๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
Case #3
ํ™˜์ž ์ •๋ณด: 22 ์„ธ, ๋‚จ์„ฑ
์ ์‘์ฆ: ์˜คํ† ๋ฐ”์ด ์‚ฌ๊ณ 

Case #3

์†Œ๊ฒฌ

์ง„๋‹จ

Barton ๊ณจ์ ˆ (Frykman IV)

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

์š”์ˆ˜๊ทผ ๊ด€์ ˆ๋กœ์˜ ์—ฐ์žฅ๊ณผ ๋ฐฐ์ธก ์šฐ์„ธ ๊ณจ์ ˆ ํŽธ์— ๊ฒฐํ•ฉ๋œ ์ฑ„๋กœ ๋‚จ์•„ ์žˆ๋Š” ๊ทผ์œ„ ์ˆ˜๊ทผ์—ด์˜ ๋ฐฐ์ธก ํƒˆ๊ตฌ๋ฅผ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ ๋ถ„์‡„ ์›์œ„ ์š”๊ณจ ๊ณจ์ ˆ.

๋‹ค์ˆ˜์˜ ๋ฏธ์„ธ ๊ณจ์ ˆ ํŽธ์ด ์š”์ˆ˜๊ทผ ๊ด€์ ˆ ๊ณต๊ฐ„์— ๋Œ์ถœ.

๊ธ‰์„ฑ ๊ฒฝ๋„ ์ „์œ„ ์ฒ™๊ณจ ๊ฒฝ์ƒ๋Œ๊ธฐ ๊ณจ์ ˆ.

๋Œ€๋Šฅํ˜•๊ณจ ์ฒ™์ธก๋ฉด์˜ ๊ธ‰์„ฑ ๋น„์ „์œ„ ๊ณจ์ ˆ.

๊ธ‰์„ฑ ๊ฒฝ๋„ ๊ฐ์ž… ์ œ2 ์ค‘์ˆ˜๊ณจ ๊ฒฝ๋ถ€ ๊ณจ์ ˆ.

์†๋ชฉ ์ฃผ์œ„ ์—ฐ๋ถ€์กฐ์ง ์ข…์ฐฝ.

