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成人大腿骨幹骨折의 治療

Femoral Shaft Fractures in Adult

대한정형외과학회지 1969년 4권 1호 p.35 ~ 39
기우성, 林采駿,
소속 상세정보
기우성 (  ) - 제17육군병원 정형외과
林采駿 (  ) - 第17陸軍病院 整形外科

Abstract


Clinical analysiss of fracture of femoral shaft in 73 cases treated at the 17 Army Hospital during; the period from May 1965 to July 1968 is presented.
1) All the patient were males and in the 3rd decade of life.
2) Sites of fracture were 28 in midshaft, 23 in lower one-third, 22 in upper one-third, and 29 cases had open fracture.
3) 32 cases(43. 8%) were injured by traffic accident which is the most common cause in this series. 4) Conservative treatment was given in 30 cases, plate fixation in 15 cases, and Kuentscher type of¬I. M. nailing in 28 cases.
5) Criteria evaluating the results were;
knee joint motion, length & alignment of the femur, and pain during weight bearing.
6) Severely comminuted fracture tends to deserve conservative measure only and sites of fracture´
contraindicated for I. M. nailing were best treated by plate or screw fixation.
7) A comparison has been made between the functional results treated by conservative method. and
open reduction (plate & screw fixation and I. M. Kuentscher nailing).
Excellent or good results were obtained, by conservative (30 cases), plate and screw fixation .
(15cases),and I. M. Kuentscher nailing(28cases), in 46.7%, 60%, and 60.7% respectively.
Functional results were slightly better in I. M. nailing than the other two methods. 8) Time of complete healing by solid bone union was;
6.5 months in (30 cases of) conservative treatment, 6 months in (10 cases of) plate and screw fixation, and 5.5 months in (22 cases of) I. M. Kuentscher nailing.
9) Postoperative infection rate(severe enough to interfere healing) was 6.6% (only one case) of plate group and 3.6%(only one case) of I. M. nailing group.

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