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์ฆ๋ก€ #1
ํ™˜์ž ์ •๋ณด: 59 ์„ธ, ๋‚จ์„ฑ
์ ์‘์ฆ: ์˜คํ† ๋ฐ”์ด ์‚ฌ๊ณ 

์ฆ๋ก€ #1

์†Œ๊ฒฌ

์ง„๋‹จ

๋ถˆ์•ˆ์ • ๊ณจ๋ฐ˜ํ™˜ ์†์ƒ (APC II)

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

์น˜๊ณจ ๊ฒฐํ•ฉ ์ด๊ฐœ ์ตœ๋Œ€ 3 cm ๋ฐ ์šฐ์ธก ์ฒœ์žฅ๊ด€์ ˆ์˜ ๊ฒฝ๋ฏธํ•œ ํ™•์žฅ์„ ๋™๋ฐ˜ํ•œ ๋ถˆ์•ˆ์ • ๊ณจ๋ฐ˜ํ™˜ ์†์ƒ.

๊ณ ๊ด€์ ˆ, ์ฒœ์žฅ๊ด€์ ˆ ๋ฐ ๋ถ€๋ถ„์ ์œผ๋กœ ์ดฌ์˜๋œ ํ•˜๋ถ€ ์š”์ถ”์˜ ๊ฒฝ๋ฏธํ•œ ํ‡ดํ–‰์„ฑ ๋ณ€ํ™”.

๋™๋งฅ ๋ฐ ์ •๊ด€ ์„ํšŒํ™”.

๊ณ ์ฐฐ

  • ๋ถˆ์•ˆ์ • ๊ณจ๋ฐ˜ ์†์ƒ์„ ์ธ์‹ํ•˜๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•ฉ๋‹ˆ๋‹ค. ์ด๋Š” ์ฆ‰๊ฐ์ ์ธ ํ™˜์ž ์ฒ˜์น˜์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๊ธฐ ๋•Œ๋ฌธ์ž…๋‹ˆ๋‹ค(๊ณจ๋ฐ˜ ๊ณ ์ •๋Œ€๋Š” ์ผ๋ฐ˜์ ์œผ๋กœ CT ์ดฌ์˜ ์ „์— ์ ์šฉ๋จ)
  • Young-Burgess ๋ถ„๋ฅ˜๊ฐ€ ๊ฐ€์žฅ ํ”ํžˆ ์‚ฌ์šฉ๋˜๋Š” ๋ถ„๋ฅ˜ ์ฒด๊ณ„์ž…๋‹ˆ๋‹ค:
    • ์ „ํ›„๋ฐฉ ์••๋ฐ•(APC) - ์น˜๊ณจ ๊ฒฐํ•ฉ์ด ์ทจ์•ฝ ๋ถ€์œ„๋กœ ๊ฐ€์žฅ ๋จผ์ € ์†์ƒ๋จ
      • APC I: ์น˜๊ณจ ๊ฒฐํ•ฉ ์ด๊ฐœ < 2.5 cm
        • ์•ˆ์ •์ 
      • APC II: ์น˜๊ณจ ๊ฒฐํ•ฉ ์ด๊ฐœ > 2.5 cm, ์ „๋ฐฉ ์ฒœ์žฅ๊ด€์ ˆ ์ด๊ฐœ
        • ์ˆ˜์ง ์•ˆ์ •์ , ํšŒ์ „ ๋ถˆ์•ˆ์ •
      • APC III: ์น˜๊ณจ ๊ฒฐํ•ฉ ์ด๊ฐœ > 5 cm, ์ „๋ฐฉ ๋ฐ ํ›„๋ฐฉ ์ฒœ์žฅ๊ด€์ ˆ ์ด๊ฐœ
        • ์ „๋ฐ˜์  ๋ถˆ์•ˆ์ •
    • ์ธก๋ฐฉ ์••๋ฐ• - ํ์‡„๊ณตํ™˜์ด ์ทจ์•ฝ ๋ถ€์œ„๋กœ ๊ฐ€์žฅ ๋จผ์ € ์†์ƒ๋จ
      • LC I: ํ์‡„๊ณตํ™˜ ๊ณจ์ ˆ ๋ฐ ์ฒœ๊ณจ ์••๋ฐ• ๊ณจ์ ˆ
        • ์•ˆ์ •์ 
      • LC II: LC I + ์žฅ๊ณจ ์ดˆ์Šน๋‹ฌ ๊ณจ์ ˆ
        • ์ˆ˜์ง ์•ˆ์ •์ , ํšŒ์ „ ๋ถˆ์•ˆ์ •
      • LC III: ๋ฐ˜๋Œ€์ธก APC ์†์ƒ์„ ๋™๋ฐ˜ํ•œ LC I/II
        • ์ „๋ฐ˜์  ๋ถˆ์•ˆ์ •
    • ์ˆ˜์ง ์ „๋‹จ - ์น˜๊ณจ ๊ฒฐํ•ฉ ๋ฐ ์ฒœ์žฅ๊ด€์ ˆ์˜ ์ด๋™์„ ๋™๋ฐ˜ํ•œ ์ˆ˜์ง ๋ฐ˜๊ณจ๋ฐ˜ ์ „์œ„
      • ์ „๋ฐ˜์  ๋ถˆ์•ˆ์ •

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

APC II unstable pelvic ring injury with widening of the pubic symphysis (red line) and anterior right sacroiliac joint (yellow line).

APC II unstable pelvic ring injury with widening of the pubic symphysis (red line) and anterior right sacroiliac joint (yellow line).

Postoperative radiograph in this patient.

Postoperative radiograph in this patient.

์ฐธ๊ณ ๋ฌธํ—Œ

  • Khurana B, Sheehan SE, Sodickson AD, Weaver MJ. Pelvic ring fractures: what the orthopedic surgeon wants to know.ย Radiographicsย 2014; 34(5): 1317-1333.

    • ์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

    ์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

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