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Sawbones 모형에서 비구 횡 골절 정복의 시뮬레이션

Simulation for Reduction of Transverse Acetabular Fractures in Sawbones Models

대한골절학회지 2019년 32권 4호 p.196 ~ 203
변성은, Mauffrey Cyril, 유제현, 박창원, 황지효,
소속 상세정보
변성은 ( Byun Seong-Eun ) - 차의과학대학교 분당차병원 정형외과
 ( Mauffrey Cyril ) - University of Colorado Denver Health Medical Center Department of Orthopaedic Surgery
유제현 ( Yoo Je-Hyun ) - 한림대학교 의과대학 성심병원 정형외과학교실
박창원 ( Park Chang-Won ) - 한림대학교 의과대학 강남성심병원 정형외과학교실
황지효 ( Hwang Ji-Hyo ) - 한림대학교 의과대학 강남성심병원 정형외과학교실

Abstract


Purpose: The transversely oriented fracture lines are very difficult to reduce during operations, even after clear exposure of the fracture site, in acetabular fractures. The purpose of this study is to verify the quality of reduction between the different subtypes (transtectal, juxtatectal, and infratectal) of transverse fractures. This study also determined the proper type of clamps to use and the proper zone for achieving accurate reductions in Sawbones models.

Materials and Methods: Six fractures in 3 different subtypes of transverse fractures were artificially created. Ten different reduction clamps were applied for reduction of the fractures. Twelve holes around the fracture were drilled for the maintenance of the clamps. The fracture displacements were measured at the extra-articular area and the intra-articular joint portion. The pictures of the intra-articular fracture displacements were taken by a camera and these were uploaded and analyzed by the TraumaCad® computer program (Brainlab).

Results: The reduction quality was poor in order of transtectal, juxtatectal and infratectal. The intraarticular opening was more prominent in the transtectal subtype. The safe zone, when giving consideration of the neurovascular bundles, was a quadrilateral surface of the ilium. Drill holes are useful for maintenance of the reduction clamps. Reduction clamps with points (Weber clamp) were the best for maintenance and accurate reduction. Regarding the concerns of placement of clamps, the middle to posterior combination was the best. The upper hole among the posterior holes in the ilium was the most likely to well reduce the intra-articular opening.

Conclusion: Transtectal was the more complicated subtype in the aspect of reduction quality. The Weber type reduction clamp was the best for reduction by centrally located holes in the quadrilateral surface and posteriorly located iliac holes in transverse acetabular fractures. The upper hole, among the posterior holes in the ilium, was the best for reduction of the fracture displacements in the intraarticular portion of acetabulum.

키워드

Transverse acetabular fracture; Reduction clamp; Sawbones

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