Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

Standard Type Cemented Hemiarthroplasty with Double Loop and Tension Band Wiring for Unstable Intertrochanteric Fractures in the Elderly

고령 환자의 전자부 불안정성 골절에 대한 이중 강선 및 인장 대 강선 고정과 표준형 시멘트 주대를 이용한 인공 고관절 반치환술

  • Cho, Hong-Man (Department of Orthopedic Surgery, Daejeon Veterans Hospital) ;
  • Lee, Seung-Ryul (Department of Orthopedic Surgery, Daejeon Veterans Hospital) ;
  • Park, Myung-Sik (Department of Orthopedic Surgery, Chonbuk National University School of Medicine) ;
  • Chung, Woo-Chull (Department of Orthopedic Surgery, Busan Veterans Hospital)
  • 조홍만 (대전 보훈병원 정형외과) ;
  • 이승렬 (대전 보훈병원 정형외과) ;
  • 박명식 (전북대학교 의학전문대학원 정형외과학교실) ;
  • 정우철 (부산 보훈병원 정형외과)
  • Published : 2010.06.30
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Abstract

Purpose: To determine follow-up results for elderly patients with osteoporosis that received standard cemented bipolar hemiarthroplasty with double loop and tension band wiring for treatment of unstable intertrochanteric hip fractures. Materials and Methods: Between May 2000 and May 2006, 86 cemented bipolar hemiarthroplasties were done in elderly patients who had unstable intertrochanteric fractures. The mean age at the time of surgery was 82 years. The average follow-up period was 5.3 years. We evaluated post-operative results by clinical and radiographic methods. Results: At the final follow-up, the mean Harris hip score was 79.2. The mean time needed for full weight bearing following surgery was 4.2 weeks and 82.5 % of patients regained their preoperative level of ambulation. All patients achieved union in the lesser trochanter fracture, but substantial trochanter displacement was observed in 4 cases. There was one case of acetabular erosion. Superficial infections were found Post-operatively in 2 cases. One case with stem subsidence (<5 mm) showed satisfactory results without subsidence in further follow-ups. Conclusion: If cemented bipolar hemiarthroplasty is properly applied in the treatment of unstable intertrochanteric hip fractures in the elderly, systematic postoperative rehabilitation, and pain control can be achieved.

목적: 골다공증이 있는 노인 환자에서 발생한 대퇴 전자간 불안정성 골절에 대해 표준형 시멘트형 인공 고관절 반 치환술과 이중 강선 고정 및 인장 대 강선고정을 시행하고 추시 결과를 알아보고자 하였다. 대상 및 방법: 2000년 5월부터 2006년 5월까지 고령의 대퇴전자간 분쇄골절 환자에서 골시멘트를 사용한 양극성 대퇴 골두 치환술을 시행하였던 86예를 대상으로 하였다. 평균 연령은 82세였고, 추시 기간은 평균 5.3 년 이었으며, 수술 후 결과를 임상적, 방사선적으로 평가 하였다. 결과: 임상적으로 82.5%의 환자가 수술전의 보행 정도를 회복하였으며 Harris hip score는 최종추시 상 평균 79.2점 전 체중 부하 보행시기는 평균 4.2주였다. 전 예에서 소전자부 골절부의 유합을 얻었고 대전자부 골절편의 전위는 4예에서 관찰 되었다. 방사선상 1예의 환자에서 비구부미란이 나타났으며, 술 후 표재성 감염이 2예에서 보였고, 침강소견(<5 mm)을 보인 1예는 추시결과 더 이상의 침강 소견 없이 만족한 결과를 보였다. 결론: 노인의 골다공성 불안정성 전자부 골절에서 표준형 시멘트 스템을 사용한 인공 고관절 반치환술은 그 적응증을 잘 고려하여 사용한다면, 환자의 조기 보행과 통증 완화 그리고 간호를 용이하게 할 수 있는 장점이 있었다.

Keywords

References

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