Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Antegrade Interlocking Intramedullary Nailing in Humeral Shaft Fractures

상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술

  • Cho, Chul-Hyun (Department of Orthopedic Surgery, School of Medicine, Keimyung University) ;
  • Song, Kwang-Soon (Department of Orthopedic Surgery, School of Medicine, Keimyung University) ;
  • Kim, Sin-Ki (Department of Orthopedic Surgery, School of Medicine, Keimyung University)
  • 조철현 (계명대학교 의과대학 정형외과학교실) ;
  • 송광순 (계명대학교 의과대학 정형외과학교실) ;
  • 김신기 (계명대학교 의과대학 정형외과학교실)
  • Received : 2010.02.16
  • Accepted : 2010.04.08
  • Published : 2010.06.15
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Abstract

Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.

목적: 상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술의 치료 결과 및 합병증에 대하여 알아 보고자 한다. 대상 및 방법: 2002년부터 2008년까지 상완골 간부 골절로 전향적 교합성 골수강내 금속정 고정술을 시행하고 골유합 기간까지 추시 관찰이 가능하였던 47예를 대상으로 임상적, 방사선학적 결과 및 술 후 합병증을 분석하였다. 술 후 추시 단순 방사선 검사로 골유합을 확인하였고, ASES 점수 평가법을 이용하여 임상적 평가를 시행하였다. 결과: 총 47예 중 41예 (87.2%)에서 골유합을 보였고, 평균 유합 시기는 14.5주였다. 주요 합병증으로 불유합이 6예, 지연 유합이 3예, 술 중 원위 상완골 후방 피질 골절이 2예, 견관절 유착성 관절막염이 1예를 포함한 영구적 견관절 동통이 2예 있었다. 임상적 결과는 우수가 29예, 양호가 11예, 보통이 4예, 불량이 3예로, 40예 (85.1%)에서 만족할 만한 결과를 보였다. 결론: 상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술은 만족할만한 골유합율 및 임상적 결과를 나타내었으며, 특히 다발성 골절 등의 동반 손상이 있는 경우 또는 분절 골절에서 유용한 하나의 치료 방법이라 사료된다.

Keywords

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  3. Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures vol.16, pp.2, 2013, https://doi.org/10.5397/CiSE.2013.16.2.107