인공고관절 전치환술 후에 발생한 삽입물 주위 골절의 치료
Treatment of Periprosthetic Fracture after Total Hip Arthroplasty
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 인공고관절 전치환술 후에 발생한 삽입물 주위 대퇴골 골절의 치료시 수술 방법과 그 결과에 대해 알아보고자 하 였다. 대상 및 방법: 연구 대상은 본원에서 2년 이상 추시가 가능하였던 12예를 대상으로 하였다. 골절의 분류는 Vancouver 분류 방법을 이용하였다. 술식은 6예에서는 골절부위에 금속판 내고정술, 6예에서는 긴 대퇴 스템을 이용한 재치환술을 시행하였다. 임상적 평가는 대퇴부 골절의 유합 유무와 대퇴 스템의 해리 정도및 Harris Hip Score를 이용한 Johansson의 방법으로 판정하였다. 결과: 전례에서 골유합 소견을 보였고, 최종 추시까지 대퇴 스템의 해리는 관찰되지 않았다. Harris Hip Score는 최종 추시시 평균 89점 이었다. 결론: 인공고관절 전치환술 후 발생한 동측 대퇴골 골절의 치료에서 스템의 안정성이 있는 경우는 골절부위의 금속판 내고 정술이 스템의 불안정성이 있는 경우는 긴 대퇴 스템을 이용한 재치환 술식을 이용하여 좋은 결과를 얻을것으로 사료된다.
Abstract
Purpose: We wished to evaluate the operative methods and short-term results of periprosthetic fracture after total hip arthroplasty. Material and Method: This study involved 12 patients that we experienced over the period of two years. The fractures were classified by the Vancouver classification. Six patients were treated with open reduction and internal fixation and another six patients were treated using revision with a long femoral stem. The results were evaluated using the Johansson method. R e s u l t s: Bony union was achieved in all patients and there was no case of femoral stem loosening. The mean Harris hip score was 89 at the final follow-up. Conclusion: We believe that in the case of periprosthetic fracture after total hip arthroplasty, open reduction and internal fixation for a stable prosthesis or revision with a long femoral stem for an unstable prosthesis both lead to good results.
참고문헌 (24)
- "Fractures of the femurduring total hip replacement and their management. JBone Joint Surg", pp.59 36~41 (1977)
- "Periprosthetic fractures of thefemur An analysis of 93 fractures.", 327, pp.238~246 (1996)
- "P r o x i m a lfemoral fractures following total hip total hip arthroplasty.Orthopedics", pp.751~753 (1992)
- "M a n a g e m e n tof intraoperative femur fractures associated with revision hiparthroplasty. Clin Orthop", pp.177~180 (1989)
- "Committee on the hip Classification and management offemoral defects in the total hip replacement {exhibit}.Presented at the 57th Annual Meeting of the AmericanAcademy of Orthopaedic Surgeons", pp.8~13 (1990)
- "Fractures of the femur inrelation to cemented hip prostheses. J Bone Joint Surg", pp.70 385~389 (1988)
- "Fractures of the femur afterhip arthroplasty. Instructional Course Lectures. 44", 44, pp.293~304 (1995)
- "Periprostheticfractures of the femur An analysis of 93 fractures.", 327, pp.238~246 (1996)
- "Femoral shaft fractures after cemented total hiparthroplasty. Int Orthop", pp.97~100 (1992)
- "Femoral lysis after cemented hiparthroplasty. J Arthroplasty", pp.285~297 (1988)
- "F r a c t u r eof the ipsilateral femur in patients with total hip replacement.J Bone Joint Surg", pp.1435~1442 (1981)
- "Femoral fractures associated with totalhip arthroplasty. Orthop Clin N Am", pp.249~257 (1992)
- "Management of ipsilateal femoral fracture after hip arthroplasty", 32, pp.1575~1583 (1997)
- "B y p a s s i n gfemoral cortical defects with cemented intramedullarystems. J Orthp Res", pp.414~421 (1991)
- "Femoral and pelvicfractures after total hip arthroplasty. Orthopedics.13", pp.1188~1189 (1990)
- "Circular constriction in the treatment offractures of the long bones", 23, pp.541~544 (1996)
- "Management of periprosthetic femoral fractures", 18, pp.18 903~906 (2003)
- "Perforation ofthe femoral shaft during total hip replacement", pp.62 234~240 (1980)
- "Trochanteric fixation by cable grip in hip replacement. JBone Joint Surg", pp.580~581 (1991)
- "Fracture of the femur aftertotal hip arthroplasty. Orthopedics", pp.1067~1070 (1989)
- "A complication of total hip reconstruction.Clin Orthop", pp.158~165 (1979)
- "Miller TO and Stamp WG", pp.67 956~958 (1985)
- "Fracture ofthe ipsilateral femur in patients with the total hiparthroplasty. J of Korean Orthop Assoc", pp.1058~1066 (1991)
- "Ogden plateand other fixation for fractures complicating femoralendoprosthesis. Clin Orthop", pp.83~90 (1988)