고령에 발생한 대퇴 전자부 불안정 골절에 대한 일차성 고관절 반치환술 = Primary Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fracture of the Femur in Elderly Patients

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to evaluate the effectiveness and advantage of bipolar hemiarthroplasty in the treatment of an unstable femoral intertrochanteric fracture in elderly patients.
Materials and Methods: 54 patients (mean age 74 year old) were reviewed, and followed for more than one year. The subjects were divided into two group, as follows, the Group I (n=34, <Singh index 3, more than 70 year old) were treated with a bipolar hemiarthroplasty, and Group II (n=20; with same condition as Group I) were treated with a compression hip screw. The results were analyzed and clinically reviewed.
Results: Group I patients showed satisfactory results compared to those in Group II using the Merle D'Aubigne hip rating scale. Complications occurred in 2 cases in Group I and 14 in Group II.
Conclusion: It is suggest that bipolar hemiarthroplasty may be used as the first treatment of choice for osteoporotic elderly patients with an unstable intertrochanteric fracture, especially those with combined medical problems or a poor general condition.

국문 초록 (Abstract)

목적: 고령이면서 골다공증이 심한 불안정 대퇴전자간 골절의 치료에 있어서 일차성 고관절 반치환술을 시행한 집단과 압박고 나사못 고정술을 시행한 집단과 결과를 비교분석하고 그 결과로 양극성 고관절 반치환술의 임상적 유용성을 알아보고자 한다.
대상 및 방법: 1992년 1월부터 2002년 12월까지 대퇴골 전자간부 불안정 골절 진단하에 수술을 시행 받은 환자중 1년이상 추시 가능하였던 환자에서, 70세 이상으로 Singh index 3 이하의 골다공증 환자인 경우로 동반질환이 있거나 전신상태가 불량한 환자에서 양극성 고관절 반치환술을 시행한 34례(Group I), Group I과 동일한 조건에서 압박고 나사못 고정술을 시행한 20례(Group II)를 총 54례를 대상으로 하여 Merle d’Aubigne의 고관절 기능 평가법에 따라 3,6, 12개월에 각각의 Group의 고관절 기능을 평가하고 그 치료 결과를 비교분석 하였다.
결과: Group I(n=34)과 Group II(n=20)에서 Merle d’Aubign 고관절 기능 평가법에 의해 양호이상 결과가 나타난 경우가 술후 3개월때 3 0례( 8 9 % )와 1 4례(70%), 술후 6개월때 2 9례( 8 5 % )와 1 0례(50%), 술후 1 2개월때 2 8례(82%)와 0례(0%)로 측정되었다.
결론: 70세 이상 고령의 불안정성 대퇴 전자간 골절 환자에서 특히 골다공증이 심한 경우나 동반질환이 존재하거나 전신 상태가 불량한 경우에서 장기간의 침상안정으로 발생할 수 있는 술후 합병증을 감소시키고 조기보행을 가능하게 할 수 있는 양극성 고관절 반 치환술이 일차적 치료법으로 제시될 수 있을 것으로 사료된다.

참고문헌 (Reference)

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