• 대한족부족관절학회지
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• 제24권2호
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• pp.87-93
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• 2020

Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteosynthesis in Sanders type II or III calcaneus fractures.

• 한국임상수의학회지
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• 제29권4호
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• pp.339-343
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• 2012

교통사고를 원인으로 3마리의 개가 경골 골간 골절로 내원하였다. 신체검사와 정형외과 검사상 이들 골절은 경골주위에 연조직 손상을 동반한 폐쇄성 골절을 보여 주었다. 방사선검사상 단순 경사골절 (증례1), 복잡 나선형골절 (증례 2), 단순 나선형골절 (증례 3)로 진단되었다. 이들 골절은 수의 절단성 금속판이나 잠김 금속판을 이용하여 최소 침습적 금속판 고정술을 적용하였다. 수술은 성공적으로 이루어지고 7주 (증례 1), 10주 (증례 2) 그리고 8주 (증례3) 후 부작용 없이 골절 치유를 확인할 수 있었다. 수술 후 모든 환자들은 빠른 골치유와 체중 지지를 관찰할 수 있었다. 최소 침습적 금속판 고정술은 수의정형외과영역에서 경골 골간 골절의 유용한 수술법으로 생각된다.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.220-226
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• 2018

Background: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. Methods: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >$5^{\circ}$ loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. Results: In all cases, complete union was achieved. The ASES and VAS scores were improved to $85.4{\pm}2.1$ and $3.2{\pm}1.3$, respectively. Twelve patients (75.0%) had greater than a $5^{\circ}$ change in NSA; the average NSA change was $3.8^{\circ}$. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a <$100^{\circ}$ active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. Conclusions: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.

• 대한정형외과학회지
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• 제52권1호
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• pp.1-6
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• 2017

목적: 쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 고정술에 대한 후향적 분석을 통해 수술 결과를 비교하고자 한다. 대상 및 방법: 2011년 11월부터 2014년 5월까지 쇄골 간부 골절로 수술을 시행한 최소 1년 이상의 추시가 가능하였던 40예에서 최소 침습적 금속판고정술 20예를 A군, 관혈적 고정술 20예를 B군으로 나누어 두 군 간의 수술시간, 골유합, 기능적 평가(American Shoulder and Elbow Society score), 수술 반흔의 길이, 술 후 통증 완화(visual analogue scale) 및 합병증에 대해 비교 분석하였다. 결과: 모든 예에서 골유합이 이루어졌으며, 양 군에서 모두 양호한 결과를 보였다(p>0.05). 평균 수술 시간은 A군에서 47.5분, B군에서 58.7분이었고, 평균 절개의 길이는 A군에서 6.2 cm, B군 10.7 cm로 유의한 차이를 보였으며, 술 후 통증의 완화에서도 A군에서 초기 빠른 회복을 보였다. 합병증으로 A군에서 부정유합 1예, 피부 감각이상 2예를 보였으며, B군에서 피부 감각이상 6예 및 수술 반흔에 대한 미용상의 문제가 2예 있었다. 결론: 쇄골 간부 골절에서 A와 B 양 군에서 대체적으로 양호한 결과를 보였으나 A군이 B군에 비해 짧은 수술시간과 수술 절개, 초기 통증 완화 항목들에서 더 좋은 결과를 보였다. 하지만 부정유합, 방사선 노출 등의 합병증 및 장기 추시 결과에 대한 연구가 더 이루어져야 할 것으로 보인다.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.286-290
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• 2013

Purpose: To report the postoperative Clinical and Radiological outcomes following distal femoral fractures in elderly patients compared with young patients. Methods: From March, 1996 to March, 2012, 83 patients who received surgical treatment for fractures of the distal femur were enrolled in this retrospective study. Ages more than 65 was named group A. Group A was 49 cases and mean age is 72.5 year(65~91year). Group B was 49 cases and mean age is 45.7 year(16~61 year). Surgical methods are retrograde IM nail, locking compression plate, cannulated screw and postoperative rehabilitation is no difference between two groups. Clinical results were evaluated using Neer scores, radiographic results and the presence of clinical complications. Results: The mean union period was 18.4(12-40) weeks in group A and 17(10-24) weeks in group B. Neer functional scores are no significant statistical difference between two groups. There are 5 cases metal breakage in group A and 1case in group B. There are 3 cases nonunion in group A and 1 case in group B. Conclusion: In the case of fractures of the distal femur in elderly patients, locking plate using minimally invasive percutaneous periosteal osteosynthesis (MIPPO) technique may be one of the most effective methods and preoperative bone stock evaluation in important.

• Clinics in Shoulder and Elbow
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• 제16권1호
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• pp.27-32
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• 2013

목적: 상완골 간부 단순 골절의 수술적 치료에서 잠김 압박 금속판을 이용한 최소 침습적 금속판 골유합술의 임상적 및 방사선학적 결과를 분석하였다. 대상 및 방법: 2010년 8월부터 2011년 5월까지 상완골 간부 단순 골절 골절에 대해 최소 침습적 금속판 골 유합술을 통해 수술을 시행하고 전향적으로 12개월 이상 추시한 6례의 환자를 대상으로 하였으며, 임상적 및 방사선학적 골유합 기간 및 술 후 관절 운동 범위와 기능을 확인하였다. 결과: 임상적 및 방사선학적 평균 골유합 기간은 각각 7.2주, 8주였다. 술 후 골 정렬에서 전후상 평균 2.8도, 측면상 내반 2도의 변형을 보였다. 술 후 12개월째 견관절 운동 범위는 전방거상 167도, 외회전 50도, 내회전 수위는 흉추 11번이었고, 평균 VAS는 1.2점, KSS는 91.3점, ASES는 26.5점, UCLA 점수는 31.5점이었다. 결론: 상완골 간부 단순 골절의 수술적 치료에서 최소 침습적 금속판 골유합술은 방사선학적 및 기능적으로 우수한 결과를 보였으며 상완골 간부 단순 골절에서 고려해 볼 수 있는 유용한 치료 방법 중 하나라고 생각된다.

• 대한족부족관절학회지
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• 제13권2호
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• pp.162-168
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• 2009

Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.