거골 경부 골절의 나사못 고정 방향에 따른 결과 비교

• Published in: 대한족부족관절학회지 Vol. 14; no. 1; pp. 79 - 83
• Main Authors: 신동은, 윤형구, 최우진, 이윤석, 한승철, Shin, Dong-Eun, Yoon, Hyung-Ku, Choi, Woo-Jin, Lee, Yoon-Seok, Han, Seung-Chul
• Format: Journal Article
• Language: Korean
• Published: 대한족부족관절학회 01.06.2010
• Subjects: 정형외과학; Talus; Screw fixation; Neck fracture; Anterior and posterior approach
• ISSN: 1738-3757; 2288-8551

Purpose: To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture. Materials and Methods: Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria. Results: The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group. Conclusion: Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.