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경골 원위간부 골절 치료의 골수강내 금속정 고정술과 최소침습 금속판 고정술의 비교: 기능적, 미용적 결과의 후향적 비교

Intramedullary Nailing versus Minimally Invasive Plate Osteosynthesis for Distal Tibia Shaft Fractures: Retrospective Comparison of Functional and Cosmetic Outcomes

윤지영|김용민|김인희|김종원|임성준|김건중|김가현
대한족부족관절학회 (korean foot and ankle society)|2023.09|대한족부족관절학회지 (journal of korean foot and ankle society)|제27권 제3호|pp. 93-98|DOI 10.14193/jkfas.2023.27.3.93

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키워드

Functional outcomeDistal tibia shaft fractureIntramedullary nailingMinimally invasive plate osteosynthesisCosmetic outcome

초록

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally inva- sive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/ Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were en- rolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respec- tively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

Abstract

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally inva- sive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/ Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were en- rolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respec- tively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

참고문헌 (21)

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관련 논문AI추천

원위 경골 골절에서 금속정 및 금속판 고정술의 결과 비교곽희철, 김정한, 이창락, 정양환대한족부족관절학회 · 대한족부족관절학회지2015 · 제19권 제3호경골 원위부 골절 치료에서 최소 침습적 접근법을 통한 잠금 나사 금속판 고정술과 교합성 골수강 내 금속정 고정술의 비교 연구김지훈, 서진수, 이창수대한족부족관절학회 · 대한족부족관절학회지2008 · 제12권 제1호족관절 기능과 증상을 중심으로 평가한 경골 원위부 골절에서의 금속정 치료 결과김병민, 노재영, 배서영대한족부족관절학회 · 대한족부족관절학회지2008 · 제12권 제1호원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과권오수, 길호진, 김영율, 김원유, 박상은, 정재중, 지종훈대한족부족관절학회 · 대한족부족관절학회지2012 · 제16권 제2호경골 원위부 골절에서 최소 침습적 잠김 압박 금속판 고정술과 함께 최소 절개를 통한 골절편간 지연 나사 고정술을 시행한 경우의 치료 결과정형진, 추지웅대한족부족관절학회 · 대한족부족관절학회지2013 · 제17권 제2호잠김-압박 금속판을 사용하여 MIPPO 수기를 적용한 원위부 경골 골절의 치료: 관절내 골절과 관절외 골절의 비교김주학, 김형수, 박재형, 유정현, 정수태, 정진하, 차승도대한족부족관절학회 · 대한족부족관절학회지2009 · 제13권 제2호

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