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대퇴골 간부 골절에 대한 골수강내 금속정 치료 후 발생한 비후성 불유합에서 금속정 교환술의 결과

Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing

대한골절학회지 2019년 32권 2호 p.83 ~ 88
조석정, 이광철, 이상홍, 이준영, 김동휘, 박성해, 조영민,
소속 상세정보
조석정 ( Jo Seok-Jung ) - 조선대학교 의학전문대학원 정형외과학교실
이광철 ( Lee Gwang-Chul ) - 조선대학교 의학전문대학원 정형외과학교실
이상홍 ( Lee Sang-Hong ) - 조선대학교 의학전문대학원 정형외과학교실
이준영 ( Lee Jun-Young ) - 조선대학교 의학전문대학원 정형외과학교실
김동휘 ( Kim Dong-Hwi ) - 조선대학교 의학전문대학원 정형외과학교실
박성해 ( Park Sung-Hae ) - 조선대학교 의학전문대학원 정형외과학교실
조영민 ( Cho Young-Min ) - 조선대학교 의학전문대학원 정형외과학교실

Abstract


Purpose: This study examined the outcomes of exchange nailing for the hypertrophic nonunion of femoral shaft fractures treated with intramedullary nailing as well as the factors affecting the treatment outcomes.

Materials and Methods: From January 1999 to March 2015, 35 patients, who had undergone intramedullary nailing with a femoral shaft fracture and underwent exchange nailing due to hypertrophic nonunion, were reviewed. This study investigated the time of union and complications, such as nonunion after exchange nailing, and analyzed the factors affecting the results.

Results: Bone union was achieved in 31 cases (88.6%) after exchange nailing and the average bone union period was 22 weeks (14?44 weeks). Complications included persistent nonunion in four cases, delayed union in one case, and superficial wound infection in one case. All four cases with nonunion were related to smoking, three of them were distal shaft fractures, and one was a midshaft fracture with underlying disease.

Conclusion: Exchange nailing produced satisfactory results as the treatment of hypertrophic nonunion after intramedullary nailing. Smoking is considered a factor for continuing nonunion even after exchange nailing. In the case of a distal shaft, where the intramedullary fixation is relatively weak, additional efforts are needed for stability.

키워드

Femur; Nonunion; Exchange; Intramedullary nailing

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