관혈적 정복술 및 금속 내고정술에 의한 주상골 불유합의 치료

Abstract

Scaphoid fracture is the most common carpal bone fracture and at least 5% of acute fractures of the scaphoid fail to unite after conservative treatment. The failure have been attributed to delay in beginning treatment, inadequate immobilization, displacement of fragments, instability due to ligamentous injury, and inadequate blood supply of the proximal fragment, Previously, some authors reported several kinds of treatment mordality for nonunion of scaphoid. Of all the techniques that have been introduced, we have used open reduction and internal fixation(O/R & I/F) with autogenous iliac bone graft(AIBG). We reviewed the 10 cases of patients who underwent 0/R & I/F with K-wire or Herbert screw and AIBG from Jan 1985 to Aug 1994. The results were as follow: 1.Among 10 cases, 9 cases were male and 1 case was female, and all cases were right hand, and most common age group was twenties(70%). 2. The most common cause of injury was falling with outstretched hand in 8 cases. 3.In the previous treatment, 8 cases had non spcific treatment and 2 cases had cast immobilization. 4.In the operation method, open reduction and internal fixation (0/R & I/F) with K-wire combined with autogenous iliac bone graft(AIBG) for S cases, and 0/R & I/F with Herbert screw combined with AIBG for 1 case and 0/R & I/F with Herbert screw without bone graft for 1 case. 5.After operation, average duration of cast imobilization was 2.8 months(2.5months-3months). 6.All patients had a bony union with average duration 6.2 months(3months-10months).