CAJ | 학술논문

目的探讨治疗同侧股骨近段合并股骨干骨折合理的治疗方法.方法 1999年至2009年我院52例手术病人,分别经由延长型PFNA及其他手术方式(股骨重建髓内钉、长DHS或者分别内固定处理).结果随访4～25个月,平均9.3月.骨折均愈合,分别固定手术复位较好但是功能差愈合时间长,用一套内固定物整体固定复位效果理想并且功能良好,其中应用延长型PFNA统计结果最好.结论在同侧股骨近段合并股骨干骨折,整体固定优于分别固定,髓内固定优于髓外固定.同时长PFNA因为力学设计和手术步骤设计方面的优势使得在处理相关骨折时较有优势.以及长PFNA手术时应注意的一些问题.
목적 탐토치료동측고골근단합병고골간골절합리적치료방법.방법 1999년지2009년아원52례수술병인,분별경유연장형PFNA급기타수술방식(고골중건수내정、장DHS혹자분별내고정처리).결과 수방4～25개월,평균9.3월.골절균유합,분별고정수술복위교호단시공능차유합시간장,용일투내고정물정체고정복위효과이상병차공능량호,기중응용연장형PFNA통계결과최호.결론 재동측고골근단합병고골간골절,정체고정우우분별고정,수내고정우우수외고정.동시장PFNA인위역학설계화수술보취설계방면적우세사득재처리상관골절시교유우세.이급장PFNA수술시응주의적일사문제.
Objective To find an appropriate way in surgery treatment of ipsilateral femoral proximal fracture combine with shaft fracture.Methods We retrospectively analyzed 52 cases which came across holistic fixation [Long proximal femoral nail anti-rotation (PFNA)\Long dynamic hip screw (DHS)] or separate fixation surgery in our department from 1999 to 2009.Results All cases were followed-up for 4 to 25 months,average of 9.3 months.All of them got heal.Separate fixation group was good in reduction but worse in function and a longer healing time.Holistic fixation group was reliable in reduction and best in function.Conclusion In this circumstance holistic fixation is better than separate fixation.Intramedullary nail is better than plate.Long PFNA showed a better result in this study than any other methods,probably because of its unique structure and operation procedure.And some critical points should be focused during Long PFNA and reconstruction nail.