the upper and lower limb among Americans over 65years of age. Epidemiology, 7:612-618, 1996. https://doi.org/10.1097/00001648-199611000-00008
  4. Bengner U, Johnell O and Redlund-Johnell I: Changes in the incidence of fracture of the upper end of the humerus during a 30-year period. Clin Orthop, 231:179-182, 1988.
  5. Caldwell JA and Smith J: Treatment of unimpacted fractures of the surgical neck of the humerus. Am J Surg, 31:141-144, 1936. https://doi.org/10.1016/S0002-9610(36)90454-3
  6. Clifford PC: Fractures of neck of the humerus; A review of the late reslut. Injury, 12:91-95, 1980. https://doi.org/10.1016/0020-1383(80)90129-1
  7. Cofield RH: Comminuted fracture of the proximal humerus. Clin orthop, 230:49-57, 1988.
  8. Cuomo F, Flaton EL, Maday HG, et al: Open reduction and internal fixation of two-and threepart displaced surgical neck fractures of the proximal humerus. J Shoulder Elbow Surg, 1: 287-295, 1992. https://doi.org/10.1016/S1058-2746(09)80055-4
  9. De Palma AF: Surgery of the shoulder. 3rd ed, Philadelphia, JB Lippincott Co: 372-406, 1983.
  10. Hawkins RJ and Angelo RL: Displaced proximal humeral fractures. Selecting treatment, avoiding pitfalls. Orthop Clin N Am, 18:421-431, 1987.
  11. Hawkins RJ, Bell RH and Gurr K: The three part fracture of the proximal humerus: operative treatment. J Bone Joint Surg, 68-A:1410-1414, 1986.
  12. Hawkins RJ and Kiefer GN: Internal fixation techniques for proximal humeral 3 fractures. Clin Orthop, 223:77-85, 1987.
  13. Kristiansen B and Christensen SW: Plate fixation of proximal humeral fractures. Acta Orthop Scand, 57:320-323, 1986. https://doi.org/10.3109/17453678608994401
  14. Kristiansen B and Kofoed H: Transcutaneous reduction and external fixation of displaced fractures of the proximal humerus. A controlled clinical trial. J Bone Joint Surg, 70-B:821-824, 1988.
  15. Louis UB: Fractures of the proximal humerus. In: Rockwood. C.A. Jr and Masten, F.A. III ed. The Shoulder. 1st Ed. Philadelphia, W.B. Saunders Co, 287-334, 1990.
  16. Neer CS: Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg, 52-A:1077-1089, 1970.
  17. Neer CS: Displaced proximal humeral fractures. II. Treatment of three part and four part displacement. J Bone Joint Surg, 52-A:1090-1103, 1970.
  18. Philips BB: Arthroscopy of upper extremity. In Campbell's operative Orthropaedics, 2613-2665. Ed by Cannale, ST. Philadelphia, Mosby, 2613-2665, 2003.
  19. Robert HC: Comminuted fractures of the proxi-mal humerus. Clin Orthop, 210:49-57, 1986.
  20. Robinson CM and Christie J: The two-part proximal humeral fracture: a review of operative treatment using two technique. Injury, 24:123-125, 1993. https://doi.org/10.1016/0020-1383(93)90204-J
  21. Young TB and Wallace WA: Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus. J Bone Joint Surg, 67-B:373-377, 1985.
  22. Zyto K, Kronberg M and Brostrom LA: Shoulder function after displaced fracture of the proximal humerus. J Shoulder Elbow Surg, 4: 331-336, 1995. https://doi.org/10.1016/S1058-2746(95)80016-6