Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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잠김 압박 금속판을 이용한 근위 상완골 골절의 내고정술

Internal Fixation of Proximal Humerus Fracture with Locking Compression Plate

  • 박철현 (영남대학교 의과대학 정형외과학교실) ;
  • 박성혁 (영남대학교 의과대학 정형외과학교실) ;
  • 서재성 (영남대학교 의과대학 정형외과학교실)
  • Park, Chul-Hyun (Department of Orthopaedic Surgery, Yeungnam University, College of Medicine) ;
  • Park, Sung-Hyuk (Department of Orthopaedic Surgery, Yeungnam University, College of Medicine) ;
  • Seo, Jae-Sung (Department of Orthopaedic Surgery, Yeungnam University, College of Medicine)
  • 발행 : 2009.06.15
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초록

목적: 상완골 근위부 골절에서 잠김 압박 금속판을 이용하여 치료한 후 그 임상적 및 방사선학적 결과를 알아 보고자 하였다. 대상 및 방법: 2005년 2월부터 2007년 9월까지 상완골 근위부 골절로 잠김 압박 금속판을 이용하여 치료받은 20명의 환자를 대상으로 하였다. 평균 연령은 60.6세였고, 평균 추시 기간은 22.3개월이었다. 임상적 결과는 Constant score 및 DASH score를 이용하여 평가하였고, 방사선학적 평가는 경간각을 이용한 Pavolainen의 방법과 상완 골두의 높이를 측정하여 평가하였다. 결과: 최종 추시 시 Constant score는 평균 75.3점이었고, 15예에서 양호 이상의 점수를 보였고, DASH score 평균 16.4점이었다. 경간각은 평균 $137.1^{\circ}$였으며 19예에서 양호 이상의 결과를 보였다. 전 예에서 골유합을 얻을 수 있었으며, 지연성 유합 및 부정 유합이 각 1예에서 관찰되었고 1예에서 나사못에 의한 자극을 보였다. 결론: 불안정성 상완골 근위부 골절에서 잠김 금속판을 이용한 내고정술은 임상적 및 방사선학적으로 양호한 결과를 보여 주었고, 적은 합병증을 나타내었으며 만족스런 정복과 안정적인 초기 고정력을 얻을 수 있어 조기에 관절 운동이 가능하였다. 잠김 압박 금속판을 이용한 내고정술은 불안정성 상완골 근위부 골절의 치료에 좋은 방법이라고 생각된다.

Purpose: We assessed the radiographic and clinical results of one surgeon's experience treating proximal humerus fractures with a locked proximal humeral plate. Materials and Methods: Twenty patients with unstable proximal humerus fractures were treated with a locking compression plate between February 2005 and September 2007. The average age of the patients was 60.6 years, and the average postoperative follow-up period was 22.3 months. The clinical results were evaluated using the Constant and DASH scores. The radiologic results were evaluated by the Paavolainen method, which measures the neck shaft angle and humeral head height. Results: At the last follow-up examination, the mean Constant score was 75.3 and 15 cases (75%) had excellent or good results; the mean DASH score was 16.4. The mean neck shaft angle was $137.1^{\circ}$, and 19 cases (95%) had good results by the Paavolainen method. There was one delayed union, malunion, and screw loosening. Conclusion: The patients treated with a locking compression plate had relatively good clinical and radiologic results, and a low complication rate. Moreover, the patients could exercise earlier due to good reduction and initial stability. Treatment of unstable proximal humerus fractures with a locking compression plate is a reliable method.

키워드

참고문헌

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피인용 문헌

  1. A Separate Approach and Cephalo-Diaphyseal Plate Fixation for the Comminuted Metadiaphyseal Fractures of the Proximal Humerus vol.26, pp.1, 2013, https://doi.org/10.12671/jkfs.2013.26.1.8
  2. Operative Treatment of Displaced Proximal Humerus Fractures with the Angular Stable Locking Compression Plate vol.14, pp.1, 2011, https://doi.org/10.5397/CiSE.2011.14.1.027
  3. Treatment of Open Proximal Humerus Fracture by Gunshot vol.15, pp.1, 2012, https://doi.org/10.5397/CiSE.2012.15.1.37
  4. The Analysis of the Treatment Outcomes of Proximal Humeral Fractures with Locking Plates vol.17, pp.1, 2014, https://doi.org/10.5397/cise.2014.17.1.10
  5. Minimal Invasive Plate Osteosynthesis in Proximal Humerus Fractures vol.13, pp.2, 2010, https://doi.org/10.5397/CiSE.2010.13.2.202