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      근위 및 원위 경골 간부 골절에서 최소 침습적 경피적 금속판 고정술과 골수강내 금속정을 이용한 치료의 비교 = The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture

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      다국어 초록 (Multilingual Abstract)

      Purpose: To compare the efficacy of the surgical treatment through the comparison of Minimally Invasive Plate Osteosynthesis (MIPO) and Intramedullary (IM) nailing in the treatment of the tibial shaft fractures expended to metaphysis retrospectively. Materials and Methods: Patients with proximal or distal third fracture of tibial shaft from May 2003 to Aug. 2006 were divided into two groups depending on the surgical method. Group A consisted of 30 patients treated with IM nailing, Group B was 29 patients treated with MIPO. The clinical outcomes were evaluated retrospectively from the time for bone union and callus formation confirmed by X-ray, functional score of knee or ankle joint, and complications including nonunion, malalignment and infection. Results: Bone union was seen radiologically at a mean of 17.4 weeks in group A, and 17.0 weeks in group B. In postoperative complications, group A showed two nonunion, two delayed-union, six malalignment, and two wound infection while group B showed only one delayed-union and one wound infection. Conclusion: There were no significant differences in the time for bony union and functional score between IM nailing and MIPO. Conventional IM nailing with only interlocking technique showed higher incidence of malalignment and deformity than MIPO for the treatment of the proximal or distal third fracture of the tibial shaft.
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      Purpose: To compare the efficacy of the surgical treatment through the comparison of Minimally Invasive Plate Osteosynthesis (MIPO) and Intramedullary (IM) nailing in the treatment of the tibial shaft fractures expended to metaphysis retrospectively. ...

      Purpose: To compare the efficacy of the surgical treatment through the comparison of Minimally Invasive Plate Osteosynthesis (MIPO) and Intramedullary (IM) nailing in the treatment of the tibial shaft fractures expended to metaphysis retrospectively. Materials and Methods: Patients with proximal or distal third fracture of tibial shaft from May 2003 to Aug. 2006 were divided into two groups depending on the surgical method. Group A consisted of 30 patients treated with IM nailing, Group B was 29 patients treated with MIPO. The clinical outcomes were evaluated retrospectively from the time for bone union and callus formation confirmed by X-ray, functional score of knee or ankle joint, and complications including nonunion, malalignment and infection. Results: Bone union was seen radiologically at a mean of 17.4 weeks in group A, and 17.0 weeks in group B. In postoperative complications, group A showed two nonunion, two delayed-union, six malalignment, and two wound infection while group B showed only one delayed-union and one wound infection. Conclusion: There were no significant differences in the time for bony union and functional score between IM nailing and MIPO. Conventional IM nailing with only interlocking technique showed higher incidence of malalignment and deformity than MIPO for the treatment of the proximal or distal third fracture of the tibial shaft.

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      참고문헌 (Reference)

      1 오창욱, "근위 경골 골절에 대한 최소 침습적 경피적 금속판 고정술" 대한골절학회 17 (17): 2004

      2 손홍문, "고에너지 경골 원위부 관절내 골절의 2단계 지연 최소 침습적 내고정술을 이용한 치료" 대한골절학회 20 (20): 4-4, 2007

      3 Bone LB, "Treatment of tibial fractures by reaming and intramedullary nailing" 68 : 877-887, 1986

      4 Janssen KW, "Treatment of distal tibial fractures: plate versus nail: a retrospective outcome analysis of matched pairs of patients" 31 : 709-714, 2007

      5 Rasmussen PS, "Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment" 55 : 1331-1350, 1973

      6 Hajek PD, "The use of one compared with two distal screws in the treatment of femoral shaft fractures with interlocking intramedullary nailing. A clinical and biomechanical analysis" 75 : 519-525, 1993

      7 Böstman O, "The fibular reciprocal fracture in tibial shaft fractures caused by indirect violence" 100 : 115-121, 1982

      8 McKibbin B, "The biology of fracture healing in long bones" 60 : 150-162, 1978

      9 Asche G, "Results of the treatment of femoral and tibial fractures following interlocking nailing and plate osteosynthesis. A comparative retrospective study" 114 : 1146-1154, 1989

