Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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원위 쇄골 불유합의 수술적 치료

Operative Treatment of Distal Clavicle Fracture Nonunion

  • 강호정 (연세대학교 의과대학 정형외과학교실) ;
  • 윤항섭 (연세대학교 의과대학 정형외과학교실) ;
  • 한수봉 (연세대학교 의과대학 정형외과학교실) ;
  • 김성재 (연세대학교 의과대학 정형외과학교실)
  • Kang, Ho-Jung (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Yoon, Hang-Seob (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Hahn, Soo-Bong (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Kim, Sung-Jae (Department of Orthopedic Surgery, Yonsei University College of Medicine)
  • 발행 : 2007.12.15
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초록

목적: 원위 쇄골 골절은 근위부나 중간부 쇄골 골절과는 다른 생역학적 구조를 가져서 지연유합과 불유합이 많이 발생한다. 원위 쇄골 불유합 치료에 대한 연구보고는 거의 없는 상태이다. 저자들은 원위 쇄골 골절 불유합에 대한 관혈적 정복 및 골이식의 수술적 치료 후 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다. 대상 및 방법: 2003년 8월부터 2006년 5월까지 원위 쇄골 불유합으로 수술 치료받은 8예를 대상으로 하였으며, 평균 연령은 38.9($21{\sim}62$세)세였고, 지배 수지 6예였다. 수상 초기 수술적 치료 후 발생한 불유합이 4예, 보존적 치료 후 발생한 불유합이 4예였고, 불유합 기간은 수상 후 평균 1년 5개월이었다. 전 예에서 자가장골 이식술 및 내고정술을 시행하였고, 내고정물은 금속판이 7예, 긴장대 강선 고정술이 1예였다. 결과: 평균 추시 기간은 14개월이었고, 방사선학적 골유합은 전 예에서 평균 8주에 관찰할 수 있었다. 최종 추시상 견관절의 운동범위는 모두 정상 소견이었고, Kona 등의 평가표에 의한 기능적 평가에서 7예에서 우수한 결과를, 1예에서 양호한 결과를 얻었다. 결론: 원위 쇄골 골절 불유합에 대한 수술적 치료는 조기 재활이 가능하고 견고한 골유합을 얻을 수 있어 추천할 만한 치료 방법으로 사료된다.

Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

키워드

참고문헌

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피인용 문헌

  1. Infected Nonunion of Clavicle Shaft after Operation: A Case Report vol.28, pp.1, 2015, https://doi.org/10.12671/jkfs.2015.28.1.77