Hip & pelvis

  • 제23권2호
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  • Pages.155-160
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  • 2011
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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비외상성 대퇴골두 무혈성 괴사에서 다발성 천공술 후 속발된 대퇴 전자하 골절 - 1례 보고 -

Subtrochanteric Femur Fracture after Multiple Drilling for Treatment of Nontraumatic Osteonecrosis of the Femoral Head - A Case Report -

  • Kim, Jong-Won (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Park, Hyun-Soo (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Rha, Jong-Deuk (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Jang, Young-Soo (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Jung, Jae-Wook (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Yang, Jin-Phil (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Choi, Jae-Hyuk (Department of Orthopedic Surgery, Hanil General Hospital)
  • 발행 : 2011.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

대퇴골두 무혈성 괴사증의 치료에 있어서 다발성 천공술은 현재 널리 이용되고 있는 대퇴골두 구제 수술 중 하나이다. 다발성 천공술은 대퇴골두에 직경이 작은 Steinmann pin을 이용하여 피질골에 여러 개의 구멍을 뚫어 골수강 내를 감압하는 술식이다. 이는 대퇴골두 핵심 감압술의 일종으로 괴사골 내부로의 혈관 재형성을 도모함과 동시에 조직의 재생을 촉진하게 된다. 알려진 수술 후 합병증으로 천공 부위 근처에서의 이소성 골 형성과 더불어 드물게 대퇴골 전자하 골절의 발생가능성이 알려져왔다. 저자들은 다발성 천공술 후 6주가 경과한 후 발생한 대퇴골 전자하 골절을 경험하였기에 보고하고자 한다.

Multiple drilling of the femoral head is a commonly-used surgical technique for the treatment of osteonecrosis. Several holes are drilled into the femoral head using a small-diameter Steinmann pin. This decompression technique promotes revascularization and regeneration of necrotic tissue in the femoral head. Known complications are heterotopic ossification and femoral subtrochanteric fractures, although these have only been rarely reported. Our case study focuses on a subtrochanteric fracture 6 weeks after a multiple drilling operation.

키워드

참고문헌

  1. Marker DR, Seyler TM, McGrath MS, Delanois RE, Ulrich SD, Mont MA. Treatment of early stage osteonecrosis of the femoral head. J Bone Joint Surg Am. 2008;90 Suppl:175-87. https://doi.org/10.2106/JBJS.H.00671
  2. Kim YM, Lee DY, Chung MS, Kang SB, Kim BS, Kim HJ. Result of multiple drilling for the early stage nontraumatic osteonecrosis of the femoral head. J Korean Orthop Assoc. 1997;32:977-83.
  3. Kim SY, Kim DH. The results of multiple drilling for the treatment of osteonecrosis of the femoral head. J Korean Hip Soc. 1999;11:30-8.
  4. Mont MA, Ragland PS, Etienne G. Core decompression of the femoral head for osteonecrosis using percutaneous multiple small-diameter drilling. Clin Orthop Relat Res. 2004;429:131-8.
  5. Marker DR, Seyler TM, Ulrich SD, Srivastava S, Mont MA. Do modern techniques improve core decompression outcomes for hip osteonecrosis?. Clin Orthop Relat Res. 2008;466:1093-103. https://doi.org/10.1007/s11999-008-0184-9
  6. Song WS, Yoo JJ, Kim YM, Kim HJ. Results of multiple drilling compared with those of conventional methods of core decompression. Clin Orthop Relat Res. 2007;454:139-46.
  7. Colwell CW Jr. The controversy of core decompression of the femoral head for osteonecrosis. Arthritis Rheum. 1989;32:797-800. https://doi.org/10.1002/anr.1780320622
  8. Berend KR, Gunneson EE, Urbaniak JR. Free vascularized fibular grafting for the treatment of postcollapse osteonecrosis of the femoral head. J Bone Joint Surg Am. 2003;85-A:987-93.
  9. Fung DA, Frey S, Menkowitz M, Mark A. Subtrochanteric fracture in a patient with trabecular metal osteonecrosis intervention implant. Orthopedics. 2008;31:614.
  10. Lieberman JR, Berry DJ, Mont MA, et al. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect. 2003;52:337-55.

피인용 문헌

  1. 대퇴골두의 연소성 골연골증의 중·서양 협진치료에 대한 임상 연구 동향: 2000년 이후 발표된 연구를 중심으로 vol.31, pp.3, 2011, https://doi.org/10.18325/jkmr.2021.31.3.57