목적: 90세 이상의 고령 환자에서 발생한 전자간 골절의 근위 대퇴정을 이용한 치료 결과를 알아 보고자 하였다. 대상 및 방법: 2005년 1월부터 2008년 12월까지 근위 대퇴정을 이용하여 치료받은 90세 이상인 대퇴골 전자간 골절 환자 20예중 6개월 이상 추시가 가능한 16예를 대상으로 하였다. 환자들의 평균 연령은 93.9세였고 여자는 13명, 남자는 3명이었다. 임상적 분석은 환자의 활동도를 변형 Koval 지수를 사용하여 분석하였고 방사선학적 분석으로는 단순 방사선 사진을 통하여 골유합 상 태 및 합병증을 조사하였다. 결과: 변형 Koval 지수는 술 전 평균 3.1에서 술 후는 평균 1.8로 감소하였다. 수상 전 상태로 기 능적 회복이 가능하였던 환자는 5명이었다. 방사선적 골유합 시기는 평균 8.2주였고 골두 천공 및 불유합 등이 관찰된 환자는 없었다. 결론: 90세 이상의 고령 환자에서 근위 대퇴정을 이용한 전자간 골절 치료 결과는 31%의 환자에 서 수상 전 보행 상태로 회복을 보였다. 그러나 방사선학적 검사상 모두 골유합 되었고 내고정과 관련된 합병증이 발생하지 않았던 바 90세 이상 고령 환자의 대퇴 전자간 골절 치료에 유용한 내 고정물로 생각된다.

Purpose: This study examined the clinical and radiologic results of a proximal femoral nail (PFN) used to treat an intertrochanteric fracture of the femur in elderly people more than 90 years of age. Materials and Methods: Between January 2005 and December 2008, 20 patients over 90 years old with an intertrochanteric fracture were treated with a PFN. Among them, 16 patients (mean age, 93.9 years; 13 females and 3 males) were followed up for a minimum of 6 months. Clinically, the modified Koval index was evaluated. Radiological bony union and complications were evaluated from the plain X-ray film. Results: The average modified Koval index decreased from 3.1 before surgery to 1.8 after surgery. Only 5 cases could return to their pre-injury status. Radiologic bony union was achieved after an average of 8.2 weeks and there were no complications, such as non-union and femoral head perforations. Conclusion: Thirty one percent of patients older than 90 years and treated for an intertrochanteric fracture with a PFN had recovered to their pre-injury ambulatory status. However, all cases showed bony union and no complications. Overall, PFN might be a good treatment option for intertrochanteric fractures in elderly people older than 90 years.

Purpose: This study examined the clinical and radiologic results of a proximal femoral nail (PFN) used to treat an intertrochanteric fracture of the femur in elderly people more than 90 years of age. Materials and Methods: Between January 2005 and December 2008, 20 patients over 90 years old with an intertrochanteric fracture were treated with a PFN. Among them, 16 patients (mean age, 93.9 years; 13 females and 3 males) were followed up for a minimum of 6 months. Clinically, the modified Koval index was evaluated. Radiological bony union and complications were evaluated from the plain X-ray film. Results: The average modified Koval index decreased from 3.1 before surgery to 1.8 after surgery. Only 5 cases could return to their pre-injury status. Radiologic bony union was achieved after an average of 8.2 weeks and there were no complications, such as non-union and femoral head perforations. Conclusion: Thirty one percent of patients older than 90 years and treated for an intertrochanteric fracture with a PFN had recovered to their pre-injury ambulatory status. However, all cases showed bony union and no complications. Overall, PFN might be a good treatment option for intertrochanteric fractures in elderly people older than 90 years.

Femur, Intertrochanteric fracture, Proximal femoral nail (PFN), Over 90 years