CAJ | 학술논문

目的探讨新型通用锁定系统(GLS)钢板治疗复杂骨折的初期临床疗效。方法 2010年1月至12月采用GIS钢板治疗10例复杂四肢及骨盆骨折患者，男7例，女3例；年龄23 ～52岁，平均35.2岁。其中尺桡骨远端陈旧性骨折骨不连1例，前臂骨干骨折3例（AO分型：22B2型1例，C2型2例），骨盆骨折4例（Tile分型：B2.2型2例，C2型2例），胫腓骨骨干骨折2例（AO分型：42B2型1例,C1型1例）。对患者骨折愈合及并发症发生情况等进行回顾性分析。结果 9例患者术后获平均7个月（3 ～12个月）随访。全部伤口均一期愈合。X线片示所有患者均获骨性愈合或融合，愈合时间平均为14周（10～ 28周），术后无内固定松动、断裂，肌腱激惹、股神经和股外侧皮神经损伤及深静脉血栓形成等并发症发生。1例Tile分型为C2型的骨盆骨折患者残留臀部后方疼痛伴跛行，其余患者功能均恢复良好。4例前臂骨折患者DASH评分平均为18.2分（0～38.5分）；3例骨盆骨折患者采用Harris髋关节评分评定疗效：优2例，良1例；2例胫腓骨干骨折患者采用SF-36量表评定疗效：均为优。结论新型GLS钢板为复杂骨折的临床治疗提供了更多的个性化选择，尤其适用于骨干部多节段复杂骨折的治疗。
목적 탐토신형통용쇄정계통(GLS)강판치료복잡골절적초기림상료효。방법 2010년1월지12월채용GIS강판치료10례복잡사지급골분골절환자，남7례，녀3례；년령23 ～52세，평균35.2세。기중척뇨골원단진구성골절골불련1례，전비골간골절3례（AO분형：22B2형1례，C2형2례），골분골절4례（Tile분형：B2.2형2례，C2형2례），경비골골간골절2례（AO분형：42B2형1례,C1형1례）。대환자골절유합급병발증발생정황등진행회고성분석。결과 9례환자술후획평균7개월（3 ～12개월）수방。전부상구균일기유합。X선편시소유환자균획골성유합혹융합，유합시간평균위14주（10～ 28주），술후무내고정송동、단렬，기건격야、고신경화고외측피신경손상급심정맥혈전형성등병발증발생。1례Tile분형위C2형적골분골절환자잔류둔부후방동통반파행，기여환자공능균회복량호。4례전비골절환자DASH평분평균위18.2분（0～38.5분）；3례골분골절환자채용Harris관관절평분평정료효：우2례，량1례；2례경비골간골절환자채용SF-36량표평정료효：균위우。결론 신형GLS강판위복잡골절적림상치료제공료경다적개성화선택，우기괄용우골간부다절단복잡골절적치료。
Objective To observe clinical efficacy of the Zimmer general locking system (GLS) in management of complex fractures.MethodsFrom January to December 2010, 10 fracture patients were managed with GLS. They were 7 men and 3 women, with an average age of 35.2 years (from 23 to 52 years) .There were one case of fracture nonunion of distal radius and ulnas, 3 cases of shaft fractures of forearm (by AO classification: one 22B2 and 2 C2), 2 cases of tibial and fibular shaft fracture (by AO classification: one 42B2 and one C1 ), and 4 cases of pelvic fracture(by Tile classification: 2 B2.2 and 2 C2). Fracture healings and complications were analyzed retrospectively.Results Nine patients were followed up for an average of 7 months (from 3 to 12 months). Radiographic bone union was achieved in all cases for an average of 14 weeks (from 10 to 28 weeks) without infection, implant loosening, tendon irritation, injury to the lateral femoral cutaneous nerve or the femoral nerve, or deep vein thrombosis. All patients obtained normal functions except one Tile C2 case who experienced residual pain and claudication. The 4 cases of forearm fracture obtained an average DASH (Disabilities of the Arm, Shoulder and Hand) score of 18.2 points (from 0 to 38.5points). By HSS (Harris Hip Score) system, the 3 cases of pelvic fractures were rated as excellent (in 2) and good (in one). By the SF-36 scale system, the 2 cases of tibial and fibular shaft fracture were both excellent. ConclusionGLS offers a new option for complex fractures, especially multi-segmental shaft ones.