경비골 도달법을 이용한 족관절 유합술 시 외과의 보존과희생 방법의 차이에 따른 결과
Outcomes of Lateral Malleolar Saving versus Sacrificing Procedure in Transfibular Ankle Arthrodesis
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. Materials and Methods: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score,visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. Results: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. Conclusion: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.
Abstract
Purpose: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. Materials and Methods: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score,visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. Results: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. Conclusion: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.
참고문헌 (28)
- Thomas RH, "Daniels TR. Ankle arthritis", J Bone Joint Surg Am, 85, pp.923~936 (2003)
- Morrey BF, "Complication and long-term results of ankle arthrodesis following trauma", J Bone Joint Surg, 62, pp.777~784 (1980)
- Scranton PE, "An overview of ankle arthrodesis", Clin Orthop, 268, pp.96~101 (1991)
- Mann Ra, "Ankle fusion", Clin Orthop, 268, pp.49~55 (1991)
- Mann Ra, "Arthrodesis of the ankle: a critical analysis", Foot Ankle Int, 19, pp.3~9 (1998)
- Verhelst MP, "Arthrodesis of the ankle joint with complete removal of the distal part of the fibula. Experience with the transfibular approach and three different types of fixation", Clin Orthop, 118, pp.93~99 (1976)
- Takakura Y, "Low tibial osteotomy for osteoarthritis of the ankle", J Bone Joint Surg, 77, pp.50~54 (1995)
- Holt ES, "Ankle arthrodesis using internal screw fixation", Clin Orthop, 268, pp.21~28 (1981)
- Morgan CD, "Long-term resuls of tibiotalar arthrodesis", J Bone Joint Surg, 67, pp.546~550 (1985)
- Albert E, "Einige Falle Kunstlicher ankylosen. Bildung an Paratischen Gliedmassen", Wien Med Rresse, 23, pp.726~728 (1882)
- Charnley J, "Compression arthrodesis of the ankle and shoulder", J Bone Joint Surg, 33, pp.180~191 (1951)
- Ratliff AHC, "Compression arthrodesis of the ankle", J Bone Joint Surg, 41, pp.524~534 (1959)
- Kimberley AG, "Malunited fractures of the ankle joint with special reference to twenty-two cases treated by arthodesis", Surg Gunecol Obstet, 62, pp.79~84 (1936)
- Campbell CJ, "Arthrodesis of the ankle: deep autogenous inlay grafts with maximum cancellous bone apposition", J Bone Joint Surg, 56, pp.63~70 (1974)
- Chuinard EG, "Distraction-Compression bone graft arthrodesis of the ankle", J Bone Joint Surg, 45, pp.481~490 (1963)
- Kennedy JC, "Arthrodesis of the ankle with particular reference to the Gallie procedure: a review of fifty cases", J Bone Joint Surg, 42, pp.1308~1316 (1960)
- White AA, "A precision posterior ankle fusion", Clin Orthop, 98, pp.239~250 (1974)
- Stulberg SD, "Arthroscopic arthrodesis of the ankle: a new surgical procedure", Am Acad Orthop Surg Technical Exhibit, 2, pp.4~9 (1988)
- Myerson MS, "Ankle arthrodesis:A comparision of an arthroscopic and an open method of treatment", Clin Orthop, 268, pp.84~95 (1991)
- Horwitz, "The use of the transfibular approach in arthrodesis of the ankle joint", Am J Surg, 55, pp.550~552 (1942)
- Adams JC, "Arthrodesis of the ankle joint. Experiencex with the transfibular approach", J Bone Joint Surg Br, 30B, pp.506~511 (1948)
- Wang GJ, "Shen WJ, Mclaughlin RE, Stamp WG. Transfibular compression arthrodesis of the ankle joint", Clin Orthop Relat Res, 289, pp.223~227 (1993)
- Chung YK, "Pyo DC. Transfibular approach for ankle and tibiotalocalcaneal arthrodesis", J Korean Soc Foot Surg, 1, pp.15~22 (1997)
- Wang JM, "Ankle arthrodesis by internal fixation with cancellous screws and fibula strut graft. -report of two cases-", J Korean Soc Fracture, 10, pp.480~488 (1997)
- 안재훈, "경비골 도달법을 이용한 발목 관절 고정술", 대한정형외과학회지, 38(6), pp.9~593 (2003), 대한정형외과학회
- Thordarson DB, "Arthrodesis of the ankle with cancellous-bone screws and fibular strut graft.Biomechanical analysis", J Bone Joint Surg, 72, pp.1359~1363 (1990)
- Colman AB, "Transfibular ankle arthrodesis with rigid internal fixation: an assessment of outcome", Foot Ankle Int, 28, pp.303~307 (2007)
- Gabreil AF, "Outcome of ankle arthrodesis using a transfibular approach", J Foot Ankle Surg, 49, pp.508~512 (2010)