CAJ | 학술논문

目的探讨AO技术治疗股骨转子部骨折的并发症和防治对策。方法回顾性分析总结1990年1月～1998年12月采用AO技术(包括130°角钢板，95°髁钢板，动力髋螺钉和动力髁螺钉)治疗137例患者中出现的46例67处术后并发症。结果三种内固定均有并发症出现。67处并发症包括下肢旋转畸形16处，成角畸形1处，髋内外翻13处，小粗隆未复位7处，内固定失败7处，晚期髋内翻6处，髋关节痛3例，膝关节僵硬5处，膝关节疼痛3处，骨折延迟愈合6处。结论造成并发症的原因是多方面的。主要有手术时机延误导致手术难度的增加，对骨折类型了解分析不充分；手术操作不规范，对所使用器材的设计特点、使用要领不熟悉；术后忽视康复指导和功能锻炼不当以及过早负重。据此提出预防对策：早期手术，遵循AO技术规范进行操作，术后重视康复治疗。
목적 탐토AO기술치료고골전자부골절적병발증화방치대책。방법회고성분석총결1990년1월～1998년12월채용AO기술(포괄130°각강판，95°과강판，동력관라정화동력과라정)치료137례환자중출현적46례67처술후병발증。결과삼충내고정균유병발증출현。67처병발증포괄하지선전기형16처，성각기형1처，관내외번13처，소조륭미복위7처，내고정실패7처，만기관내번6처，관관절통3례，슬관절강경5처，슬관절동통3처，골절연지유합6처。결론조성병발증적원인시다방면적。주요유수술시궤연오도치수술난도적증가，대골절류형료해분석불충분；수술조작불규범，대소사용기재적설계특점、사용요령불숙실；술후홀시강복지도화공능단련불당이급과조부중。거차제출예방대책：조기수술，준순AO기술규범진행조작，술후중시강복치료。
Objective To discuss the complications and preventive measures for treatment of femoral trochanteric fractures by AO technique. Methods Forty six cases (67sites) of complications which occurred during the 137 consecutive cases of femoral trochanteric fracture in Jun. 1990 ～Dec. 1998 were reviewed, and the causes of complications were analyzed. Results The complications included 16 lower extremity rotatary deformity, one angled deformity, 13 deformity of hip, 7 non-reduction of trochanter minor fracture, 7 failure in fixation , 6 delayed varus deformity of hip, 3 hip pain, 5 stiffness of the knee, 3 knee pain and 6 delay healing. Conclusion The causes of complications were polyergic as follows: the delay of the opportunity of the operation. the unfamiliar of fracture type; the non-standard AO technique; the ignorance of the physical therapy. Appropriate preventive measures were presented which emphasized the proper operative opportunity, the standard AO technique and importance of the physical therapy