다발성 Kirschner 강선을 이용한 제 5중족골 기저부 골절의 수술적 치료
Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires
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Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires(K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distanceof fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visualanalog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) midfootscore at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bonyunion in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantlydecreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a Kwireinto the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.
Abstract
Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires(K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distanceof fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visualanalog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) midfootscore at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bonyunion in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantlydecreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a Kwireinto the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.
참고문헌 (22)
- Hasselman CT, "Foot and ankle fractures in elderly white women. Incidence and risk factors", J Bone Joint Surg Am, 85, pp.820~824 (2003)
- Petrisor BA, "The epidemiology of metatarsal fractures", Foot Ankle Int, 27, pp.172~174 (2006)
- Lawrence SJ, "Jones' fractures and related fractures of the proximal fifth metatarsal", Foot Ankle, 14, pp.358~365 (1993)
- 성기선, "제5 중족골 기저부 제 I, II구역 비전위성 골절의 보존적 치료", 대한족부족관절학회지, 12(2), pp.185~188 (2008), 대한족부족관절학회
- Thomas JL, "Three-wire fixation technique for displaced fifth metatarsal base fractures", J Foot Ankle Surg, 50, pp.776~779 (2011)
- Dameron TB Jr, "Fractures and anatomical variations of the proximal portion of the fifth metatarsal", J Bone Joint Surg Am, 57, pp.788~792 (1975)
- Wiener BD, "Treatment of fractures of the fifth metatarsal : a prospective study", Foot Ankle Int, 18, pp.267~269 (1997)
- Quill GE Jr, "Fractures of the proximal fifth metatarsal", Orthop Clin North Am, 26, pp.353~361 (1995)
- Jones R. I, "Fracture of the base of the fifth metatarsal bone by indirect violence", Ann Surg, 35, pp.697~700 (1902)
- Rammelt S, "Metatarsal fractures", Injury, 35(2), pp.SB77~SB86 (2004)
- Hatch RL, "Diagnosis and management of metatarsal fractures", Am Fam Physician, 76, pp.817~826 (2007)
- 안종국, "인장대 강선 고정술을 이용한 제5 중족골 기저부 골절의 수술적 치료", 대한족부족관절학회지, 15(1), pp.18~21 (2011), 대한족부족관절학회
- 서진수, "제5 중족골 기저부 골절의 수술적 치료", 대한족부족관절학회지, 12(2), pp.189~196 (2008), 대한족부족관절학회
- Husain ZS, "Relative stability of tension band versus two-cortex screw fixation for treating fifth metatarsal base avulsion fractures", J Foot Ankle Surg, 39, pp.89~95 (2000)
- Meena S, "Delayed migration of K-wire into popliteal fossa used for tension band wiring of patellar fracture", Chin J Traumatol, 16, pp.186~188 (2013)
- Konda SR, "Progressive migration of broken Kirschner wire into the proximal tibia following tension-band wiring technique of a patellar fracture--case report", Bull NYU Hosp Jt Dis, 70, pp.279~282 (2012)
- Park SY, "Intracardiac migration of a Kirschner wire: case report and literature review", Int J Cardiovasc Imaging, 27(1), pp.85~88 (2011)
- Kędra M, "Intraspinal K-wire migration after humeral fracture fixation", Eur J Cardiothorac Surg, 39, pp.1079~ (2011)
- Huang TW, "Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations", J Trauma, 68, pp.173~176 (2010)
- Karlsson MK, "Fractures of the olecranon: a 15- to 25-year followup of 73 pa- tients", Clin Orthop Relat Res, (403), pp.205~212 (2002)
- Mullett JH, "K-wire position in tension band wiring of the olecranon-a comparison of two techniques", Injury, 31, pp.427~431 (2000)
- Prayson MJ, "Biomechanical comparison of fixation methods in transverse olecranon fractures : a cadaveric study", J Orthop Trauma, 11, pp.565~572 (1997)