종골의 관절 함몰 골절에서 6.5 mm 해면골 나사와 Steinmann 핀을 이용한 치료의 유용성
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To report the radiographic and clinical results of 6.5 mm cancellous full threaded buttress screw or Steinmann pin fixation to maintain a reduction of calcaneal posterior facet depression fracture. Materials and Methods: From June 2009 to June 2012, 50 consecutive cases with calcaneal joint depression fracture that underwent open reduction and screw or pin fixation were enrolled in this study. A 6.5 mm cancellous full threaded screw was inserted from the posteroinferior aspect of the calcaneal tuberosity to the posterior facet (group A) or Steinman pin was inserted from the posterosuperior aspect of the calcaneal tuberosity to the calcaneocuboidal joint (group B). Both preoperative and postoperative Bohler and Gissane angles were measured radiographically, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were assessed. Results: The mean age of patients was 44.1 years, and the mean follow-up period was 27.2 months. According to the Sanders classification, 28 cases were type II and 22 cases were type III. In Sanders type II, Bohler and Gissane angles improved significantly from 10.1o and 126.2o preoperatively to 27.2o and 117.1o, respectively, in the immediate postoperative radiograph, and at the final follow-up, 26.6o and 118.6o, respectively. In Sanders type III, Bohler and Gissane angles improved significantly from 5.0o and 129.8o to 29.9o and 119.3o, respectively, in the immediate postoperative radiograph, and 26.9o and 120.2o at the final follow-up. All cases achieved bony union, and the average period until complete union was 13.3 weeks. AOFAS ankle-hindfoot scale was 82.6 in Sanders type II and 77.3 in Sanders type III at the final follow-up. Conclusion: A 6.5 mm cancellous full threaded buttress screw or Steinman pin fixation is a noninvasive treatment method with a merit of being able to maintain the bearing capacity of the posterior facet comparable to plate fixation
Abstract
Purpose: To report the radiographic and clinical results of 6.5 mm cancellous full threaded buttress screw or Steinmann pin fixation to maintain a reduction of calcaneal posterior facet depression fracture. Materials and Methods: From June 2009 to June 2012, 50 consecutive cases with calcaneal joint depression fracture that underwent open reduction and screw or pin fixation were enrolled in this study. A 6.5 mm cancellous full threaded screw was inserted from the posteroinferior aspect of the calcaneal tuberosity to the posterior facet (group A) or Steinman pin was inserted from the posterosuperior aspect of the calcaneal tuberosity to the calcaneocuboidal joint (group B). Both preoperative and postoperative Bohler and Gissane angles were measured radiographically, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were assessed. Results: The mean age of patients was 44.1 years, and the mean follow-up period was 27.2 months. According to the Sanders classification, 28 cases were type II and 22 cases were type III. In Sanders type II, Bohler and Gissane angles improved significantly from 10.1o and 126.2o preoperatively to 27.2o and 117.1o, respectively, in the immediate postoperative radiograph, and at the final follow-up, 26.6o and 118.6o, respectively. In Sanders type III, Bohler and Gissane angles improved significantly from 5.0o and 129.8o to 29.9o and 119.3o, respectively, in the immediate postoperative radiograph, and 26.9o and 120.2o at the final follow-up. All cases achieved bony union, and the average period until complete union was 13.3 weeks. AOFAS ankle-hindfoot scale was 82.6 in Sanders type II and 77.3 in Sanders type III at the final follow-up. Conclusion: A 6.5 mm cancellous full threaded buttress screw or Steinman pin fixation is a noninvasive treatment method with a merit of being able to maintain the bearing capacity of the posterior facet comparable to plate fixation