๊ณ ์ฐฐ

  • ์›์œ„ ์š”๊ณจ ๊ณจ์ ˆ์€ ํ”ํžˆ ๋‹ค์Œ 3๊ฐ€์ง€ ๊ณ ์œ ๋ช…์‚ฌ ์ค‘ ํ•˜๋‚˜๋กœ ๋ถˆ๋ฆฝ๋‹ˆ๋‹ค:
    • Colles ๊ณจ์ ˆ - ์›์œ„ ์š”๊ณจ ๊ด€์ ˆ๋ฉด์˜ ๋ฐฐ์ธก ๊ธฐ์šธ๊ธฐ๋ฅผ ๊ฐ€์ง„ ํšก๊ณจ์ ˆ. ๊ด€๋ จ ๊ฐ์ž… ๋ฐ/๋˜๋Š” ๊ด€์ ˆ๋‚ด ์—ฐ์žฅ์ด ์žˆ์„ ์ˆ˜ ์žˆ์Œ
      • ์ผ๋ถ€์—์„œ๋Š” ๊ด€์ ˆ๋‚ด ์—ฐ์žฅ์ด ์—†๋Š” ๊ณจ์ ˆ์—๋งŒ ์ด ์šฉ์–ด๋ฅผ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค
    • Smith ๊ณจ์ ˆ - ์›์œ„ ์š”๊ณจ ๊ด€์ ˆ๋ฉด์˜ ์žฅ์ธก ๊ธฐ์šธ๊ธฐ๋ฅผ ๊ฐ€์ง„ ํšก๊ณจ์ ˆ. ๊ด€๋ จ ๊ฐ์ž… ๋ฐ/๋˜๋Š” ๊ด€์ ˆ๋‚ด ์—ฐ์žฅ์ด ์žˆ์„ ์ˆ˜ ์žˆ์Œ
    • Barton ๊ณจ์ ˆ - ๊ด€์ ˆ๋ฉด ๋‹จ์ฐจ๋ฅผ ์ดˆ๋ž˜ํ•  ์ˆ˜ ์žˆ๋Š” ์‚ฌ์„  ๋ฐฉํ–ฅ์˜ ๊ด€์ ˆ๋‚ด ์›์œ„ ์š”๊ณจ ๊ณจ์ ˆ
      • ์—„๋ฐ€ํžˆ Barton ๊ณจ์ ˆ์€ ๋ฐฐ์ธก ๊ด€์ ˆ๋ฉด์„ ํฌํ•จํ•ฉ๋‹ˆ๋‹ค. ์žฅ์ธก ๊ด€์ ˆ๋ฉด์„ ํฌํ•จํ•˜๋Š” ๊ฒฝ์šฐ ์—ญ Barton ๊ณจ์ ˆ์ด๋ผ ํ•ฉ๋‹ˆ๋‹ค
  • ์›์œ„ ์š”๊ณจ ๊ณจ์ ˆ์— ํ”ํžˆ ์‚ฌ์šฉ๋˜๋Š” ๋ถ„๋ฅ˜ ์ฒด๊ณ„๋Š” Frykman ๋ถ„๋ฅ˜๋กœ, AP ๋ฐฉ์‚ฌ์„  ์‚ฌ์ง„์ƒ ๊ณจ์ ˆ ์†Œ๊ฒฌ์— ๊ธฐ๋ฐ˜ํ•ฉ๋‹ˆ๋‹ค:
    • Type I: ๊ด€์ ˆ์™ธ ํšก ๊ณจ๊ฐ„๋‹จ ๊ณจ์ ˆ
    • Type II: type I์— ์ฒ™๊ณจ ๊ฒฝ์ƒ๋Œ๊ธฐ ๊ณจ์ ˆ ๋™๋ฐ˜
    • Type III: ์š”์ˆ˜๊ทผ ๊ด€์ ˆ๋กœ ์—ฐ์žฅ๋˜๋Š” ์›์œ„ ์š”๊ณจ ๊ณจ์ ˆ
    • Type IV: type III์— ์ฒ™๊ณจ ๊ฒฝ์ƒ๋Œ๊ธฐ ๊ณจ์ ˆ ๋™๋ฐ˜
    • Type V: ์›์œ„ ์š”์ฒ™ ๊ด€์ ˆ์„ ์นจ๋ฒ”ํ•˜๋‚˜ ์š”์ˆ˜๊ทผ ๊ด€์ ˆ์€ ์นจ๋ฒ”ํ•˜์ง€ ์•Š๋Š” ํšก๊ณจ์ ˆ
    • Type VI: type V์— ์ฒ™๊ณจ ๊ฒฝ์ƒ๋Œ๊ธฐ ๊ณจ์ ˆ ๋™๋ฐ˜
    • Type VII: ์›์œ„ ์š”์ฒ™ ๊ด€์ ˆ๊ณผ ์š”์ˆ˜๊ทผ ๊ด€์ ˆ ๋ชจ๋‘๋ฅผ ์นจ๋ฒ”ํ•˜๋Š” ๋ถ„์‡„ ๊ณจ์ ˆ
    • Type VIII: type VII์— ์ฒ™๊ณจ ๊ฒฝ์ƒ๋Œ๊ธฐ ๊ณจ์ ˆ ๋™๋ฐ˜
  • ๊ฐ์ž… ์š”๊ณจ ๊ณจ์ ˆ์„ ๋ณผ ๋•Œ ์ฒ™๊ณจ ์–‘์„ฑ ๋ณ€์ด๋„ ๋ฐ˜๋“œ์‹œ ํ™•์ธํ•˜์„ธ์š”. ์ด๋Š” ์ฒ™๊ณจ ์ถฉ๋Œ๋กœ ์ธํ•œ ์žฅ๊ธฐ์  ์ดํ™˜์„ ์ดˆ๋ž˜ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค

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

Barton fracture with dorsal displacement (red arrow).

Barton fracture with dorsal displacement (red arrow).

Red arrows: nondisplaced fracture of the trapezium. Yellow arrow: ulnar styloid fracture. Blue arrow: impacted second metacarpal neck fracture.

Red arrows: nondisplaced fracture of the trapezium. Yellow arrow: ulnar styloid fracture. Blue arrow: impacted second metacarpal neck fracture.

Types of distal radial fractures.

Types of distal radial fractures.

์ฐธ๊ณ ๋ฌธํ—Œ

  • Porrino Jr JA, Maloney E, Scherer K, Mulcahy H, Ha AS, Allan C. Fracture of the distal radius: epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol 2014; 203(3): 551-559.
  • Meena S, Sharma P, Sambharia AK, Dawar A. Fractures of Distal Radius: An Overview. Journal of Family Medicine and Primary Care 2014; 3(4): 325-332.

    • ์‚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”.

    /5
    ํ”ผ๋“œ๋ฐฑ์„ ๋ณด๋‚ด์ฃผ์…”์„œ ๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค. ์†Œ์ค‘ํžˆ ๋ฐ˜์˜ํ•˜๊ฒ ์Šต๋‹ˆ๋‹ค.