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Duke Whan Chung,이재훈 대한정형외과학회 2012 Clinics in Orthopedic Surgery Vol.4 No.1
Background: The purpose of this article is to report the effi cacy of the extension block pinning and additional intrafocal pinningtechnique applied to cases whose mallet fractures were not reduced with extension block pinning alone. Methods: We retrospectively reviewed 14 digits with 14 patients who were treated with the extension block pinning and additionalintrafocal pinning technique. There were eight men and six women with an average age of 34 years. The average articularsurface involvement was 52%. The average follow-up was 16 months and the mean time from injury to operation was 23 days. Results: All the cases achieved anatomic reduction of fractures. By Crawford’s classifi cation, 9 were excellent and 5 were good. The average active fl exion of the distal interphalangeal joint was 78 degrees and the average extension loss was 1.8 degrees. Bone union was observed in all cases after a postoperative mean of 38.4 days. Complications such as skin necrosis, fracture ofbony fragments, and nail-plate deformity were not found. Conclusions: Additional intrafocal pinning technique is considered a simple and useful method to obtain anatomic reduction ofmallet fractures in cases where extension block pinning alone is insuffi cient to restore the anatomic confi guration of the articularsurface.
변동 나선 워누형 나사[Acutrak<SUP>®</SUP> Screw]를 이용한 발목 관절 고정술
정덕환(Duke Whan Chung),이재훈(Jae Hoon Lee),정비오(Bi O Jeong),박근호(Keun Ho Park) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.2
목적: 발목 관절의 관절염에 대하여 변동 나선 원추형 나사(Acutrak<SUP>®</SUP>)를 이용하여 관절 고정술을 시행하고 그 임상적, 방사선학적 결과를 보고하고자 한다. 대상 및 방법: 변동 나선 원추형 나사를 이용한 발목 관절 고정술을 시행 후 1년 이상의 추시가 가능하였던 14명 16예를 대상으로 하였다. 미국 정형외과 족부족관절학회(American Orthopaedic Foot and Ankle Society)의 족관절-후족부 기능 평가기준(ankle-hindfoot functional scale), 시각 상사 척도 동통 점수(Visual analogue scale pain score), 수술 후 합병증 및 환자의 만족도를 통하여 임상적 평가를 하였으며 발목 관절의 유합 시기, 관절 고정의 위치 및 주위 관절의 퇴행성 변화 유무 및 진행을 통한 방사선학적인 평가를 시행하였다. 결과: 평균 추시 기간은 1년 3개월이었고 미국 정형외과 족부족관절학회 족관절-후족부 기능 평가기준은 수술전 평균 38.9점(범위: 27-57점에서 최종 추시 시 평균 77.3점(범위: 66-89점)으로 향상되었으며 시각 상사 척도 동통 점수는 평균 7.9(범위: 3-10)에서 2.9(범위: 0-5)로 감소되었고, 13예(81%)에서 수술 결과에 만족하였다. 전 예에서 평균 11.2주(범위: 6-16주)에 방사선학적 유합 소견을 얻었다. 결론: 발목 관절의 관절염에 변동 나선 원추형 나사를 이용한 관절 고정술을 시행하여 임상적 및 방사선학적으로 만족할 만한 단기 추시 결과를 얻을 수 있었다. Purpose: The purpose of this study was to evaluate the clinical and radiologic results of open arthrodesis with using variable pitch tapered screws (Acutrak<SUP>®</SUP> screw) for treating ankle arthritis. Materials and Methods: The subjects were 14 patients with 16 cases of performing ankle arthrodesis with using variable pitch tapered screws. Clinical evaluation was performed with using the American Orthopaedic Foot and Ankle Society ankle-hindfoot functional scale and the visual analogue scale pain score, and we assessed the postoperative complications and the patient's satisfaction. Radiological evaluation was performed by the assessing the time to union, the position of union, and the degenerative changes of the adjacent joints of the foot. Results: The average follow-up period was 15 months. The ankle-hindfoot functional scale was improved from an average of 38.9 points (range: 27-57 points) preoperatively to an average of 77.3 points (range: 66-89 points) at the last follow up. The visual analogue scale pain score was decreased from an average of 7.9 (range: 3-10) to 2.9 (range: 0-5), and 13 cases (81%) were satisfied with the outcome of surgery. For all the cases, radiological union was obtained at an average of 11.2 weeks (range: 6-16 weeks). Conclusion: We performed arthrodesis with using variable pitch tapered screws for treating ankle arthritis, and satisfactory short term results were obtained both clinically and radiologically.