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전위성 관절 내 종골 골절 후 발생한 외상성 거골하 관절염에서 거골하 관절유합술 후 컴퓨터 단층 촬영을 통한 유합 부위 분석

Computed Tomography Image Analysis of the Fusion Site of Subtalar Arthrodesis for Traumatic Arthritis after a Displaced Intraarticular Calcaneal Fracture

대한골절학회지 2019년 32권 3호 p.121 ~ 127
박홍기, 심재앙, 김한솔, 이병훈,
소속 상세정보
박홍기 ( Park Hong-Gi ) - 가천대학교 길병원 정형외과
심재앙 ( Sim Jae-Ang ) - 가천대학교 길병원 정형외과
김한솔 ( Kim Han-Soul ) - 가천대학교 길병원 정형외과
이병훈 ( Lee Byung-Hoon ) - 가천대학교 길병원 정형외과

Abstract


Purpose: The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography.

Materials and Methods: The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017.

Results: An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%).

Conclusion: Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.

키워드

Calcaneus; Fractures; Intra-articular; Subtalar joint; Arthritis; Computed tomography; Arthrodesis

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