Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

Results of Treating Senile Osteoporotic Peritrochanteric Fracture with Proximal Femoral Nail Antirotation (PFNA)

골다공증을 동반한 고령의 대퇴 전자 주위 골절에서 항회전 근위 대퇴 골수정(PFNA)의 치료 결과

  • Lee, Kyung-Jae (Department of Orthopedic Surgery, College of Medicine, Keimyung University) ;
  • Min, Byung-Woo (Department of Orthopedic Surgery, College of Medicine, Keimyung University) ;
  • Kim, Sin-Gi (Department of Orthopedic Surgery, College of Medicine, Keimyung University) ;
  • Song, Kwang-Soon (Department of Orthopedic Surgery, College of Medicine, Keimyung University) ;
  • Bae, Ki-Cheor (Department of Orthopedic Surgery, College of Medicine, Keimyung University) ;
  • Cho, Chul-Hyun (Department of Orthopedic Surgery, College of Medicine, Keimyung University)
  • 이경재 (계명대학교 의과대학 정형외과학교실) ;
  • 민병우 (계명대학교 의과대학 정형외과학교실) ;
  • 김신기 (계명대학교 의과대학 정형외과학교실) ;
  • 송광순 (계명대학교 의과대학 정형외과학교실) ;
  • 배기철 (계명대학교 의과대학 정형외과학교실) ;
  • 조철현 (계명대학교 의과대학 정형외과학교실)
  • Published : 2009.06.30

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Abstract

Purpose: The purpose of this study was to evaluate the results of treating senile osteoporotic peritrochanteric fracture with proximal femoral nail antirotation (PFNA). Materials and Methods: Between November 2006 and December 2007, 21 patients older than 65 years of age with intertrochanteric and subtrochanteric fractures were treated with PFNA. The mean duration of follow-up was 12.9 months and the mean age was 74.5 years. Results: The mean operation time was 48.8 minutes (range: 25-90 minutes). The time to ambulation averaged 7.9 days. Eighty point nine percent (17 cases) of the patients returned to their previous walking status at 6 months after operation. The average T-score was -3.3. Eighteen cases (85.7%) achieved acceptable reduction and the mean time to radiologic bony union was 17.4 weeks. The average amount of PFNA blade sliding was 4 mm and the neck-shaft angle was changed to 1.3 degrees varus displacement at the final follow-up. The complications included pulmonary edema in 1 case and protrusion of the PFNA blade into the hip joint in 1 case. Conclusion: Because of the reduced operation time, favorable walking ability and low rate of complications, PFNA is an acceptable alternative for fixation of senile osteoporotic peritrochanteric fracture.

목적: 골다공증을 동반한 고령의 대퇴 전자 주위 골절 환자의 치료에 있어서 항회전 근위 대퇴 골수정(Proximal Femoral Nail Antirotation, PFNA)의 치료 결과를 알아보고자 하였다. 대상 및 방법: 2006년 11월부터 2007년 12월까지 PFNA를 이용하여 치료한 65세 이상의 대퇴전자 주위 골절 환자 중 6개월 이상 추시 관찰이 가능하였던 21예를 대상으로 하였다. 추시 기간은 평균 12.9개월이었으며 연령은 평균 74.5세였다. 결과: 수술 시간은 평균 48.8분이었으며 술후 평균 79일에 보행기를 이용한 보행이 가능하였고 80.9%에서 수상 전 보행 상태를 회복할 수 있었다. 평균 T-score는 -33 이었다. 18예에서 만족할 만한 골절 정복을 얻을 수 있었으며 평균 17.4주에 골유합을 얻을 수 있었다. Blade의 평균활강은 4 mm였으며 대퇴 경간각은 평균 1.3도 내반 전위를 보였다. 1예에서 폐부종이 발생하였으며 1예에서 불유합 및 PFNA blade의 골두 천공이 발생하였다. 결론: 골다공증을 동반한 대퇴 전자 주위 골절에 있어서 항회전 근위 대퇴골수정을 이용한 수술법은 수술 시간이 짧고 술후 환자의 보행 능력이 양호하였으며 합병증도 적어 유용한 치료 방법의 하나라고 사료된다.

Keywords

References

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