내측 거골 체에 발생한 골연골 병변에서 다발성 천공술의 치료 결과

국문 초록 (Abstract)

목적: 내측 거골 체에 발생한 골연골 병변에서 다발성 천공술 후, 평균 77개월의 추시 결과를 보고하고자 한다.
대상 및 방법: 1997년 3월부터 2002년 12월까지 거골의 골연골 병변 중 내측 거골 체에 국한되며 K 강선을 이용하여, 관혈적 또는 관절경으로 천공술을 시행 받고 최소 36개월 이상 추시 가능하였던 15명의 환자 16예를 대상으로 하였다. 수술 시 평균 연령은 34.4세(범위, 19-58세)이었으며, 평균 추시 기간은 77개월(범위, 41-107개월)이었다.
결과: 운동 시 술 전 평균 VAS 점수는 6.8점에서 최종 추시 시 2.1점으로 유의하게 감소하였다(p=0.004). 미국정형외과족부족관절학회의 족관절-후족부 점수는 술 전 64점에서 최종 추시 시 86.2점으로 유의하게 호전되었다(p=0.001). 수술 당시 나이가 30세 이하였던 8예에서는 최종 추시의 운동 시 VAS 점수는 1.8점, 미국정형외과족부족관절학회의 족관절-후족부 점수는 91.1점이었다. 31세 이상의 8예에서는 각각 2.4점, 81.2점으로 양군간에 VAS 점수 차이는 없었으나(p=0.22), 미국정형외과족부족관절학회의 족관절-후족부 점수는 유의한 차이(p=0.001)를 보였다.
결론: 내측 거골 체에 발생한 골연골 병변에서 대부분 10 mm 미만의 크기에서는 다발성 천공술로 족관절의 동통 감소와 기능적 향상을 얻을 수 있었다. 다발생 천공술은 특히 젊은 연령에서 유용한 치료 방법이 될 수 있을 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the treatment outcomes of transmalleolar multiple drilling with a K-wire for an osteochondral lesion of the medial talar dome after an mean follow-up period of 77 months.
Materials and Methods: Among patients treated surgically for a symptomatic osteochondral lesion of the talus between March 1997 and December 2002, sixteen ankles (fifteen patients) with a medial talar dome lesion were treated by transmalleolar multiple drilling and followed-up for at least 3 years. The average age at the time of surgery was 34.4 years (range, 19-58 years). The mean follow-up period was 77 months (range, 41-107 months).
Results: At the latest follow-up, the average VAS at motion decreased from 6.8 to 2.1 (p=0.004). The AOFAS score improved from 64 points to 86.2 points (p=0.001). The 8 ankles in those less than thirty years of age at that time of surgery showed a VAS at motion of 1.8 and an AOFAS score of 91.1 points. In contrast, 8 ankles in those who older than thirty one years of age had a VAS at motion of 2.4 and an AOFAS score of 81.2 points. The younger group showed a significantly better AOFAS score than the older group (p=0.001). However, there was no significant difference in the VAS score (p=0.22).
Conclusion: Multiple drilling has a good effect in pain control and ankle function for patients with an osteochondral lesion of the medial talar dome 10 mm. The procedure is particularly effective and useful in younger patients.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• 참고문헌
• =국문초록=

참고문헌 (Reference)

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