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고관절 치환술 후 삽입물의 안정성 판단과 대퇴 삽입물 주위 골절의 치료 원칙

Decision-Making and Principle of Management in Periprosthetic Femoral Fracture after Total Hip Arthroplasty

  • 김범수 (계명대학교 의과대학 정형외과학교실) ;
  • 이경재 (계명대학교 의과대학 정형외과학교실) ;
  • 민병우 (계명대학교 의과대학 정형외과학교실)
  • Kim, Beom-Soo (Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine) ;
  • Lee, Kyung-Jae (Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine) ;
  • Min, Byung-Woo (Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine)
  • 투고 : 2020.08.31
  • 심사 : 2020.10.19
  • 발행 : 2021.06.30

초록

대퇴 삽입물 주위 골절은 고관절 치환술 후 발생하는 가장 치료하기 어려운 합병증 중 하나이며, 만족스러운 치료 결과를 얻으려면 면밀한 임상 및 방사선 사진 평가, 정확한 분류 및 치료 원칙에 대한 이해가 필수적이다. Vancouver 분류 시스템은 이러한 삽입물 주위 골절의 치료를 계획하기 위한 간단하고 효과적인 방법이다. 대퇴 스템이 안정된 골절은 견고한 내고정으로 효과적으로 치료할 수 있지만 대퇴 스템 해리가 동반된 경우 삽입물 주위 대퇴 골절은 재치환술이 필요하다. 고관절 치환술 후 발생할 수 있는 삽입물 주위 대퇴 골절 환자의 치료 원리와 대퇴 스템의 안정성을 평가하는 방법에 대해 설명하고자 한다.

Periprosthetic femoral fractures remain as one of the most challenging complications following total hip arthroplasty. A thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are essential to obtain optimal results for these fractures. The Vancouver classification system is a simple, effective, and reproducible method for the planning treatments of these injuries. The fractures associated with a stable femoral stem can be treated effectively with osteosynthesis, but periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. This paper describes the principle of the treatment of patients with periprosthetic femoral fractures and how to assess the stability of the femoral stem.

키워드

참고문헌

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