Journal of the Korean Fracture Society (대한골절학회지)

The Korean Fracture Society (대한골절학회)
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Anatomically Percutaneous Wiring Reduction in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures

원위 경골 골절의 최소 침습적 금속판 치료에서 해부학적 경피적 강선 정복

  • Kim, Young-Mo (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Kang, Chan (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Hwang, Deuk-Soo (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Joo, Yong-Bum (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Lee, Woo-Yong (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Hwang, Jung-Mo (Department of Orthopedic Surgery, Chungnam National University School of Medicine)
  • 김영모 (충남대학교병원 정형외과학교실) ;
  • 강찬 (충남대학교병원 정형외과학교실) ;
  • 황득수 (충남대학교병원 정형외과학교실) ;
  • 주용범 (충남대학교병원 정형외과학교실) ;
  • 이우용 (충남대학교병원 정형외과학교실) ;
  • 황정모 (충남대학교병원 정형외과학교실)
  • Published : 2011.07.25
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Abstract

Purpose: To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures. Materials and Methods: 17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked. Results: The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points. Conclusion: By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.

목 적: 원위 경골 사상 골절의 금속판을 이용한 최소 침습적 내고정술 시행 중에 강선을 이용한 해부학적 골절 정복 및 유지 방법에 대하여 보고하고자 한다. 대상 및 방법: 2007년 8월부터 2010년 2월까지 원위 경골 사상, 나선형 또는 횡형 골절로 진단받고 내측 금속판을 이용한 최소 침습적 내고정을 시행한 환자 중 경피적 강선 정복 방법으로 해부학 정복이 가능했던 17예의 환자를 대상으로 하였다. 평균 연령은 50세, 평균 추시 기간은 18개월이었다. 수술 후 단순 방사선 사진상의 골유합까지의 기간, 각 변형 정도 및 합병증 유무를 조사하였다. Olerud and Molander ankle 점수와 보행 시 VAS pain 점수를 수술 후 족관절 기능의 평가 지표로 사용하였다. 결 과: 전후방 방사선 사진에서 골유합 후 내/외측 각 변형은 평균 0.9도, 측면 방사선 사진에서 전/후방 각 변형은 2.0도이었다. Olerud and Molander 점수는 평균 89.4점이었으며, 보행 시 족관절 VAS pain 점수는 0점이었다. 결 론: 원위 경골 사상 골절의 치료에서 강선을 이용한 경피적 골절 정복 방법으로 쉽게 해부학적 정복을 이룰 수 있고, 강선 차체만으로도 정복을 유지할 수 있어서 추가적인 도수 정복 유지 없이 금속판을 간단하게 고정할 수 있는 장점이 있다.

Keywords

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