Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Operative Treatment of Capitellar Fractures Associated with/without Other Injury Around the Elbow

단순 혹은 주관절 주위 손상을 동반한 소두 골절의 수술적 치료

  • Kang, Ho-Jung (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Park, Kwang-Hwan (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Lee, Jung-Kil (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Choi, Yun-Rak (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Hahn, Soo-Bong (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Kim, Sung-Jae (Department of Orthopaedic Surgery, Yonsei University College of Medicine)
  • 강호정 (연세대학교 의과대학 정형외과학교실) ;
  • 박광환 (연세대학교 의과대학 정형외과학교실) ;
  • 이정길 (연세대학교 의과대학 정형외과학교실) ;
  • 최윤락 (연세대학교 의과대학 정형외과학교실) ;
  • 한수봉 (연세대학교 의과대학 정형외과학교실) ;
  • 김성재 (연세대학교 의과대학 정형외과학교실)
  • Published : 2009.12.15
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Abstract

Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

목적: 단순 소두 골절 및 주관절 주위 손상을 동반한 소두 골절의 수술적 치료에 대한 결과를 분석하고 예후 인자를 알아보고자 하였다. 대상 및 방법: 관혈적 정복 및 내고정술을 시행한 25명의 환자 (평균나이, 49세)를 대상으로 하였고, 소두 골절은 1형 골절이 19예, 3형 골절이 6예 있었다. 평균 추시 기간은 14.8개월이었고 최종 추시시 방사선학적 및 기능적 결과를 분석하여 소두 골절의 형태, 동반 골절 유무가 예후에 영향을 미치는가를 평가하였다. 결과: 25예 중 24예에서 평균 1년에 방사선학적 유합을 얻었으며, 기능적 결과는 Broberg와 Morrey의 점수에 의해 우수 18예, 양호 4예, 보통 2예, 불량 1예였다. 소두 골절은 1형의 빈도가 가장 높았고, 동반 주위 골절은 외과 골절이 가장 많았다. 1형 골절이 3형 골절인 경우보다, 주위골절이 있는 경우 비관절면 골절인 경우가 관절면 골절인 경우보다 임상적 결과가 좋았다. 나이, 동반골절의 종류, 소두 골절에 대한 내고정물의 종류, 수술적 접근법, 수술 후 고정 기간에 따른 임상적 결과의 차이는 없었다. 결론: 전체의 88%에서 만족할 만한 결과를 얻었다. 그리고 소두 골절의 형태와 추가적인 관절면 골절 동반 유무가 중요한 예후 인자로 조사되었다.

Keywords

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