상완골 간부 단순 골절에서 최소 침습적 금속판 골유합술을 이용한 치료

국문 초록 (Abstract)

목적: 상완골 간부 단순 골절의 수술적 치료에서 잠김 압박 금속판을 이용한 최소 침습적 금속판 골유합술의 임상적 및 방사선학적 결과를 분석하였다.
대상 및 방법: 2010년 8월부터 2011년 5월까지 상완골 간부 단순 골절 골절에 대해 최소 침습적 금속판골 유합술을 통해 수술을 시행하고 전향적으로 12개월 이상 추시한 6례의 환자를 대상으로 하였으며, 임상적 및 방사선학적 골유합 기간 및 술 후 관절 운동 범위와 기능을 확인하였다.
결과: 임상적 및 방사선학적 평균 골유합 기간은 각각 7.2주, 8주였다. 술 후 골 정렬에서 전후상 평균 2.8도, 측면상 내반 2도의 변형을 보였다. 술 후 12개월째 견관절 운동 범위는 전방거상 167도, 외회전 50도, 내회전 수위는 흉추 11번이었고, 평균 VAS는 1.2점, KSS는 91.3점, ASES는 26.5점, UCLA 점수는 31.5점이었다.
결론: 상완골 간부 단순 골절의 수술적 치료에서 최소 침습적 금속판 골유합술은 방사선학적 및 기능적으로 우수한 결과를 보였으며 상완골 간부 단순 골절에서 고려해 볼 수 있는 유용한 치료 방법 중 하나라고 생각된다.

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study is to evaluate the clinical and radiological outcomes of treatment of humerus shaft simple fracture by minimally invasive percutaneous osteosynthesis (MIPO) technique using locking compression plate (LCP).
Materials and Methods: Six patients who were operated for humerus shaft simple fracture from August 2010 to May 2011 were enrolled for this study. We checked the cause of injury and the accompanying injuries and evaluated the operation time, the clinical and radiological period of union, postoperative range of motion of the shoulder and elbow joint, pain, activities in daily living, radiologic alignment, and other complications.
Results: The clinical period of bone union was 7.2 weeks on average, and the radiologic period of bone union was 8 weeks on average. Follow-up period was more than 12 months in all cases. The angulation through postoperative alignment was 2.8 degrees in AP view and 2 degrees in lateral view. The postoperative range of motion was 167 degrees in forward flexion, 50 degrees in external rotation, and thoracic vertebra 12 level in internal rotation. The average value of visual analogue scale (VAS) was 1.2 and that of KSS was 91.3. The American Shoulder and Elbow Surgeons’ score (ASES) was 26.5 and the UCLA score was 31.5.
Conclusion: MIPO technique for the humerus shaft simple fracture showed good functional and radiological outcomes and may be considered as one of the treatment options for humerus shaft simple fracture.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• REFERENCES
• 초록

참고문헌 (Reference)

1 변영수, "최소 침습적 금속판 골유합술" 대한골절학회 20 (20): 18-18, 2007

2 Collinge C, "Treatment of complex tibial periarticular fractures using percutaneous techniques" 375 : 69-77, 2000

3 Bae SW, "Postoperative functional assessments in adult humerus shaft fractures-comparison among plates and screws, intramedullary nail and external fixator" 14 : 228-235, 2001

4 Mast J, "Planning and reduction technique in fracture surgery" Springer- Verlag 48-200, 1989

5 Volgas DA, "Nonunions of the humerus" 419 : 46-50, 2004

6 Shin SJ, "Minimally invasive plate osteosynthesis of humeral shaft fractures: a technique to aid fracture reduction and minimize complications" 26 : 585-589, 2012

7 Shetty MS, "Minimally invasive plate osteosynthesis for humerus diaphyseal fractures" 45 : 520-526, 2011

8 Concha JM, "Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible?" 34 : 1297-1305, 2010

9 Apivatthakakul T, "Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible?" 36 : 530-538, 2005

10 Krettek C, "Minimally invasive percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures" 28 : 20-30, 1997

11 Schutz M, "Minimally invasive fracture stabilization of distal femoral fractures with the LISS: a prospective multicenter study. Results of a clinical study with special emphasis on difficult cases" 32 : 48-54, 2001

12 Gautier E, "Guidelines for the clinical application of the LCP" 34 : 63-76, 2003

13 Wagner M, "General principles for the clinical use of the LCP" 34 : 31-42, 2003

14 Michael D, "Fractures of the humeral shaft" Lippincott Williams & Wilkins 1117-1159, 2006

15 Gregory PR., "Fractures of the humeral shaft" Lippincott Williams & Wilkins 973-996, 2001

16 Schemitsch EH, "Fractures of the diaphyseal humerus" Saunders 1481-1511, 2001

17 Stannard J P, "Fracture stabilization of proximal tibial fractures with the proximal tibial LISS: early experience in Birmingham, Alabama (USA)" 34 : 36-42, 2003

18 Perren SM, "Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation; choosing a new balance between stability and biology" 84 : 1093-1110, 2002

19 Fears RL, "Diagnosis and treatment of complications" Saunders 567-578, 1998

20 Ruedi TP, "AO principles of fracture management" Thieme 139-305, 2000

21 Tong GO, "AO manual of fracture management. Minimally invasive plate osteosynthesis (MIPO)" Thieme 66-325, 2007