Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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Precontoured Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료

Operative Treatment of the Displaced Midshaft Clavicle Fracture Using Precontoured Locking Compression Plate

  • 김정우 (원광대학교 의과대학 정형외과학교실) ;
  • 강홍제 (원광대학교 의과대학 정형외과학교실) ;
  • 노성현 (원광대학교 의과대학 정형외과학교실)
  • Kim, Jeong Woo (Department of Orthopaedic Surgery, School of Medicine, Wonkwang University) ;
  • Kang, Hong Je (Department of Orthopaedic Surgery, School of Medicine, Wonkwang University) ;
  • No, Sung Hyun (Department of Orthopaedic Surgery, School of Medicine, Wonkwang University)
  • 투고 : 2012.04.18
  • 심사 : 2012.09.26
  • 발행 : 2012.12.31
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초록

목적: 전위성 쇄골 간부 골절에서 관혈적 정복술 후 윤곽 성형된 잠김 압박 금속판(precontoured locking compression plate)을 이용하여 내고정을 시행한 환자를 대상으로 방사선학적 결과 및 임상적 결과를 분석하여 윤곽 성형된 잠김 압박 금속판의 유용성을 알아보고자 하였다. 대상 및 방법: 2009년 3월부터 2010년 2월까지 본원에서 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용하여 관혈적 정복 및 금속 고정술을 시행하고 1년 이상의 추시가 가능했던 34예를 대상으로 하였다. 수술 후 방사선학적 결과는 골유합 여부와 성별 및 나이에 따른 골유합 시기의 차이를 평가 하였으며 임상적 결과는 최종 추시 시 quick DASH Score 및 반대측과 관절 운동 범위의 차이를 평가 하여 분석하였다. 결과: 방사선학적 평가에서 모든 예에서 골유합을 얻을 수 있었으며 평균 골유합 기간은 12.3주였으며 성별 및 나이에 따른 골유합 기간은 통계학적으로 유의한 차이를 보이지 않았다(p=0.87). 임상적 평가에서 최종 quick DASH Score는 평균 23.5점 (12~42)이었으며, 최종 추시시 견관절의 운동은 건측과 비교 시 통계학적으로 유의한 차이를 보이지 않았다 (p=0.69). 결론: 전위성 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용한 내고정술은 정확한 해부학적 정복과 견고한 내고정을 유지 할 수 있어 조기 운동이 가능하여 견관절 운동의 회복과 함께 전례에서 골유합을 얻을 수 있어 쇄골 간부 골절 치료에서 유용하게 사용될 수 있다고 사료된다.

Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

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참고문헌

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피인용 문헌

  1. Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture vol.20, pp.4, 2015, https://doi.org/10.12790/jkssh.2015.20.4.168