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      경피적 정복술을 이용한 경골 후외측과 골절의 치료 = The Treatment of Posterolateral Malleolar Fractures using Percutaneous Reduction Technique

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      https://www.riss.kr/link?id=A75655763

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      다국어 초록 (Multilingual Abstract)

      Purpose: To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture. Materials and Methods: From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted. Results: The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good. Conclusion: Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.
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      Purpose: To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture. Materials a...

      Purpose: To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture. Materials and Methods: From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted. Results: The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good. Conclusion: Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.

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      참고문헌 (Reference)

      1 이창수, "후과 골절의 존재 여부에 따른 족관절 골절의 결과 비교 연구" 대한정형외과학회 42 (42): 470-474, 2007

      2 Jaskulka RA, "of the posterior tibial margin: their role in the prognosis of malleolar fractures" 29 : 1565-1570, 1989

      3 Weber M, "Trimalleolar fractures with impaction of the posteromedial tibial plafond: implications for talar stability" 25 : 716-727, 2004

      4 Mc Danial WJ, "Trimalleolar fractures of the ankle. An end result study" 122 : 37-45, 1977

      5 Jeong HJ, "Treatment of the posterior malleolar fracture" 11 : 924-931, 1998

      6 Strenge KB, "Technique tip: percutaneus screw fixation of posterior malleolar fractures" 27 : 650-652, 2006

      7 Harper MC, "Posterior malleolar fracture of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation" 70 : 1348-1356, 1988

      8 Haraguchi N, "Pathoanatomy of posterior malleolar fractures of the ankle" 88 : 1085-1092, 2006

      9 De Vries JS, "Long-term results of ankle fractures with a posterior malleolar fragment" 44 : 211-217, 2005

      10 Boggs LR, "Isolated posterior malleolar fractures" 4 : 334-336, 1986

      1 이창수, "후과 골절의 존재 여부에 따른 족관절 골절의 결과 비교 연구" 대한정형외과학회 42 (42): 470-474, 2007

      2 Jaskulka RA, "of the posterior tibial margin: their role in the prognosis of malleolar fractures" 29 : 1565-1570, 1989

      3 Weber M, "Trimalleolar fractures with impaction of the posteromedial tibial plafond: implications for talar stability" 25 : 716-727, 2004

      4 Mc Danial WJ, "Trimalleolar fractures of the ankle. An end result study" 122 : 37-45, 1977

      5 Jeong HJ, "Treatment of the posterior malleolar fracture" 11 : 924-931, 1998

      6 Strenge KB, "Technique tip: percutaneus screw fixation of posterior malleolar fractures" 27 : 650-652, 2006

      7 Harper MC, "Posterior malleolar fracture of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation" 70 : 1348-1356, 1988

      8 Haraguchi N, "Pathoanatomy of posterior malleolar fractures of the ankle" 88 : 1085-1092, 2006

      9 De Vries JS, "Long-term results of ankle fractures with a posterior malleolar fragment" 44 : 211-217, 2005

      10 Boggs LR, "Isolated posterior malleolar fractures" 4 : 334-336, 1986

      11 Nugent JF, "Isolated posterior malleolar ankle fractures" 29 : 80-83, 1990

      12 Neumaier Probst E, "Isolated fracture of the posterolateral tibial lip (Volkmann's triangle)" 38 : 359-362, 1997

      13 Baird RA, "Fractures of the distal part of the fibula associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament" 69 : 1346-1352, 1987

      14 Michelson JD, "Fractures about the ankle" 77 : 142-152, 1995

      15 Court-Brown CM, "Adult ankle fractures--an increasing problem?" 69 : 43-47, 1998

      16 Kim SJ, "A clinical study of the trimalleolar fractures of the ankle" 2 : 145-154, 1989

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      2016 0.05 0.05 0.04
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