๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #2
ํ™˜์ž ์ •๋ณด: 16 ์„ธ, ๋‚จ์„ฑ
์ ์‘์ฆ: ์œก์•ˆ์  ๋ณ€ํ˜•์„ ๋™๋ฐ˜ํ•œ ๋ฐœ๋ชฉ ์†์ƒ

์ฆ๋ก€ #2

์†Œ๊ฒฌ

์ง„๋‹จ

Weber Cํ˜• ๊ณจ์ ˆ

๋ฐœ๋ชฉ ํƒˆ๊ตฌ

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

์•ฝ 1 cm ์ค‘์ฒฉ ๋ฐ ํ›„์™ธ์ธก ๊ฐํ˜•์„ฑ์„ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ ์‚ฌ์„  ์›์œ„ ๋น„๊ณจ ๊ณจ์ ˆ (Weber Cํ˜•)๊ณผ ๊ด€๋ จ ์›์œ„ ๊ฒฝ๋น„ ์ธ๋Œ€๊ฒฐํ•ฉ ์ด๊ฐœ ๋ฐ ๊ฒฝ๊ฑฐ๊ณจ ๊ด€์ ˆ ํ›„๋ฐฉ ํƒˆ๊ตฌ. MRI๋กœ ์ธ๋Œ€ ์†์ƒ์˜ ๋ฒ”์œ„๋ฅผ ์ถ”๊ฐ€ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.

์•ฝ 2 cm ์™ธ์ธก ์ „์œ„๋ฅผ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ ๊ฒฌ์ธ ๋‚ด๊ณผ ๊ณจ์ ˆ.

์•ฝ 2 cm ์™ธ์ธก ์ „์œ„๋ฅผ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ ๊ฒฝ๋„ ๋ถ„์‡„ ํ›„๊ณผ ๊ณจ์ ˆ.

๊ณ ์ฐฐ

  • ๋ณด๋‹ค ๋ณต์žกํ•œ ๋ฐœ๋ชฉ ๊ณจ์ ˆ ๋ถ„๋ฅ˜ ์ฒด๊ณ„๊ฐ€ ์กด์žฌํ•˜์ง€๋งŒ, ์ตœ์†Œํ•œ Weber ๋ถ„๋ฅ˜์— ์ต์ˆ™ํ•ด์•ผ ํ•ฉ๋‹ˆ๋‹ค:
    • Weber Aํ˜•: ๊ฑฐ๊ณจ ์›๊ฐœ ๋†’์ด ์•„๋ž˜์˜ ์™ธ๊ณผ ๊ณจ์ ˆ - ์ „ํ˜•์ ์œผ๋กœ ์•ˆ์ •์ ์ด๋ฉฐ ๋ณด์กด์ ์œผ๋กœ ๊ด€๋ฆฌ๋ฉ๋‹ˆ๋‹ค
    • Weber Bํ˜•: ๊ฑฐ๊ณจ ์›๊ฐœ ๋†’์ด์—์„œ ๊ณจ์ ˆ์„ ์ด ๋‚ด์ธก์œผ๋กœ ๋‚˜๊ฐ€๋Š” ์™ธ๊ณผ ๊ณจ์ ˆ - ๋‚ด์ธก ๊ตฌ์กฐ๊ฐ€ ์˜จ์ „ํ•˜๋ฉด ์•ˆ์ •์ : ๋‚ด์ธก ๊ด€์ ˆ ๊ฐ„๊ฒฉ ํ™•์žฅ(์‚ผ๊ฐ์ธ๋Œ€ ์†์ƒ ์‹œ์‚ฌ) ๋ฐ ์›์œ„ ๊ฒฝ๋น„ ์ธ๋Œ€๊ฒฐํ•ฉ ์ด๊ฐœ๋ฅผ ํ™•์ธํ•˜์‹ญ์‹œ์˜ค
    • Weber Cํ˜•: ๊ฑฐ๊ณจ ์›๊ฐœ ๋†’์ด ์œ„์˜ ์™ธ๊ณผ ๊ณจ์ ˆ - ์›์œ„ ๊ฒฝ๋น„ ์ธ๋Œ€๊ฒฐํ•ฉ ์†์ƒ๊ณผ ๊ด€๋ จ๋˜์–ด ๋Œ€๊ฐœ ๋ถˆ์•ˆ์ •ํ•ฉ๋‹ˆ๋‹ค
  • ์š”๊ณจ๊ณผ ์ฒ™๊ณจ์ฒ˜๋Ÿผ, ๊ฒฝ๊ณจ๊ณผ ๋น„๊ณจ์„ ํ•˜๋‚˜์˜ ํ™˜ํ˜• ๊ตฌ์กฐ๋กœ ์ƒ๊ฐํ•˜์‹ญ์‹œ์˜ค. ํ•œ ๊ณณ์—์„œ ์†์ƒ(๊ณจ์ ˆ ๋˜๋Š” ๊ด€์ ˆ ์•„ํƒˆ๊ตฌ)์ด ๋ณด์ด๋ฉด ๋‚˜๋จธ์ง€ ํ™˜ํ˜• ๊ตฌ์กฐ์—์„œ ์ถ”๊ฐ€ ์†์ƒ์„ ๊ฒ€์‚ฌํ•˜์‹ญ์‹œ์˜ค. ๋ฐœ๋ชฉ ๊ด€์ ˆ์˜ ๋‚ด์ธก ๊ด€์ ˆ ๊ฐ„๊ฒฉ ์ด๊ฐœ๋งŒ ๋ณด์ด๋ฉด, ๊ทผ์œ„ ๋น„๊ณจ (Maisonneuve) ๊ณจ์ ˆ์„ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด ๊ฒฝ๋น„๊ณจ ๋ฐฉ์‚ฌ์„  ์ดฌ์˜์„ ์‹œํ–‰ํ•˜์‹ญ์‹œ์˜ค

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

Weber type C fracture - Angulated distal fibular fracture (red arrow) with associated tibiofibular syndesmotic injury and displaced posterior (blue arrow) and medial (yellow arrow) malleolar fractures.

Weber type C fracture - Angulated distal fibular fracture (red arrow) with associated tibiofibular syndesmotic injury and displaced posterior (blue arrow) and medial (yellow arrow) malleolar fractures.

Posterior dislocation of the ankle with the talar dome (red dotted line) positioned posterior to the tibial plafond (blue dotted line).

Posterior dislocation of the ankle with the talar dome (red dotted line) positioned posterior to the tibial plafond (blue dotted line).

Radiograph in this patient after ORIF.

Radiograph in this patient after ORIF.

์‚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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