성인 대퇴골 간부골절에 대한 임상적 고찰

Abstract

The management of fractures of the femur has presented a challenge to the physician since the origin of orthopedic surgery. Furthermore advances in mechanization and acceleration of travel have been accompanied by an increase in the mem ; er and severity of fractures and those in the shaft of the femur are no exception. The available literature on those fractures and experience -with 188 fractures of the femoral shaft of adults seen at the Keimyung University Dong San Medical Center over a period of 4 years and 6 months have been reviewed. The results were as follows 1. The fractures occured commonly in the 21—40 years age group (55.7%) in adult. Males comprised cases (72. 6%). 2. Fractures were caused by traffic accident (69.7%) mainly. Pedestrian injuries were particularity common. 3. Closed fractures were 146 cases, most frequent site was at the middle third of femoral shaft and comminuted fractures were most common. 4. Associated injuries were common in 102 cases and in order of frequency these were fractures of tibia and fibula, pelvic bone, skull, ribs and others. 5. The period of bony union was 18.2 weeks with sskeletal traction and cast immobilization, 16.5 weeks with Klintscher nailing, 19.0 weeks with ordinary plate and 14.2 weeks with compression plate. 6. The optimal operation time was 8th day to 21th day from trauma, that attained primary union (90. 0%) mostly. 7. The period of postoperative immobilization was 4.6 weeks with Klintscher nailing, 9.8 weeks with ordinary plate and 7.2 weeks with commpression plate. This short immobilization period was reinforced with cautious non-weight bearing crutch walking and ischial weight bearing long leg brace. 8. Complications were developed in order of frequency limitation of motion of knee, delayed union, infection and nonunion. But each problem were improved with continuous vigorous physical therapy, bone graft and antibiotics instillating.