Journal of Trauma and Injury

  • 제23권1호
  • /
  • Pages.1-5
  • /
  • 2010
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

대퇴골 전자부 역사상 골절의 압박고 나사를 이용한 치료

Treatment of Reverse Oblique Trochanteric Fracture with Compression Hip Screw

  • 김동휘 (조선대학교 의과대학 정형외과학교실) ;
  • 이상홍 (조선대학교 의과대학 정형외과학교실) ;
  • 하상호 (조선대학교 의과대학 정형외과학교실) ;
  • 유재원 (조선대학교 의과대학 정형외과학교실)
  • Kim, Dong-Hui (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Lee, Sang-Hong (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Ha, Sang-Ho (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • You, Jae-Won (Department of Orthopaedic Surgery, College of Medicine, Chosun University)
  • 투고 : 2010.04.23
  • 심사 : 2010.06.07
  • 발행 : 2010.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: To investigate the results of treatment of reverse oblique trochanteric fractures with compression hip screw. Methods: We reviewed the results of 12 cases of reverse oblique trochanteric fracture treated with compression hip screw from January 2000 to December 2006 which could be followed up for more than 1 year. The mean follow up period was 26 months (15~40). The mean age was 48 years old. Injury mechanism was composed of 6 cases of traffic accident and 6 cases of fall down. 8 persons were man. We investigated the union time, degree of neck-shaft angle change, amount of sliding of compression hip screw, complications, functional and clinical results. Results: 10 cases were united and the mean union time were 5 months (3~8). The mean neck-shaft angle change was 3.5 degrees (0~12). The amount of sliding of compression hip screw was 8.9 mm (2~24). There were six coxa vara, six leg due to coxa vara shortening, two nonunion, and one superficial infection. Unsatisfactory results of Jensen's social function score and Parker and Palmer's mobility score were studied. Conclusion: The results of treatment of reverse oblique trochanteric fractures with compression hip screw were relatively unsatisfied.

키워드

참고문헌

  1. Melton LJ, 3rd, Ilstrup DM, Riggs BL, Beckenbaugh RD. Fifty-year trend in hip fracture incidence. Clin Orthop Relat Res. 1982;162:144-9.
  2. George J, Andrew T, Daniel J. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83:643-50. https://doi.org/10.2106/00004623-200105000-00001
  3. Wagner R, Wechbach A, Sellmair U, Blattert T. Extra-articular proximal femur fracture in the elderly - dynamic hip screw or intramedullary hip screw for fracture management? Langenbecks Arch Chir Suppl Kongressbd. 1996;113:963-6.
  4. Hardy DC, Descamps PY, Krallis P, et al. Use of an intramedullary hip-screw compared with a compression hip-screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one hundred patients. J Bone Joint Surg Am. 1998;80:618-30. https://doi.org/10.2106/00004623-199805000-00002
  5. Lorich DG, Geller DS, Nielson JH. Osteoporotic pertrochanteric hip fractures: management and current controversies. Instr Course Lect. 2004;53:441-54.
  6. Sadowski C, Lubbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study. J Bone Joint Surg Am. 2002;84:372-81. https://doi.org/10.2106/00004623-200203000-00007
  7. Jensen JS. Determining factors for the mortality following hip fractures. Injury. 1984;15:411-4. https://doi.org/10.1016/0020-1383(84)90209-2
  8. Parker MJ, Palmar CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br. 1993;75:797-8.
  9. Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowitz R. The proximal femoral nail (PFN)-a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand. 2003;74:53-8. https://doi.org/10.1080/00016470310013662
  10. Baumgaertner MR, Curtin SL, Lindskog DM. Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures. Clin Orthop Relat Res. 1998;348:87-94.
  11. Fielding JW, Cochran GV, Zickel RE. Biomechanical characteristics and surgical management of subtrochanteric fractures. Orthop Clin North Am. 1974;5:629-50.
  12. Aune AK, Ekeland A, Odegaard B, Grogaard B, Alho A. Gamma nail vs compression screw for trochanteric femoral fractures. 15 reoperations in a prospective, randomized study of 378 patients. Acta Orthop Scand. 1994;65:127-30. https://doi.org/10.3109/17453679408995418
  13. Thorngren KG. Optimal treatment of hip fractures. Acta Orthop Scand. 1991;241:31-4.
  14. Jeon TS, Kim WS, Kim SB, Hwang CM, Kim KT, Kim SH. Treatment of communited subtrochanteric fractures of the femur by high energy trauma. J Korean Fracture Soc. 2006;19:135-40. https://doi.org/10.12671/jkfs.2006.19.2.135
  15. Joachim W, Cirk AH. Pitfalls and complications in the use of the proximal femoral nail. Langenbeck Arc Surg. 2004:196-212.
  16. Schatzker J, Waddell JP. Subtrochanteric fractures of the femur. Orthop Clin North Am. 1980;11:539-54.
  17. Yoo JH, Yang KH, Park SY, Won JH, Yoon HK. The treatment of unstable reverse oblique intertrochanteric fractures with proximal femoral nail (PFN). J Korean Orthop Assoc. 2005;40:733-40. https://doi.org/10.4055/jkoa.2005.40.6.733
  18. Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty-two intertrochanteric hip fractures. J Bone Joint Surg Am. 1979;61:216-21. https://doi.org/10.2106/00004623-197961020-00009
  19. Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001 May;83-A: 643-50.
  20. Herrera A, Domingo LJ, Calvo A, Martinez A, Cuenca J. A comparative study of trochanteric fractures treated with the gamma nail or the proximal femoral nail. Int Orthop. 2002;26:365-9. https://doi.org/10.1007/s00264-002-0389-6
  21. Domingo LJ, Cecilia D, Herrera A, Resines C. Trochanteric fractures treated with a proximal femoral nail. Int Orthop. 2001;25:298-301. https://doi.org/10.1007/s002640100275
  22. Velasco RU, Comfort TH. Analysis of treatment problems in subtraochanteric fractures of the femur. J Trauma. 1978;18:513-23. https://doi.org/10.1097/00005373-197807000-00006
  23. Lee SH. The treatment of unstable intertrochanteric fracture of the femur with compression hip screw. The Korean Society of Traumatology. 1998;11:187-92.
  24. Cho JH. The compression hip screw with trochanter stabilizing plate for internal fixation of unstable intertrochanteric fractures. J Korean Fracture Soc. 2005;18-3:221-6. https://doi.org/10.12671/jkfs.2005.18.3.221
  25. Bridle SH, Patel AD, Bircher M, Calvert PT. Fixation of intertrochanteric fracture of femur randomized prospective comparison of gamma nail and the dynamic hip screw. J Bone Joint Surg Br. 1991;73:330-5.
  26. Hwang DS, Kwak SK, Woo SM. Results of cementless hemiarthroplasty for elderly patients with unstable intertrochanteric fractures. J Korean Hip Soc. 2004;16:386-91.
  27. Sohn JM, Jahng JH, Ha NK, Cho ST, Choi KY. Primary bipolar hemiarthroplasty for treatment of unstable intertrochanteric fracture of the femur in elderly patients. J Korean Fracture Soc. 2003;16:37-44. https://doi.org/10.12671/jksf.2003.16.1.37