초록 열기/닫기 버튼
목적: 족관절 삼과 골절에서 관절면의 25% 이내를 침범하는작은 후과 골편에 대한 나사못 고정술 여부에 따른 결과를 비교하고자 하였다. 대상 및 방법: 후과 골편이 관절면의 15%-25%를 침범한총 32예(32명)를 대상으로 내고정 여부에 따라 두 군(고정군 20예, 비고정군 12예)으로 분류하였으며, 최소 추시 기간은 12개월이었다. 고정군과 비고정군에서 후과 골편 크기의중앙값은 각각 24.6% (범위 22.3%-25.0%)와 22.1% (범위17.4%-24.3%)였다. 두 군 간의 임상적 및 방사선적 결과를비교 분석하였다. 결과: 최종 추시상, 두 군 간 AOFAS ( p=0.501), VAS(p=0.578), 족관절 운동 범위(p=0.552) 등의 임상적 결과의차이는 없었다. 방사선적 분석 결과로 두 군 간 관절면 층 형성(p=0.289), 골편 간극(p=0.289)의 차이는 없었다. 합병증은 고정군에서 지연 유합이 1예, 창상 감염이 1예 있었다. 결론: 족관절 삼과 골절에서 작은 후과 골편에 대한 나사못고정군과 비고정군은 모두 만족스러운 결과를 보여주었다. 따라서, 작은 후과 골편을 동반한 경우 관절면의 정복이 이루어진다면 추가적인 내고정술을 시행하지 않더라도 만족할만한 결과를 얻을 수 있을 것으로 생각한다.
Purpose: This study was undertaken to compare outcomes of screw fixation and non-fixation of a small-sized posterior malleolar fragment involving less than 25% articular surface in ankle trimalleolar fractures. Materials and Methods: A total of 32 consecutive ankles (32 patients), with posterior malleolar fragment involving 15%-25% of the joint surface, were enrolled in the study. Patients were divided into 2 groups according to whether the fragment was fixed or not (fixed: 20 ankles, non-fixed: 12 ankles). The minimum follow-up period was 12 months. Median size of the posterior malleolar fragment in the fixed and non-fixed groups were 24.6% (range, 22.3%-25.0%) and 22.1% (range, 17.4%-24.3%), respectively. Complications as well as clinical and radiographic outcomes were compared and analyzed between the two groups. Results: Clinical outcomes, including American Orthopaedic Foot & Ankle Society (p=0.501), visual analogue scale (p=0.578), and ankle range of motion (p=0.552), showed no difference between groups at the final follow-up. No differences were obtained in the radiographic outcomes, including joint stepoff (p=0.289) and fragment gap (p=0.289). Complications, including 1 case of delayed union and 1 case of wound infection, were reported in the fixed group. Conclusion: Clinical outcomes and radiographic outcomes of the non-fixation group were satisfactory and comparable to the fixation group. Our results indicate that anatomical reduction with small-sized posterior malleolar fragment in ankle trimalleolar fractures is sufficient for satisfactory outcomes, without the need for additional internal fixation.
키워드열기/닫기 버튼
Ankle, Posterior malleolus fracture, Small-sized fragment, Screw fixation, Non-fixation
