๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #3
ํ™˜์ž ์ •๋ณด: 18 ์„ธ, ์—ฌ์„ฑ
์ ์‘์ฆ: ์™ธ์ƒ

์ฆ๋ก€ #3

์†Œ๊ฒฌ

์ง„๋‹จ

์ˆ˜์ง ์ „๋‹จ๋ ฅ ๊ณจ๋ฐ˜ํ™˜ ์†์ƒ

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

์น˜๊ณจ๊ฒฐํ•ฉ ๋ฐ ์ขŒ์ธก ์ฒœ์žฅ๊ด€์ ˆ ์ด๊ฐœ, ์ขŒ์ธก ๊ณจ๋ฐ˜์˜ ์ƒ๋ฐฉ ์ „์œ„๋ฅผ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ ๋ถˆ์•ˆ์ • ์ˆ˜์ง ์ „๋‹จ๋ ฅ ๊ณจ๋ฐ˜ํ™˜ ์†์ƒ, ์ขŒ์ธก ์ฒœ๊ณจ์ต(์ƒ๋ฐฉ ์ „์œ„๋œ S1 ๊ณจํŽธ), ์šฐ์ธก ์ƒ์น˜๊ณจ์ง€(๋ถ„์‡„) ๋ฐ ํ•˜์น˜๊ณจ์ง€, ์ขŒ์ธก L5 ํšก๋Œ๊ธฐ(์™ธ์ธก ๊ฒฌ์ธ) ๊ณจ์ ˆ.

๊ณ ๊ด€์ ˆ ๋˜๋Š” ์šฐ์ธก ์ฒœ์žฅ๊ด€์ ˆ์˜ ๋ถ€์ •๋ ฌ ์—†์Œ.

๊ณ ์ฐฐ

  • ๋ถˆ์•ˆ์ • ๊ณจ๋ฐ˜ ์†์ƒ์„ ์ธ์‹ํ•  ์ˆ˜ ์žˆ๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•˜๋ฉฐ, ์ด๋Š” ์ฆ‰๊ฐ์ ์ธ ํ™˜์ž ๊ด€๋ฆฌ์— ์˜ํ–ฅ์„ ๋ฏธ์นฉ๋‹ˆ๋‹ค(๊ณจ๋ฐ˜ ๊ฒฐํ•ฉ๊ธฐ๋Š” ์ผ๋ฐ˜์ ์œผ๋กœ ํ™˜์ž๊ฐ€ CT ์˜์ƒ์„ ๋ฐ›๊ธฐ ์ „์— ์žฅ์ฐฉ๋ฉ๋‹ˆ๋‹ค)
  • Young Burgess ๋ถ„๋ฅ˜๊ฐ€ ๊ฐ€์žฅ ํ”ํ•˜๊ฒŒ ์‚ฌ์šฉ๋ฉ๋‹ˆ๋‹ค:
    • ์ „ํ›„ ์••๋ฐ•(APC) - ์น˜๊ณจ๊ฒฐํ•ฉ์ด ์•ฝํ•œ ๋ถ€์œ„์ด๋ฏ€๋กœ ๋จผ์ € ์˜ํ–ฅ์„ ๋ฐ›์Šต๋‹ˆ๋‹ค
      • APC I: ์น˜๊ณจ๊ฒฐํ•ฉ ํ™•๋Œ€ < 2.5 cm
        • ์•ˆ์ •
      • APC II: ์น˜๊ณจ๊ฒฐํ•ฉ ํ™•๋Œ€ > 2.5 cm, ์ „๋ฐฉ ์ฒœ์žฅ๊ด€์ ˆ ํ™•๋Œ€
        • ์ˆ˜์ง ์•ˆ์ •, ํšŒ์ „ ๋ถˆ์•ˆ์ •
      • APC III: ์น˜๊ณจ๊ฒฐํ•ฉ ํ™•๋Œ€ > 5 cm, ์ „๋ฐฉ ๋ฐ ํ›„๋ฐฉ ์ฒœ์žฅ๊ด€์ ˆ ํ™•๋Œ€
        • ์ „๋ฐ˜์  ๋ถˆ์•ˆ์ •
    • ์ธก๋ฐฉ ์••๋ฐ• - ํ์‡„๊ณตํ™˜์ด ์•ฝํ•œ ๋ถ€์œ„์ด๋ฏ€๋กœ ๋จผ์ € ์˜ํ–ฅ์„ ๋ฐ›์Šต๋‹ˆ๋‹ค
      • 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: LC I/II + ๋ฐ˜๋Œ€์ธก APC ์†์ƒ
        • ์ „๋ฐ˜์  ๋ถˆ์•ˆ์ •
    • ์ˆ˜์ง ์ „๋‹จ๋ ฅ - ์น˜๊ณจ๊ฒฐํ•ฉ ๋ฐ ์ฒœ์žฅ๊ด€์ ˆ ํŽธ์œ„๋ฅผ ๋™๋ฐ˜ํ•œ ๊ณจ๋ฐ˜์˜ ์ˆ˜์ง ์ „์œ„
      • ์ „๋ฐ˜์  ๋ถˆ์•ˆ์ •

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

Widening and offset of the pubic symphysis (red arrow) and left sacroiliac joint (yellow arrow). Fractures of the right superior (white arrow) and inferior (gray arrow) pubic rami. Displaced fractures of the left sacral ala (blue arrow) and left L5 transverse process (black arrow).

Widening and offset of the pubic symphysis (red arrow) and left sacroiliac joint (yellow arrow). Fractures of the right superior (white arrow) and inferior (gray arrow) pubic rami. Displaced fractures of the left sacral ala (blue arrow) and left L5 transverse process (black arrow).

์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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