항회전 근위 대퇴 골수정(PFNA)과 근위 대퇴 골수정(PFN)의 결과 분석
The Results of Proximal Femoral Nail Antirotation - A Comparative Study with Proximal Femoral Nail -
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목적: 근위 대퇴 전자부 주위 골절의 치료에 있어서 항회전 근위 대퇴 골수정의 치료 결과를 근위 대퇴 골수정과 비교하여 분석 하고자 한다. 대상 및 방법: 2007년 2월부터 2008년 3월까지 항회전 근위 대퇴 골수정으로 치료를 받은 환자 24명(I 군)와 2005년 1월부터 2007년 1월까지 근위 대퇴 골수정을 이용하여 수술 받은 24명의 환자를(II 군) 대조 군으로 하여 비교하였다. 두 군 사이에서 수술 시간, 예상 출혈량, 수혈량, 중환자실 이용 빈도, 배액량, 평균 재원 일수, 합병증, 방사선학적 골 유합, TAD, 대퇴 경간 각 의 차이, 검과 나사의 이동 거리, Jensen의 기능적 점수와 Parker와 Palmer의 활동 점수를 비교하였다. 결과: 술 중 예상 출혈량, 배액량, 수술 후 합병증, 검과 나사의 이동 거리 그리고 대퇴 경간 각에서 통계학적인 의의가 있었고 (p<0.05) 그 외 모든 결과에서 통계학적인 의의가 없었다(p>0.05). 결론: 대퇴 근위 전자부 주위 골절의 치료에 있어서 항회전 근위 대퇴 골수정을 이용한 술식은 근위 대퇴 골수정에 비하여 비교 적 양호한 임상적 결과가 관찰되었다.
Abstract
Purpose: This study was performed to compare the results between PFNA (Proximal Femoral Nail Antirotation) and PFN (Proximal Femoral Nail) in the treatment of peritrochanteric fracture. Materials and Methods: The patient group with PFNA (n=24, group I) was taken from operations between February, 2007, and March, 2008, whereas the PFN patient group (n=24, group II) were taken from January, 2005, to January, 2007. Both groups were carefully compared with regard to operation time, estimated blood loss, amount of transfusion, ICU care, amount of drainage, average duration of admission, intra- and postoperative complications, radiologic union, Tip Apex Distance (TAD), the change of neck shaft angle, the sliding length of lag screw, Jensen's functional score, and Paker and Palmer's mobility score. Results: The results of our study showed statistical (P<0.05) advantages of PFNA over PFN where estimated blood loss, amount of drainage, rate of complication, neck and shaft angle, and sliding length were concerned. However, there was no statistical significance between the two groups regarding the other areas that were examined (p>0.05). Conclusion: PFNA appears to be more effective than PFN for the treatment of peritrochanteric fractures of the proximal femur.
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