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Galeazzi 골절의 임상적 고찰

Other Titles
 Clinical study of galeazzi's fracture 
Authors
 이정모 
Issue Date
1987
Description
의학과/석사
Abstract
[한글]Galeazzi 골절은 하요척관절의 탈구가 동반된 요골 간부의 골절을 말한다. 이 골절의 특징은 상완요골근, 방형회내근, 무지신전근 및 외전근에 의한 요골의 단축 및 회전과 하 요척관절의 탈구로 변형이 초래되는 것이다. 그러므로 보존적 치료 보다는 수술적 치료에

의한 견고한 내고정술로서 만족할만한 결과를 얻을 수 있다.

이에 저자는 1978년 1월부터 1986년 12월 까지 연세대학교 원주의과대학 정형외과학 교실에서 치료받고 추시관찰이 가능하였던 28례의 Galeazzi 골절 환자를 대상으로 골절의 원인, 골절의 양상, 치료 방법 및 결과에 대해 임상적 분석을 하여 다음과 같은 결론을

얻었다.

1. 총 28례 중 소아 2례, 성인 26례로 소아에서는 드물게 나타났고 남자 24례, 여자 4례로 남자에서 6배 높은 빈도를 보였다.

2. 수상 원인으로는 교통사고 10례(36%), 추락 8례(29%) 기계에 의한 손상 5례(18%), 직접 타박 4례(14%), 폭발사고 1례(3%)순 이었다.

3. 요골 골절의 부위는 요골 중하1/3 접합부가 13례(47%), 중간1/3 부위 8례(29%) 상중1/3 접합부 4례(14%), 원위1/3부위 2례(7%), 근위1/3 부위 1례(3%) 순으로 나타났고 중하1/3 접합부가 47%로 제일 높은 빈도를 보였다.

4. 요골 골절의 양상은 단순 골절이 21례(78%), 분쇄 골절이 7례(22%)였고 단순 골절은 횡골절 11례 사골절 9례, 및 나선형 골절 1례가 있었다. 또한 폐쇄성 골절은 22례(81%), 개방성 골절은 6례(19%)이었고 2례에서 grade Ⅲ의 연부조직 손상이 있었다.

5. 하요척관절의 탈구는 23례(82%)에서 방사선 사진상 진단이 가능하였다.

6. 동반손상은 총 16례(57%)에서 있었으며 두부 손상이 6례, 수부 손상이 4례, 하지 손상이 2례, 척추 손상이 2례, 장골 및 상완골 골절이 각각 1례씩 있었다.

7. 총 28례 중 5례는 보존적 치료를 하여 우수 1례, 양호 2례, 불량 2례를 보였으며 22례는 관혈적 정복 및 내고정술로 치료하여 우수 13례, 양호 8례, 불량 1례로 나타났고 금속판 고정술이 골수강내 고정술보다 결과가 좋은 것으로 나타났다. 또 1례에서 외고정술

을 시행하여 불량한 결과를 얻었다.

8. 합병증으로는 지연 유합과 하요척 관절의 아탈구 및 재탈구가 각각 2례, 각형성 및 감염이 각각 1례씩 있었다.



[영문]Galeazzi's fracture has been described as a fracture of the radius complicated by a dislocation of the distal radloulnar joint. This fracture, with angulation of the distal radius and dislocation of the distal radioulnar joint, shows the tendency to

redisplacement after reduction due to a variety of factors including the brachioradialis muscle, the pronator quadratus muscle and the thumb abductors and extensors. Because of these factors, this fracture may rarely be treated by manipulation and plaster immobilization alone. The treatment of choice for

Galeazzi's fracture is open reducation and internal fixation.

The author reviewed the cases of 28 patients with Galeazzi's fracture who had been treated at the Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine from January 1978 to December 1986. This study emphasized the nature of the injury, the Level of the radial fracture, treatment and results.

The results were as follows:

1. The subjects included 2 children and 26 adults. Males were affected more frequently than females, and the sex ratio was 6:1.

2. The causes of injury included car accidents in ten cases(36%), falls in eight cases (29%), injuries from machinery in five cases (18%), direct blows in four cases (l4%) and explosion in one case (3%).

3. The fracture occured most often at the junction of the muddle and distal thirds of the radial shaft in thirteen cases (47%), and less often in the muddle third of the radial shaft, eight cases (29%). Infrequent sites of fracture included the junction of the proximal and middle thirds in four cases (14%), the distal third in two cases (7%) and the proximal third of the radius in one case (3%).

4. Twenty-one cases (78%) experienced fractures composed of only two fragments, but seven cases (22%) were multifragment fractures. The transverse fracture was the most frequent simple fracture (eleven cases). In none cases, the fracture was oblique and in one case, spiral. In twenty-two cases, the fractures were closed and in six cases, open. Two oases of open fractures had grade Ⅲ soft tissue injuries.

5. Roentgenographic diagnosis of the distal radioulnar joint disruption was possible in 82% of the cases.

6. Associated injuries were noted in 57% of the cases including six cases of head injuries, four cases of hand injuries, two cases of injury to the lower extremities, two cases of spinal injury, one case of a fractured pelvis and one case of a fractured humerus.

7. Conservative treatment was given in five cases and operative treatment twenty-two cases. Conservative treatment gave excellent results in one case, fair results in two cases and poor in two cases, while operative treatment resulted in an excellent outcome in thirteen cases, a fair outcome in eight cases and poor in

one case.

8. Six cases experienced complications including delayed union in two cases, subluxation of the distal radioulnar joint in two cases, angulation in one case and infection in one case.
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https://ymlib.yonsei.ac.kr/catalog/search/book-detail/?cid=CAT000000003391
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1. College of Medicine (의과대학) > Others (기타) > 2. Thesis
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/116632
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