Hip & pelvis

  • 제22권1호
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  • Pages.1-12
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  • 2010
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
권호 표지

대퇴 전자간 골절, 전자하 골절의 수술적 치료

Surgical Treatment of Femur Intertrochanteric and Subtrochanteric Fracture

  • 김종오 (이화여자대학교 의학전문대학원 목동병원 정형외과학교실) ;
  • 김태호 (삼육서울병원 정형외과)
  • Kim, Jong-Oh (Department of Orthopedic Surgery, Mokdong Hospital, Ewha Woman’s University School of Medicine) ;
  • Kim, Tae-Ho (Department of Orthopedic Surgery, Sahmyook Medical Center)
  • 발행 : 2010.03.31
⟨ 이전 논문 다음 논문 ⟩

초록

전자간 골절과 전자하 골절은 고관절부의 관절 낭 외 골절이며 두 연령군에서 호발한다. 젊은 환자에서는 고에너지 손상으로 인해 발생하며 전자하 골절이나 대퇴 경부 기저부(basicervical)형의 골절이 많으며 노령에서는 골다공증과 동반된 저에너지 손상으로 전자간 골절이 많다. 전자간 골절과 전자하 골절 등 대퇴 근위부 골절은 고관절 주변의 근육의 강한 힘의 작용으로 골절의 정복이 어려울 수 있고 지연 나사의 위치가 골절 유합과 결과에 큰 영향을 미치기 때문에 올바른 기구를 사용하여 정복과 지연 나사의 위치에 신경써서 치료한다면 골절에 의한 합병증을 줄일 수 있을 것이라 사료된다. 이에 저자들은 전자간 골절, 전자하 골절에 대하여 문헌 고찰과 함께 활강압박 고 나사와 골수내 금속정의 특징, 수술 방법에 대해 기술하고자 한다.

Femur intertrochanteric and subtrochanteric fractures are extracapsular hip fractures and they show a bimodal age distribution. Most hip fractures in young patient are subtrochanteric or basicervical fractures that are caused by high energy injury. Most of the hip fractures in old patients are intertrochanteric fractures related to osteoporosis and low energy injury. For proximal hip fractures, the muscles around the hip joint make reduction difficult and the position of the lag screws affects healing of the fracture. To lower the complications of these fractures, surgeons can use an appropriate implant along with performing good reduction and good lag screw positioning. We report here on our review of femur intertrochanteric and subtrochanteric fractures, the characteristics of compression hip screws, the intramedullary devices and the technical pitfalls.

키워드

참고문헌

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