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Arthroscopically assisted Cancellous Bone Grafting and Percutaneous K-Wires Fixation for the Treatment of Scaphoid Nonunions
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ÀÌ¿µ±Ù(Lee Young-Kun) - ÀüÁÖ´Ù¼ÕÁ¤Çü¿Ü°ú
¿ì»óÇö(Woo Sang-Hyun) - ´ë±¸ ´õºíÀ¯º´¿ø
(Ho Pak-Cheong) - È«ÄáÁß¹®ÀÇ°ú´ëÇк´¿ø
¹ÚÁö°(Park Ji-Kang) - ÃæºÏ´ëÇб³ ÀÇ°ú´ëÇÐ ÃæºÏ´ëÇб³º´¿ø Á¤Çü¿Ü°úÇб³½Ç
±èÁÖ¿ë(Kim Joo-Yong) - ÀÎÁ¦´ëÇб³ ÀÇ°ú´ëÇÐ ºÎ»ê¹éº´¿ø Á¤Çü¿Ü°úÇб³½Ç
Abstract
¸ñ Àû: ÁÖ»ó°ñ ºÒÀ¯ÇÕÀÇ Ä¡·á¸¦ À§ÇÏ¿© °üÀý°æÀû °ñÀ̽ļú ¹× °æÇÇÀû K-°¼± °íÁ¤À» ½ÃÇàÇÑ È¯ÀÚ¸¦ ´ë»óÀ¸·Î Ä¡·á °á°ú ¸¦ ºÐ¼®ÇÏ¿´´Ù.
¹æ ¹ý: ÁÖ»ó°ñ ºÒÀ¯ÇÕÀ¸·Î °üÀý°æÀû °ñÀ̽ļú ¹× °æÇÇÀû K-°¼± °íÁ¤¼úÀ» ½ÃÇà¹ÞÀº ȯÀÚ 20¸íÀ» ´ë»óÀ¸·Î ÇÏ¿´´Ù. ¼Õ »ó ÈÄ ºÒÀ¯ÇÕ ¼ö¼ú±îÁöÀÇ ±â°£Àº Æò±Õ 74°³¿ù(¹üÀ§, 3-480°³¿ù)À̾ú°í, ±â´ÉÀû °á°ú´Â ¼ö¼ú Àü°ú ÃÖÁ¾ Ã߽à ½Ã¿¡ ÃøÁ¤ ÇÑ modified Mayo wrist score¿Í visual analogue scale (VAS)¸¦ ÀÌ¿ëÇÏ¿© Æò°¡ÇÏ¿´´Ù.
°á °ú: 20¸í ¸ðµÎ¿¡¼ °ñÀ¯ÇÕÀ» ¾òÀ» ¼ö ÀÖ¾ú°í, °ñÀ¯ÇÕ±îÁö ¼Ò¿äµÈ Æò±Õ ½Ã°£Àº 9.7ÁÖ(¹üÀ§, 7-14ÁÖ)¿´´Ù. VAS score ´Â ¼ö¼ú Àü Æò±Õ 6.3Á¡(¹üÀ§, 4-8Á¡)¿¡¼ ÃÖÁ¾ Ã߽à ½Ã Æò±Õ 1.62Á¡(¹üÀ§, 0-3Á¡)À¸·Î Çâ»óµÇ¾úÀ¸¸ç, modified Mayo wrist score´Â ¼ö¼ú Àü Æò±Õ 62.5Á¡¿¡¼ ÃÖÁ¾ Ã߽à ½Ã Æò±Õ 85.7Á¡À¸·Î Çâ»óµÇ¾ú´Ù.
°á ·Ð: ÁÖ»ó°ñ ºÒÀ¯ÇÕ Ä¡·á¿¡ ´ëÇÑ °üÀý°æÀû °ñÀ̽ļú ¹× °æÇÇÀû K-°¼± °íÁ¤¼úÀº ÃÖ¼Ò Ä§½ÀÀûÀÎ ¹æ¹ýÀ¸·Î º¸´Ù »ý¹°ÇÐ ÀûÀÎ »óÅ¿¡¼ ºÒÀ¯ÇÕÀ» Ä¡·áÇÒ ¼ö ÀÖ´Â ±âȸ¸¦ Á¦°øÇØ ÁÖ´Â ÀåÁ¡À» °¡Áø ÁÁÀº Ä¡·á ¹æ¹ýÀ̶ó°í »ý°¢µÈ´Ù.
Purpose: The purpose of this study was to analyze the clinical results of patients with scaphoid nonunions treated with arthroscopically assisted bone grafting and percutaneous K-wires fixation.
Methods: We retrospectively reviewed 20 patients with a scaphoid nonunions which was treated with arthroscopically assisted bone grafting and percutaneous K-wires fixation from November 2008 to July 2012. Time from injury to treatment was 74 months (range, 3-480 months) in average. Functional outcome was evaluated using the modified Mayo wrist score and visual analogue scale (VAS) for pain, which were measured before operation and at the last follow up.
Results: All nonunions were healed successfully. The average radiologic union time was 9.7 weeks (range, 7-14 weeks). The average VAS score improved from 6.3 (range, 4-8) preoperatively to 1.6 (range, 0-3) at the last follow up. The average modified Mayo wrist score increased from 62.5 preoperatively to 85.7 at the last follow-up.
Conclusion: Arthroscopically assisted bone grafting and percutaneous K-wires fixation is an effective treatment method for a scaphoid nonunion. It may provide more biological environment than open surgery as a minimally invasive procedure.
Å°¿öµå
Scaphoid nonunion, Arthroscopy, Bone graft, K-wire
KMID :
0621520140190010019
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