Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate

Wolter 금속판를 이용한 제 2형 원위부 쇄골 골절의 치료

  • Shin, Sung-Il (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Song, Kyung-Won (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Lee, Jin-Young (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Lee, Seung-Yong (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Kim, Gab-Rae (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Hyun, Yoon-Suk (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Lee, Kwang-Nam (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Lee, Eun-Soo (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University School of Medicine)
  • 신성일 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 송경원 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 이진영 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 이승용 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 김갑래 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 현윤석 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 이광남 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 이은수 (한림대학교 의과대학 강동성심병원 정형외과학교실)
  • Published : 2009.06.15
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Abstract

Purpose: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. Materials and Methods: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score Results: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. Conclusion: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result.

목적: 본 연구는 Wolter 금속판을 이용한 제 2형 원위부 쇄골 골절 치료의 임상적 결과를 평가하고자 하였다. 대상 및 방법: 2004년부터 2007년까지 Wolter 금속판으로 치료한 제 2형 원위부 쇄골 골절을 가진 16명의 환자를 대상으로 하였다. 평균 나이는 32.6세 이었고, 수술 후 평균 추시 기간은 22.9 개월이었다. 정복 및 골유합의 평가는 수술 직후 및 최종 방사선 소견을 이용하였고, 기능적 평가는 Kona의 기능적 평가 기준 및 Constant 점수를 사용하였다. 결과: Kona의 기능적 평가기준에 의해 우수 12예, 양호 3예, 보통 1예의 결과를 보였으며 Constant 점수는 평균 90점을 보였다. 16예 모두에서 골 유합을 확인하였으며, 합병증으로는 1예에서 금속판의 갈고리 부분이 돌출되어 피부에서 촉지 되었으며, 1예에서 견봉 골절이 발생하였으나 2예 모두 만족할 만한 골유합 소견을 보였으며, 그 외 견봉-쇄골 관절의 관절염, 감염증 등 다른 합병증은 관찰되지 않았다. 결론: 제 2형 원위부 쇄골 골절에서 Wolter 금속판을 이용한 고정법은 쉽게 만족스런 정복과 견고한 고정을 얻을 수 있고, 불유합의 발생이 적으며, 임상적 결과가 우수한 수술 방법이라고 생각된다.

Keywords

References

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