경골 근위부 골절에서 잠김압박금속판(LCP)의 MIPO 술기를 이용한 치료

Abstract

Purpose : Examining the results and the effectiveness of the patients treated proximal tibia fractures using LCP(locking compression plate) by MIPO(minimal invasive plate osteosynthesis) technique with method of retrograde analysis. Materials and Methods : Among the 23 patients, 16 male, 7 female, and mean age of 52.7(23~88), who are performed with proximal tibia fracture operated in our hospital, and suitable of following up for more than a year. According to the AO/ASIF classification, there are 7 cases of A3, 7 cases of C2, 6 cases of A2, 2 cases of C3, and 1 case of C1. Causes of the injuries were 21 cases of traffic accident, 2 cases of pedestrian accident, and so on. On the 10 cases, fractures of upper limb, pelvic bone, lower limb like femur fracture, thorax and brain damage are accompanied. Finally, the range of joint motion, the arrangement on radiological studies, and another complications are also discussed. Results : Mean operation time was 59 minutes(40~85). 17 cases were treated at the anterior lateral proximal tibia using anatomical LCP. 3 cases were operated at the anterior medial side of the tibia using bent LCP by MIPO technique. and 3 cases were performed at the proximal tibia using L-shape LCP. Mean bone union time was 13.7 weeks(10~20). Among the patients above, author observed 19 cases of the patients with no more than 5 degrees of valgus, 2 cases with 6 to 8 degrees of valgus, and 2 cases of varus on more than 5 degrees. On 2 cases, author found superficial infection on wound site, but completely resolved with dressing and antibiotics. And also, on 3 cases of the 17 patients treated on anterior lateral tibia, and on 2 cases of the 6 patients treated on anterior medial tibia are suffered irritation by the proximal site of the LCP though, specific care were not required. On 17 cases, the normal range of motion though, on 6 cases of the patients with ipsilateral patellar fracture, or ipsilateral femur supracondylar fracture, there were mild limit of the motion. Conclusion : Treatment of proximal tibia fracture using LCP by MIPO technique can be considered an effective method to shorten operation time, to prevent deep infection and damage of connective tissue. However, owing to the reason that thick material of the LCP might cause the irritation of the skin, attention about the adjustment of the site of the LCP is highly required. When it comes to the patients with defect on anterior medial tibia have risk of varus deformity, that is alarming to the physician to repair the arrangement of the bone.