비구 전 후주 골절에 대해서 Cerclage Passer를 이용한 환상 강선 고정술기 및 결과

국문 초록 (Abstract)

목적: 양주 또는 T형 타입의 비구 골절은 정복이 매우 어려우며 불완전한 정복의 경우 추후 고관절의 외상성 관절염 등의 합병증이 발생한다. 본 저자들은 이에 대해 cerclage passer를 이용한 환상 강선 고정술을 시행하였고, 임상 및 방사선 결과를 보고하고자 한다.
대상 및 방법: 2013년 3월부터 2014년 12월까지 전위성 비구 골절로 cerclage passer를 이용해 수술한 최소 1년 이상 추시 관찰이 가능하였던 8예를 대상으로 하였다. 장골능의 전외측부에서 외전근과 골막 사이와 대 좌골 절흔까지 cerclage passer를 통과시킨 후 강선을 조이면서 골절을 정복하였다. 이후 내고정을 추가하여 고정력을 보강하였으며, 이에 대해 임상적 및 방사선적으로 분석하였다.
결과: 8예 모두 3 ㎜ 이하의 관절면의 정복을 얻었으며, 평균 골유합 기간은 11.8주(9-15주)였다. 방사선적 결과는 우수가 5예(62.5%), 양호가 3예(37.5%)였으며 임상적 결과는 7예(87.5%)에서 양호 이상의 결과를 얻었다.
결론: Cerclage passer를 이용한 환상 강선 고정술은 복잡한 형태의 비구 골절의 정복에 있어 매우 안전하고 유용한 수술 술기로 생각된다.

다국어 초록 (Multilingual Abstract)

Purpose: Both column and T-shaped acetabular fractures are frequently presented with difficulty in reduction. Incomplete reduction may cause traumatic arthritis in the hip joint, resulting in inferior clinical outcomes. The purpose of this study is to introduce our wiring technique and to report the clinical and radiological outcomes of such technique.
Materials and Methods: Eight patients who underwent our proposed technique for having acetabular fracture with displaced quadrilateral plate between March 2013 and December 2014 were enrolled. All patients were followed-up more than 1 year. The wire passer was set up from an anterolateral aspect of the iliac crest to the greater sciatic notch, between the abductor muscle and the periosteum. The quadrilateral plate of acetabular fracture was reduced with wiring. Internal fixation was added to the pelvic brim. An analysis of the clinical and radiological outcomes was performed.
Results: Reduction was performed within the 3 mm intra-articular step-off in all patients. The mean duration of union was 11.8 weeks (9–15 weeks). Five patients (62.5%) showed excellent results, and radiologically, three patients (37.5%) showed good results, and seven patients (87.5%) showed better than good results.
Conclusion: The cerclage wiring fixation technique using a large cerclage passer instrument can be a useful and safe reduction method in some cases of acetabular fractures.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• REFERENCES

참고문헌 (Reference)

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