참고문헌 (26)
- Cave EF, "Fracture of the os calcis--the problem in general", Clin Orthop Relat Res, 30, pp.64~66 (1963)
- Fitzgibbons TC, "Rockwood and Green’s factures in adults", pp.2133~2179 (2001), Lippincott Williams & Wilkins;
- Murphy GA, "Campbell’s operative orthopaedics", pp.4231~4283 (2003), Mosby
- Tscherne H, "Major fractures of the pilon, the talus and the calcaneus: current concepts of treatment", Springer-Verlag, pp.153~174 (1993)
- Abidi NA, "Woundhealing risk factors after open reduction and internal fixation of calcaneal fractures", Foot Ankle Int, 19, pp.856~861 (1998)
- Benirschke SK, "Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures", Clin Orthop Relat Res, 292, pp.128~134 (1993)
- Barei DP, "Fractures of the calcaneus", Orthop Clin North Am, 33, pp.263~285 (2002)
- Stephenson JR, "Surgical treatment of displaced intraarticular fractures of the calcaneus. A combined lateral and medial approach", Clin Orthop Relat Res, 290, pp.68~75 (1993)
- Essex-Lopresti P, "The mechanism, reduction technique, and results in fractures of the os calcis", Br J Surg, 39, pp.395~419 (1952)
- Letournel E, "Topics in orthopedic trauma", pp.173~192 (1984), University Park press
- Letournel E, "Open treatment of acute calcaneal fractures", Clin Orthop Relat Res, 290, pp.60~67 (1993)
- Zwipp H, "Osteosynthesis of displaced intraarticular fractures of the calcaneus. Results in 123cases", Clin Orthop Relat Res, 290, pp.76~86 (1993)
- Sanders R, "Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification", Clin Orthop Relat Res, 290, pp.87~95 (1993)
- Ross SD, "The operative treatment of fractures of the os calcis", Clin Orthop Relat Res, 199, pp.132~143 (1985)
- Thordarson DB, "Operative vs. nonoperative treatment of intra-articular fractures of the calcaneus: a prospective randomized trial", Foot Ankle Int, 17, pp.2~9 (1996)
- Basile A, "Operative versus nonoperative treatment of displaced intra-articular calcaneal fractures in elderly patients", J Foot Ankle Surg, 49, pp.25~32 (2010)
- Robb CA, "Comparison of non-operative and surgical treatment of displaced calcaneal fractures", The Foot, 17, pp.169~173 (2007)
- Palmer I, "The mechanism and treatment of fractures of the calcaneus;open reduction with the use of cancellous grafts", J Bone Joint Surg Am, 30, pp.2~8 (1948)
- Maxfield JE, "Experiences with the Palmer open reduction of fractures of the calcaneus", J Bone Joint Surg Am, 37, pp.99~106 (1955)
- McReynold IS, "Controversies in orthopedic surgery", pp.232~254 (1982), Sanders
- Levine DS, "An introduction to the minimally invasive osteosynthesis of intra-articular calcaneal fractures", Injury, 32(Suppl 1), pp.SA51~54 (2001)
- Schepers T, "Percutaneous treatment of displaced intraarticular calcaneal fractures", J Orthop Sci, 12, pp.22~27 (2007)
- Widen A, "Fractures of the calcaneus : a clinical study with special reference to the technique and results of open reduction", Acta Chir Scand Suppl, 188, pp.1~119 (1954)
- 이명진, "전위된 관절 내 종골 골절에서 관혈적 정복 및 AO 종골 금속판을 이용한 내고정술", 대한골절학회지, 23(3), pp.303~309 (2010), 대한골절학회
- 문정석, "Sanders 2형 종골 골절에 대한 두 가지 외측도달법의 비교연구 Sanders 2형 종골 골절에 대한 두 가지 외측도달법의 비교연구", 대한골절학회지, 22(1), pp.13~18 (2009), 대한골절학회
- 이윤태, "종골의 관절 내 골절에서 외측 광범위 도달법을 이용한 F형 금속판 고정술과 잠김 금속판 고정술의 비교", 대한족부족관절학회지, 16(3), pp.175~180 (2012), 대한족부족관절학회