골 시멘트와 경피적 핀 삽입술로 치료한 골다공성 요골 원위부 골절 - 12례 분석

Purpose : There are difficulties in treatment of distal radius fracture with osteoporosis because loosening of internal or external fixation is very common. Redisplacement of fracture fragments causes long immobilization and malunion. Through using bone cement andpercutaneous pinning, we tried to overcome these obstacles to treat the patients with osteoporotic distal radius fracture. <BR> Materials and Methods : We treated 12 patients with osteoporotic distal radius fracture. As treatment methods, under the general anesthesia or brachial plexus regional block, we reduced fracture fragments of distal radius under the fluoroscopic image intensifier and fixed percutaneously with K-wire and injected bone cement into fracture site using vertebroplasty kit. At post operation 6th week, we removed K-wires and performed passive ROM exercise of the wrist joint.<BR> Results : Among total 12 cases, 10 cases(83.8%) showed excellent and good result, 1 case(8.3%) fair, 1 case (8.3%) poor. There were 4 cases of complications, leakage of bone cement into radiocarpal joint in 1 case, redisplacement of fracture site in 1 case, and pin tract infection in 2 cases.<BR> Discussion and conclusions : Leakage of bone cement into radiocarpal joint happened in case with intraarticular fracture of distal radius. Conclusively, except the case with intraarticular fracture of distal radius, if we get anatomical reduction of fracture site with closed manipulation and percutaneous pinning, we think that percutaneous K-wire fixation and percutaneous bone cement (PMMA) injection can be considerable treatment methods in patients with osteoporotic distal radius fracture.