비구골절의 치료
Treatment of the Acetabular Fracture
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초록
고 에너지 손상으로 발생하는 비구 골절은 골절 기전에 따라 다양한 형태를 보이며 복잡한 해부학 구조물로 이루어져 있다. 진단은 일반 방사선 사진과 함께 입체적인 영상 파악이 요구되므로 3차원적컴퓨터 단층 촬영을 시행하는 것이 필요하다. 치료 방법으로는 보존적 치료, 관혈적 정복술 및 내고정술, 경피적 나사 고정술, 일차적 인공 고관절 전 치환술 등을 시행할 수 있다. 그러나 많은 동반손상과 불량한 골질의 상태, 골절의 분쇄 및 관절면의 손상등으로 인하여 치료가 난해하고 혈전 색전증, 외상성 골관절염, 무혈성 괴사증, 감염, 신경마비, 이소성 골형성 등 합병증의 발생률이 높다. 그러므로 골절을 정확히 분류하고 가능한 해부학적 고정및 견고한 내고정을 통한 조기 재활을 시행해야하며, 발생 가능한 합병증을 예방하는데 주의가 필요하다.
Abstract
Acetabular fractures resulting from a high-energy injury show variable forms according to each fracture mechanism, and are composed of complex anatomical structures. Plain radiographs accompanying threedimensional computer tomography is inevitable, because it is necessary to perform a multidirectional imaging analysis as a diagnosis. Conservative treatment, open reduction with internal fixation, percutaneous screw fixation, and primary artificial hip replacement can be performed. Despite the various treatment methods to the associated injuries, such as comminuted fracture, articular surface injury, poor bone quality and etc, are huge burden for the treatment. Further, there are varying complications, such as thromboembolism, post-traumatic osteoarthritis, avascular necrosis, infection, nerve palsy, heterotopic bone formation and etc. Therefore,physicians need to an accurate classification of fracture and be able to provide rehabilitation, as soon as possible,after rigid internal fixation via open anatomical articular reduction. also In addition, physicians must also pay great attention to prevent complications.
참고문헌 (27)
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