개에서 원형외고정장치를 이용한 관절주위 골절의 안정화

Stabilization of Short Juxta-articular Fractures Using a Circular External Skeletal Fixator System in Dogs

  • Cheong, Hye-Yeon (College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Joo-Ho (College of Veterinary Medicine, Chonbuk National University) ;
  • Cha, Jae-Gwan (College of Veterinary Medicine, Chonbuk National University) ;
  • Seol, Jae-Won (College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Min-Su (College of Veterinary Medicine, Chonbuk National University) ;
  • Lee, Hae-Beom (College of Veterinary Medicine, Chungnam National University)
  • 심사 : 2014.12.08
  • 발행 : 2014.12.31

초록

세마리의 개가 골절을 주증으로 내원하였다. 증례 1(1.8 kg의 5개월령 암컷 몰티즈)과 증례 2(3.0 kg의 6개월령 암컷 푸들)는 좌측 후지의 체중부중을 하지 않는 파행을, 증례 3(3.3 kg의 나이를 알 수 없는 암컷 잡종견)은 좌측 전지의 체중부중을 하지 않는 파행을 보였다. 정형외과 검사시 손상받은 부위의 통증, 염발음, 촉진상의 불안정성과 광범위한 연부조직 부종을 보였으며 신경학적 이상소견은 관찰되지 않았다. 방사선 검사상 증례 1와 2에서 좌측 근위 경골 골간단과 비골의 골절이, 증례 3에서는 좌측 근위 요골 골간단과 척골의 골절이 관찰되었다. 모든 증례는 골절편이 짧은 관절주위 폐쇄형 골절이었다. 술 중에는 투시장치를 이용해 2개 또는 3개의 원형고정장치의 적절한 위치에 삽입하였다. 술 후 방사선 사진에서 골절부위의 적절한 배열과 위치를 확인하였다. 방사선학적으로 5주에서 14주 사이에서 골유합이 확인되었고 임플란트의 고정 실패나 핀 주변 감염은 나타나지 않았다. 기능상 결과는 모든 증례에서 매우 좋은 것으로 나타났다. 따라서, 원형외고정장치는 뼈판이나 외고정장치를 사용할 수 없는 짧은 골절편을 가진 관절주의의 골절정복에 성공적으로 이용할 수 있을 거라 사료된다.

Three dogs were admitted for repair of bone fracture. Case 1 (Maltese, 1.8 kg, intact female, 5-month-old) and case 2 (poodle, 3.0 kg, intact female, 6-month-old) had non-weight bearing lameness in the left pelvic limb, and case 3 (mixed, 3.3 kg, intact female, age unknown) had non-weight-bearing lameness in the left thoracic limb. On orthopedic examination, there was pain, crepitus, palpable instability and substantial soft tissue swelling on the affected side. No neurological deficits were identified. Radiographs revealed left proximal metaphyseal tibial and fibular fractures in cases 1 and 2, and left proximal metaphyseal radial and ulnar fractures in case 3. All cases had closed long-bone fractures with short juxta-articular fracture segments. Under fluoroscopic guidance, proper placement of the ring fixation elements was confirmed during surgery. Two or three rings were used to stabilize fractures with traditional circular external skeletal fixators (CESF). Postoperative radiographs showed acceptable alignment and apposition of the previously identified fracture. Time to radiographic union ranged from 5 to 14 weeks and there were no signs of implant failure or pin tract infection. Functional outcomes were excellent in all cases. CESF can be successfully used to reduce short juxta-articular fractures in which bone plates or external skeletal fixation cannot be applied.

키워드

참고문헌

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