Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail

골수정을 이용한 대퇴골 전자간 골절의 새로운 치료 경향

  • Kim, Junyoung (Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Choi, Kihong (Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yang, Kyu Hyun (Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 김준영 (연세대학교 의과대학 강남세브란스병원 정형외과학교실) ;
  • 최기홍 (연세대학교 의과대학 강남세브란스병원 정형외과학교실) ;
  • 양규현 (연세대학교 의과대학 강남세브란스병원 정형외과학교실)
  • Received : 2019.11.21
  • Accepted : 2020.02.14
  • Published : 2020.06.30
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Abstract

A gamma nail has been used to treat intertrochanteric fractures since 1988. Although such cephalomedullary nails have mechanical advantages over extramedullary fixation devices, such as sliding hip screw, their beneficial effects on treating the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 fractures are still controversial. During their 30-year history, many problems have been overcome, and new types of cephalomedullary nails have been introduced in clinical practice. New cephalomedullary nail systems facilitate nailing procedures and enhance the purchase capability of the femoral head by a lag screw. On the other hand, the failure rate still depends on the hands of the orthopedic surgeons. This review article focused on the basic principle of medial support and restoration of a medial buttress during the treatment of trochanteric fractures using a cephalomedullary nail.

골수강 내 금속정(골수정)은 1988년부터 대퇴골 전자간 골절을 치료하는 데 사용되어 왔다. 골수정은 활강고나사와 같은 골수강 외 고정 장치에 비하여 기계적 이점이 있으나 대퇴 전자간 골절 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 및 31-A2 골절 치료에 활강고나사보다 유리한 고정 기구인지에 대해서는 논란이 계속되고 있다. 지난 30년 동안 여러 시행 착오가 극복되었고 새로운 유형의 대퇴 골수정이 개발되어 임상에서 사용되고 있다. 새로 개발된 골수정은 삽입 과정이 쉬워지고 지연나사를 사용한 대퇴 골두의 고정 능력이 향상되어 왔다. 그러나 고정 실패율은 여전히 정형외과 의사의 수술 술기에 달려 있다고 할 수 있다. 이 종설에서 우리는 골수정을 이용하여 대퇴 전자간 골절을 치료하는 동안 내측 지지대 복원의 중요성에 대해 초점을 맞추고 그 기본 원칙에 대하여 논의해 보고자 한다.

Keywords

References

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