Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -

고령의 전자간부 골에서 시행한 시멘트 대퇴주대를 사용한 양극성 반치환술 - 최소 2년 추시 결과 -

  • Hwang, Sung-Kwan (Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University) ;
  • Kang, Dong-Hyun (Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University) ;
  • Cho, Tae-Yeon (Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University) ;
  • Yi, Chang-Ho (Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University)
  • 황성관 (연세대학교 원주의과대학 정형외과학교실) ;
  • 강동현 (연세대학교 원주의과대학 정형외과학교실) ;
  • 조태연 (연세대학교 원주의과대학 정형외과학교실) ;
  • 이창호 (연세대학교 원주의과대학 정형외과학교실)
  • Published : 2010.09.30
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Abstract

Purpose: The purpose of this study was to evaluate the usefulness of bipolar hemiarthroplasty using a cemented femoral stem for treating femoral trochanteric region hip fractures in elderly patients. Materials and Methods: This study includes 47 hips were available to be follow up for over 2 years, between December 1995 and December 2002. Clinical evaluation was done using Koval' classification before the fracture and at last follow-up, and Harris' hip score at the last follow up. Radiological evaluation was done via the plain radiographs. Results: The Koval classification was as follows: recovery to the condition before fracture in 15 cases (31.9%), degradation by 1 class in 31 cases (66.0%) and degradation by 2 classes in 1 case (2.1%). The Harris hip score was 84.6 points at the last follow-up. All the cases showed stable fixation of the femoral stem. Postoperative complications were reported as 1 case of pneumonia, 1 case of deep vein thrombosis, 1 case of pulmonary thromboembolism, 1 case of pulmonary edema, 3 cases of stress ulcer, 1 case of superficial infection and 1 case of deep infection. Superficial pressure sore occurred in 1 case, postoperative delirium occurred in 9 cases and partial rupture of the bladder in 1 case. Conclusion: Bipolar hemiarthroplasty using a cemented femoral stem was effective and satisfactory for the treatment of elderly patients with intertrochanter fractures. But further studies that will focus on complications are required.

목적: 고령의 전자간부 골절 환자에서 시멘트 대퇴 주대를 이용한 양극성 반치환술의 결과를 임상적 및 방사선학적으로 분석 하고자 하였다. 대상 및 방법: 1995년 12월부터 2002년 12월까지 전자간부 골절로 시멘트 대퇴주대를 이용한 양극성 고관절 반치환술을 시행받은 고령의 환자 중 2년이상 추시가 가능하였던 47명을 상으로 하였다. 임상적 평가는 최종 추시 시 Harris 고관절 점수와 Koval의 분류에 의한 수상전 및 최종 추시 보행상태를 분석하였으며, 단순 방사선 사진을 통해 방사선학적 평가를 하였다. 결과: 최종 추시시 Harris 고관절 평균점수는 84.6점 이었으며, Koval에 의한 보행능력은 수상 전 보행능력으로 회복 15명(31.9%), 수상전보다 1단계 감소 31명(66.0%), 2단계 감소 1명(2.1%)로 나타났으며, 골용해나 대퇴주대 이완을 보이는 소견은 관찰되지 않았다. 술 후 합병증의 경우 폐렴, 심부혈전증, 폐색전증, 폐부종이 각각 1예(2.1%), 스트레스성 궤양이 3예(6.4%), 천부 감염 및 심부 감염이 각각 1예(2.1%), 천부 욕창 2예(4.2%) 발생하였으며, 수술 후 섬망이 9예(19.1%), 방광 부분 파열이 1예(2.1%) 발생하였다. 결론: 시멘트형 대퇴 주대를 사용한 양극성 인공관절 반치환술은 고령환자의 대퇴골 전자간부 골절의 우수한 치료법으로 향후 합병증에 대한 연구가 필요하다.

Keywords

References

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