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고령의 대퇴 전자간 분쇄골절에서 대전자부 재부착 기구를 이용한 양극성 고관절 반치환술

Bipolar Hemiarthroplasty using the Greater Trochanter Reattachment Device(GTRD) for Comminuted Intertrochanteric Fracture in Elderly Patients

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목적: 전신상태가 불량한 고령의 대퇴 전자간 분쇄골절 환자에 있어서 대전자부 재부착 기구를 이용하여 시멘트성 양극성 반치환술을 시행 후 결과를 분석하였다. 대상 및 방법: 2001년 1월부터 2002년 1월까지 75세 이상의 대전자부 골절 환자에서 상기 방법으로 수술을 시행한 환 자 중 1년 6개월 이상 추시가 가능했던 1 2예를 대상으로 하였다. 술 후 임상적 평가로는 Harris 고관절 점수와 J o h n s o n 의 일상생활 기능 평가를 사용하였고, 방사선학적 평가로는 B a r r a c k의 골시멘트 점수 평가 방법에 따라 평가 하였다. 결과: 술 후 Harris 고관절 점수는 평균 72점이었고 일상생활 기능 평가에서는 보통 이상의 결과가 9예 이었으며, Barrack 방사선학적 평가는 8예에서 양호한 압박화를 보여 주었다. 기존 질환이 있어 자세유지가 불가능한 환자 1예에서 술 후 3주에 탈구가 발생하였으나 방사선 투시하 비관혈적 방법으로 정복 후 고관절 외전 보조기로 유지하여 치료하였다. 결론: 고령의 대퇴 전자간 분쇄골절에 대전자부 재부착 기구를 이용한 시멘트성 양극성 반치환술은 제한된 적응증에도 불 구하고 유용한 치료방법이라 생각된다.

Abstract

Purpose: This study was performed to analyze the outcome of cemented bipolar hemiarthroplasty using the greater trochanter reattachment device (GTRD) for comminuted intertrochanteric fracture in elderly patients. Materials and Methods: From January 2001 to January 2002, 12 patients 75 years or older underwent cemented bipolar hemiarthroplasty using GTRD for comminuted intertrochanteric fracture. They were followed up for more than one year and six months. We evaluated the postoperative Harris hip score (HHS) and their daily activities of life, and we assessed radiological results using Barrack's cement score. R e s u l t s: The mean postoperative HHS was 72 points. In rating the daily activity of life, nine of the patients` postoperative results were above fair. According to Barrack`s cement scoring system, eight patients had excellent or good radiologic results. One patient had a hip dislocation that was successfully managed by closed reduction and an abduction brace. Conclusion: In spite of its known limitations, cemented bipolar hemiarthroplasty using GTRD is a useful treatment method for comminuted intertrochanteric fractures.

참고문헌 (21)

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