      10 Freedman EL, "Radiographic analysis of tibial fracture malalignment following intramedullary nailing" 315 : 25-33, 1995

      1 오창욱, "근위 경골 골절에 대한 최소 침습적 경피적 금속판 고정술" 대한골절학회 17 (17): 2004

      2 손홍문, "고에너지 경골 원위부 관절내 골절의 2단계 지연 최소 침습적 내고정술을 이용한 치료" 대한골절학회 20 (20): 4-4, 2007

      3 Bone LB, "Treatment of tibial fractures by reaming and intramedullary nailing" 68 : 877-887, 1986

      4 Janssen KW, "Treatment of distal tibial fractures: plate versus nail: a retrospective outcome analysis of matched pairs of patients" 31 : 709-714, 2007

      5 Rasmussen PS, "Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment" 55 : 1331-1350, 1973

      6 Hajek PD, "The use of one compared with two distal screws in the treatment of femoral shaft fractures with interlocking intramedullary nailing. A clinical and biomechanical analysis" 75 : 519-525, 1993

      7 Böstman O, "The fibular reciprocal fracture in tibial shaft fractures caused by indirect violence" 100 : 115-121, 1982

      8 McKibbin B, "The biology of fracture healing in long bones" 60 : 150-162, 1978

      9 Asche G, "Results of the treatment of femoral and tibial fractures following interlocking nailing and plate osteosynthesis. A comparative retrospective study" 114 : 1146-1154, 1989

      10 Freedman EL, "Radiographic analysis of tibial fracture malalignment following intramedullary nailing" 315 : 25-33, 1995

      11 Lang GJ, "Proximal third tibial shaft fractures. Should they be nailed?" 315 : 64-74, 1995

      12 Gustilo RB, "Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses" 58 : 453-458, 1976

      13 Burwell HN, "Plate fixation of tibial shaft fractures. A survey of 181 injuries" 53 : 258-271, 1971

      14 Gorczyca JT, "Modified tibial nails for treating distal tibia fractures" 16 : 18-22, 2002

      15 Helfet DL, "Minimally invasive percutaneous plate osteosynthesis of fractures of the distal tibia" 53 : 471-475, 2004

      16 Hasenboehler E, "Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: a retrospective study of 32 patients" 38 : 365-370, 2007

      17 Konrath G, "Intramedullary nailing of unstable diaphyseal fractures of the tibia with distal intraarticular involvement" 11 : 200-205, 1997

      18 Melis GC, "Intramedullary nailing in segmental tibial fractures" 63 : 1310-1318, 1981

      19 Henley MB, "Influences of some design parameters on the biomechanics of the unreamed tibial intramedullary nail" 7 : 311-319, 1993

      20 Ovadia DN, "Fractures of the tibial plafond" 68 : 543-551, 1986

      21 Ricci WM, "Fractures of the proximal third of the tibial shaft treated with intramedullary nails and blocking screws" 15 : 264-270, 2001

      22 Krackhardt T, "Fractures of the distal tibia treated with closed reduction and minimally invasive plating" 125 : 87-94, 2005

      23 Claes L, "Fixation technique influences osteogenesis of comminuted fractures" 336 : 221-229, 1999

      24 Perren SM, "Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology" 84 : 1093-1110, 2002

      25 Robinson CM, "Distal metaphyseal fractures of the tibia with minimal involvement of the ankle. Classification and treatment by locked intramedullary nailing" 77 : 781-787, 1995

      26 McFerran MA, "Complications encountered in the treatment of pilon fractures" 6 : 195-200, 1992

      27 Johner R, "Classification of tibial shaft fractures and correlation with results after rigid internal fixation" 178 : 7-25, 1983

      28 D'Aubigne RM, "Blind intramedullary nailing for tibial fractures" 105 : 267-275, 1974

      29 Olerud C, "Bi- and trimalleolar ankle fractures operated with nonrigid internal fixation" 206 : 253-260, 1986

      30 Richter D, "Ankle para-articular tibial fracture. Is osteosynthesis with the unreamed intramedullary nail adequate?" 69 : 563-570, 1998

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