경골 원위부 골절 치료에서 최소 침습적 접근법을 통한 잠금 나사 금속판 고정술과 교합성 골수강 내 금속정 고정술의 비교 연구
A Comparative Study of Interlocking IM Nailing and LCP Fixation through MIPPO Technique in the Treatment of Distal Metaphyseal Tibial Fracture
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Purpose: To evaluate and compare the outcome between interlocking IM nailing and LCP fixation in the treatment of distal metaphyseal tibial fracture. Materials and Methods: From January 2000 to December 2007, 17 patient were treated by interlocking IM nail and 13 patient were treated by LCP fixation for distal metaphyseal tibial fracture. Results: According to AO classification, there were 2 type A1 fracture (12%), 6 type A2 fracture (36%), 3 type A3 fracture (18%), 4 type B1 fracture (24%), 1 type B3 fracture (6%), 1 type C1 fracture (6%) in interlocking IM nailing group and 1 type A2 fracture (7.7%), 2 type A3 fracture (15.4%), 3 type B1 fracture (23%), 3 type B2 fracture (23%), 3 type C1 fracture (23%), 1 type C2 fracture (7.7%) in LCP fixation group. The clinical functional outcome (according to AOFAS score) is 75.6 point in IM nailing group and 81.5 point in LCP fixation group. In IM nailing group, 65% of patient showed satisfactory result and In LCP fixation group, 77% of patient showed satisfactory result. Conclusion: There is no difference on clinical results between IM nailing and MIPPO (minimal invasive percutaneous plate osteosynthesis) group in the treatment of distal tibia fracture. But MIPPO group have higher subjective satisfactory score and less complication rate. The weakness of our study is a small case number and limited follow-up and we believe a better designed prospective study will be needed.
Abstract
Purpose: To evaluate and compare the outcome between interlocking IM nailing and LCP fixation in the treatment of distal metaphyseal tibial fracture. Materials and Methods: From January 2000 to December 2007, 17 patient were treated by interlocking IM nail and 13 patient were treated by LCP fixation for distal metaphyseal tibial fracture. Results: According to AO classification, there were 2 type A1 fracture (12%), 6 type A2 fracture (36%), 3 type A3 fracture (18%), 4 type B1 fracture (24%), 1 type B3 fracture (6%), 1 type C1 fracture (6%) in interlocking IM nailing group and 1 type A2 fracture (7.7%), 2 type A3 fracture (15.4%), 3 type B1 fracture (23%), 3 type B2 fracture (23%), 3 type C1 fracture (23%), 1 type C2 fracture (7.7%) in LCP fixation group. The clinical functional outcome (according to AOFAS score) is 75.6 point in IM nailing group and 81.5 point in LCP fixation group. In IM nailing group, 65% of patient showed satisfactory result and In LCP fixation group, 77% of patient showed satisfactory result. Conclusion: There is no difference on clinical results between IM nailing and MIPPO (minimal invasive percutaneous plate osteosynthesis) group in the treatment of distal tibia fracture. But MIPPO group have higher subjective satisfactory score and less complication rate. The weakness of our study is a small case number and limited follow-up and we believe a better designed prospective study will be needed.
참고문헌 (21)
- Asche G, "Result of the treatment of femoral and tibial fractures following interlocking nailing and plate osteosynthesis. A comparative retrospective study", Zentralbl Chir, 114, pp.1146~1154 (1989)
- Borrelli J, "Pilon fractures: assessment and treatment", Orthop Clin North Am, 33, pp.231~245 (2002)
- Bostman O, "The fibular reciprocal fracture in tibial shaft fractures caused by indirect violence", Arch Orthop Trauma Surg, 100, pp.115~121 (1982)
- Bradley GW, "Effects of flexural rigidity of plates on bone healing", J Bone Joint Surg, 61(A), pp.866~872 (1979)
- Chrisovitsinos JP, "Bridge plating osteosynthesis of 20 comminuted fractures of the femur", Acta Orthop Scand Suppl, 275, pp.72~76 (1997)
- Collinge C, "Treatment of complex tibial periarticular fractures using percutaneous techniques", Clin Orthop, 375, pp.69~77 (2000)
- Collinge CA, "Percutaneous plating in the lower extremity", J Am Acad Orthop Surg, 8, pp.211~216 (2000)
- Hahn D, "Intramedullary nail breakage in distal fractures of the tibia", Injury, 27, pp.323~327 (1996)
- Helfet D, "Minimally invasive plate osteosynthesis of distal fractures of the tibia", Injury, 28, pp.42~48 (1997)
- Helfet DL, "Minimally invasive percutaneous plate osteosynthesis of fractures of the distal tibia", Instr Course Lect, 53, pp.471~475 (2004)
- Ibrahim T, "Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales", J Foot Ankle Surg, 46, pp.65~74 (2007)
- Kim JR, "Treatment of distal tibial fractures by interlocking intramedullary nailing", J Korean Fracture Soc, 16, pp.348~355 (2003)
- Krettek C, "The mechanical effect of blocking screws (“Poller screws”) in stabilizing tibia fractures with short proximal or distal fragments after insertion of smalldiameter intramedullary nails", J Orthop Trauma, 13, pp.550~553 (1999)
- Krettek C, "Minimally invasivve percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures", Injury, 28, pp.A20~A30 (1997)
- Krettek C, "The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails", J Bone Joint Surg, 81, pp.963~968 (1999)
- McKibbin B, "The biology of fracture healing in long bones", J Bone Joint Surg, 60(B), pp.150~162 (1978)
- Melis GC, "Intramedullary nailing in segmental tibial fractures", J Bone Joint Surg, 63(A), pp.1310~1318 (1981)
- Mosheiff R, "The unreamed tibial nail in the treatment of distal metaphyseal fractures", Injury, 30, pp.83~90 (1999)
- Nork SE, "Intramedullary nailing of distal metaphyseal tibial fractures", J Bone Joint Surg, 87(A), pp.1213~1221 (2005)
- Park IH, "Interlocking intramedullary nailing for treating most distal tibial fracture", J Korean Fracture Soc, 16, pp.356~362 (2003)
- Tucker HL, "Management of unstable open and closed tibial fractures using the Ilizarov method", Clin Orthop, 280, pp.125~135 (1992)