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Results of Intramedullary Nailing of Femoral Shaft Fracture - Trochanteric Entry Portal (Sirus Nail) versus Piriformis Entry Portal (M/DN Nail) -
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ÇÏ»óÈ£(Ha Sang-Ho) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ Á¤Çü¿Ü°úÇб³½Ç
±è¿õÈñ(Kim Woong-Hee) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ Á¤Çü¿Ü°úÇб³½Ç
À̱¤Ã¶(Lee Gwang-Chul) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ Á¤Çü¿Ü°úÇб³½Ç
Abstract
¸ñÀû: ´ëÅð °£ºÎ °ñÀý ±Ý¼ÓÁ¤ »ðÀÔ¼ú Ä¡·á¿¡¼ ÀÌ»ó¿Í ¹× ´ëÀüÀÚ »ðÀÔÁ¡À» ÀÌ¿ëÇÑ Ä¡·á °á°ú¸¦ ºñ±³ÇÏ°íÀÚ ÇÏ¿´´Ù.
´ë»ó ¹× ¹æ¹ý: 2001³â 2¿ùºÎÅÍ 2010³â 5¿ù±îÁö ´ëÅð °£ºÎ °ñÀý¿¡¼ °ñ¼ö° ³» ±Ý¼ÓÁ¤ »ðÀÔ¼úÀ» ½ÃÇàÇÑ 432¿¹ Áß ´ëÀüÀÚ »ðÀÔÁ¡À» ÀÌ¿ëÇÑ 180¸íÀ» 1±º, ÀÌ»ó¿Í »ðÀÔÁ¡À» ÀÌ¿ëÇÑ 170¸íÀ» 2±ºÀ¸·Î ÇÏ¿© °á°ú¸¦ Á¶»çÇÏ¿´´Ù.
°á°ú: ¾ç ±º¿¡¼ ±â´É Á¡¼ö, ¿îµ¿ ¹üÀ§, À¯ÇձⰣ ¹× Á¤·ÄÀº À¯»çÇÏ¿´´Ù. ¼ö¼ú ½Ã°£Àº °úüÁß±º¿¡¼ 1±º¿¡¼ 92ºÐ, 2±º¿¡¼ 120ºÐÀ¸·Î Åë°èÀûÀ¸·Î À¯ÀÇÇÑ Â÷ÀÌ°¡ ÀÖ¾ú´Ù. ÃâÇ÷·®Àº 1±º¿¡¼ 280 ml, 2±º¿¡¼ 336 ml·Î Â÷ÀÌ°¡ ÀÖ¾ú°í, °úüÁßÀÏ °æ¿ì 2±º¿¡¼ ¸¹Àº ÃâÇ÷·®À» º¸¿´´Ù. C-Çü Åõ½ÃÀåÄ¡ ³ëÃ⠽ð£Àº 2±ºº¸´Ù 1±º¿¡¼ Àû°Ô ³ªÅ¸³µÁö¸¸ Åë°èÀû À¯ÀǼºÀº ¾ø¾ú´Ù. ºÒÀ¯ÇÕÀº 10¿¹, 11¿¹, Áö¿¬À¯ÇÕÀº °¢°¢ 4¿¹·Î ºñ½ÁÇÏ¿´´Ù. ÀÇÀμº °ñÀýÀº 18¿¹, 4¿¹·Î 1±º¿¡¼ ºóµµ°¡ ³ô¾ÒÀ¸¸ç Åë°èÀûÀ¸·Î À¯ÀÇÇÑ Â÷À̸¦ º¸¿´´Ù.
°á·Ð: µÎ ±º¿¡¼ ÀÓ»óÀû ¹× ¹æ»ç¼±ÇÐÀû °á°ú, ÇÕº´Áõ µîÀº Å« Â÷ÀÌ°¡ ¾ø¾ú´Ù. ´ëÀüÀÚ »ðÀÔÁ¡À» ÀÌ¿ëÇÑ °æ¿ì ¼ö¼ú ½Ã°£ÀÌ ´õ ª°í ÃâÇ÷·®ÀÌ Àû¾úÀ¸¸ç ÀÇÀμº °ñÀýÀÇ ºóµµ´Â ´õ ³ô¾Ò´Ù.
Purpose: To compare treatment results obtained using the trochanteric (Sirus nail) entry portal with those obtained using the Piriformis fossa (M/DN) entry portal during intramedullary (IM) nailing of femur shaft fractures.
Materials and Methods: Four hundreds and thirty-two patients treated for femur shaft fracture using IM nails from February, 2001 to May, 2010 were divided into two groups. group 1 was composed of 180 patients treated through the trochanteric (Sirus nail; n=180) entry portal, while group 2 contained 170 patients treated through the piriformis fossa (M/DN nail; n=170) entry portal. We compared the clinical and radiographic findings of both groups to evaluate the treatment results.
Results: Functional result, range of motion and union time (18, 20 weeks) were similar in both groups. The operation time of patients in the over-weighted group was 90 minutes in group 1 and 120 minutes in group 2 (p£¼0.05). Additionally, the blood loss was 280 ml in group 1 and 335 ml in group 2, and in case of over-weight patients, group 2 showed more blood loss (p£¼0.05). The duration of exposure to fluoroscopy differed slightly, with group 1 being less exposed than group 2; however, this difference was not significant (p£¾0.05). There were 18 iatrogenic fractures in group 1 and 4 in group 2 (p£¼0.05).
Conclusion: There was not much difference in complications based on clinical and radiographic findings of both groups. For groups using the trochanteric entry portal, the operation time was shorter and blood loss was lower than in groups using the piriformis entry portal. Iatrogenic fracture occurred more often in the group using the trochanteric entry portal than in the group using the piriformis entry portal.
Å°¿öµå
ÀüÀÚºÎ, ÀÌ»ó¿ÍºÎ, ´ëÅð°ñ °ñÀý, ³»°íÁ¤¼ú, °ñ¼ö°³» ±Ý¼ÓÁ¤
Trochanter, Piriformis fossa, Femoral fracture, Internal fixation, Intramedullary Nail, Sirus, M/DN
KMID :
0386420140270010050
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