족부 제2형 부주상골에서 절제술과 골유합술 간의 임상적 결과 비교
Comparison of Clinical Outcome of Excision versus Osteosynthesis in Type II Accessory Navicular
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Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon’s preference, patient’s chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.
Abstract
Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon’s preference, patient’s chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.
참고문헌 (31)
- Bareither DJ, "Os tibiale externum or sesamoid in the tendon of tibialis posterior", J Foot Ankle Surg, 34, pp.429~434 (1995)
- Bennett GL, "Surgical treatment of symptomatic accessory tarsal navicular", J Pediatr Orthop, 10, pp.445~449 (1990)
- Grogan DP, "The painful accessory navicular: a clinical and histopathological study", Foot Ankle, 10, pp.164~169 (1989)
- Kiter E, "Evaluation of simple excision in the treatment of symptomatic accessory navicular associated with flat feet", J Orthop Sci, 5, pp.333~335 (2000)
- O'Rahilly R, "A survey of carpal and tarsal anomalies", J Bone Joint Surg Am, 35, pp.626~642 (1953)
- Romanowski CA, "The accessory navicular-- an important cause of medial foot pain", Clin Radiol, 46, pp.261~264 (1992)
- Ugolini PA, "The accessory navicular", Foot Ankle Clin, 9, pp.165~180 (2004)
- Demeyere N, "Quiz case. Symptomatic type II accessory navicular", Eur J Radiol, 37, pp.60~63 (2001)
- Issever AS, "Accessory navicular bone: when ankle pain does not originate from the ankle", Clin Rheumatol, 26, pp.2143~2144 (2007)
- Miller TT, "The symptomatic accessory tarsal navicular bone: assessment with MR imaging", Radiology, 195, pp.849~853 (1995)
- Geist ES, "The accessory scaphoid bone", J Bone Joint Surg AM, 7, pp.570~574 (1925)
- Kidner FC, "The prehallux (accessory scaphoid) in its relation to flat-foot", J Bone Joint Surg Am, 11, pp.831~837 (1929)
- Malicky ES, "Modification of the Kidner procedure with fusion of the primary and accessory navicular bones", Foot Ankle Int, 20, pp.53~54 (1999)
- Lawson JP, "The painful accessory navicular", Skeletal Radiol, 12, pp.250~262 (1984)
- Ray S, "Surgical treatment of the accessory navicular", Clin Orthop Relat Res, 177, pp.61~66 (1983)
- Sullivan JA, "The relationship of the accessory navicular to the development of the flat foot", Clin Orthop Relat Res, 144, pp.233~237 (1979)
- Jasiewickz B, "Results of simple excision technique in the surgical treatment of symtomatic accessory navicular bones", Foot Ankle Surg, 14, pp.57~61 (2008)
- Kopp FJ, "Clinical outcome of surgical treatment of the symptomatic accessory navicular", Foot Ankle Int, 25, pp.27~30 (2004)
- Chung JW, "Outcome of fusion of a painful accessory navicular to the primary navicular", Foot Ankle Int, 30, pp.106~109 (2009)
- Macnicol MF, "Surgical treatment of the symptomatic accessory navicular", J Bone Joint Surg Br, 66, pp.218~226 (1984)
- Tan SM, "Surgical treatment of symptomatic accessory navicular", Ann Acad Med Singapore, 24, pp.379~381 (1995)
- Scott AT, "Fusion versus excision of the symptomatic Type II accessory navicular: a prospective study", Foot Ankle Int, 30, pp.10~15 (2009)
- Kanatli U, "The relationship between accessory navicular and medial longitudinal arch: evaluation with a plantar pressure distribution measurement system", Foot Ankle Int, 24, pp.486~489 (2003)
- Zadek I, "The significance of the accessory tarsal scaphoid", J Bone Joint Surg Am, 8, pp.618~626 (1926)
- Kidner FC, "The prehallux in relation to flatfoot", JAMA, 101, pp.1539~1542 (1933)
- Grana WA, "An analysis of autograft fixation after anterior cruciate ligament reconstruction in a rabbit model", Am J Sports Med, 22, pp.344~351 (1994)
- Panni AS, "Graft healing after anterior cruciate ligament reconstruction in rabbits", Clin Orthop Relat Res, 343, pp.203~212 (1997)
- Rodeo SA, "Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog", J Bone Joint Surg Am, 75, pp.1795~1803 (1993)
- Tomita F, "Comparison of intraosseous graft healing between the doubled flexor tendon graft and the bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction", Arthroscopy, 17, pp.461~476 (2001)
- 이명철, "A comparative study of the healing of tendon autograft and tendon-bone autograft using patellar tendon in rabbits", INTERNATIONAL ORTHOPAEDICS, 25(1), pp.35~39, SPRINGER-VERLAG
- Ostrum RF, "Bone injury, regeneration and repair. 1st ed. Orthopaedic Basic Science", pp.277~323 (1994), American Academy of Orthopaedic Surgeons