잠김 압박 금속판을 이용한 장골의 전이성 병적 골절의 치료

국문 초록 (Abstract)

목적: 장골에 발생한 전이성 병적 및 임박 골절에 대한 잠김 압박 금속판을 이용한 치료 결과를 분석하고자 하였다.
대상 및 방법: 장골에 발생한 악성 종양의 전이성 병적 및 임박 골절에 대하여 잠김 압박 금속판으로 치료 받은 25명(28예)을 대상으로 시행하였다. 환자의 수술 시 평균 연령은 62.4세였으며, 골절 발생 위치는 상완골 11예, 대퇴골 11예, 경골 6예였다. 기능적 평가로 Musculoskeletal Tumor Society (MSTS) 점수와 상지의 경우 기능의 회복 정도를, 하지의 경우 술 후 거동이 가능하였던 시기를 평가하였으며, 수술 전, 후의 시각 통증 척도와 수술 시간, 수술 후 환자의 만족도 및 합병증에 대하여 분석하였다.
결과: 평균 수술 시간은 81.3분이었으며 추시 중 평균 MSTS 점수는 19.8점이었다. 수술 후 휠체어 보행이 가능던했 시기는 평균 3.3 일이며, 시각 통증 척도는 술 전 평균 8.1점에서 술 후 1주일째 평균 2.9점으로 호전되었다. 모든 환자에서 만족도는 ‘만족’ 이상으로 평가되었으며, 1예에서 술 후 3개월째 정복 소실과 나사못 파괴가 발생하였고 1예에서 일시적 요골신경 손상이 발생하였다.
결론: 골간단 및 골간에 발생한 전이성 병적 및 임박 골절에 대한 잠김 압박 금속판을 이용한 치료는 골수강내 금속정 삽입술과 함께 병행할 만한 효과적인 방법 중 하나이다.

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study is to evaluate the results and the advantages of the operative treatment of metastatic pathologic fractures in long bones using locking compression plates.
Materials and Methods: Twenty-five patients (28 cases) who underwent open reduction and internal fixation with a locking compression plate with or without cement augmentation for pathologic fractures in long bones resulting from metastatic cancer between 2004 and 2013 were reviewed retrospectively. Mean age at the time of surgery was 62.8 years. Pathologic fractures occurred in 11 cases in the humerus, 11 cases in the femur, and 6 cases in the tibia. Functional analysis of Musculoskeletal Tumor Society (MSTS) scores, functional restoration condition of patients with upper extremity involvements, and interval to wheelchair ambulation in patients with lower extremity involvements was performed. Pain relief (visual analogue scale, VAS) and operation time, postoperative satisfaction with individuals, and complications were evaluated.
Results: Mean operation time was 81.3 minutes and mean MSTS scores were 19.8. Mean time from operation to wheelchair ambulation was 3.3 days. Mean VAS improved from 8.1 preoperatively to 2.9 at 1 week postoperatively. Most patients reported that they were more than ‘satisfied’. One transient radial nerve palsy and one late complication of screw breakage and reduction loss had occurred at postoperative 3 months.
Conclusion: Internal fixation with a locking compression plate in metastatic pathologic fractures can be an effective treatment option in the meta or diaphyseal area of long bones.

목차 (Table of Contents)

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

참고문헌 (Reference)

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