경골 원위간부 골절 치료의 골수강내 금속정 고정술과 최소침습 금속판 고정술의 비교: 기능적, 미용적 결과의 후향적 비교 (Intramedullary Nailing versus Minimally Invasive Plate Osteosynthesis for Distal Tibia Shaft Fractures: Retrospective Comparison of Functional and Cosmetic Outcomes)

서지정보

· 발행기관 : 대한족부족관절학회
· 수록지 정보 : 대한족부족관절학회지 / 27권 / 3호 / 93 ~ 98페이지
· 저자명 : 김가현, 김인희, 김건중, 임성준, 윤지영, 김종원, 김용민

초록

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally inva- sive plate osteosynthesis (MIPO) for distal tibia shaft fractures.
Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/ Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were en- rolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively.
Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respec- tively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001).
Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

영어초록

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally inva- sive plate osteosynthesis (MIPO) for distal tibia shaft fractures.
Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/ Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were en- rolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively.
Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respec- tively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001).
Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

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