추락사고에 의해 발생한 흉요추부 방출성 골절에서 족부족관절 골절 동반 여부에 따른 차이 = Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures

다국어 초록 (Multilingual Abstract)

Study Design: This is a retrospective clinical study.
Objectives: To know how the associated foot or ankle fracture influences the fracture pattern in the thoracolumbar burst fractures caused by falls from height.
Summary of Literature Review: There were few studies on how the foot or ankle fracture influences the thoracolumbar fracture caused by falls from height.
Materials and Methods: We reviewed 46 subjects, who underwent surgery due to burst fracture of the thoracic or lumbar region,caused by fall accidents, from May 2004 to October 2008. Among them, we defined 19 cases that had associated foot or ankle fractures as group A, and the other 27 cases as group B. We analyzed the differences of radiological and clinical findings, and functional outcomes between the two groups.
Results: The falling heights were higher in group A than in group B (P<0.01). Thoracolumbar junction (T11-L2) was the most common location involved in both groups, but group A had more fractures on the lower lumbar region (L3-5), relatively (p=0.03). Kyphotic deformity was more severe in group B (p=0.01) but there were no significant differences in the wedge angle, amount of canal compromise,compression rate of anterior column between both groups (p=0.08, 0.46, 0.76). More segments were fused in group B (P=0.04).
Neurologic deficit was more common in group B (p=0.03), but there were many complications related with foot or ankle fractures in group A (38%).There was no significant difference in the final clinical outcome between both groups (Pain scale p= 0.48, Work scale p=1.00).
Conclusions: In patients who had burst fractures in the thoracic or lumbar region associated with foot or ankle fractures, there was a tendency to increase the incidence of lower lumbar fracture, relatively. The neurologic deficits were less common in this group of patients, but there was no difference in the functional outcome.

국문 초록 (Abstract)

연구 계획: 후향적 임상 연구목적: 추락사고에 의해 발생한 흉요추부 방출성 골절에서 동반된 족부 족관절 골절이 척추 골절 의 양상에 미치는 영향에 대하여 알아보고자 하였다.
선행문헌의 요약: 낙상환자에서 족부 족관절 골절이 흉요추부 골절에 미치는 영향에 대한 보고는 드물다.
대상 및 방법: 2004년 5월부터 2008년 10월까지 추락사고에 의한 방출성 흉요추부 골절로 수술적 치료를 받은 46명을 대상으로 하였다. 족부 족관절골절이 동반되었던 A군 19명과 대조군 B군 27명으로 구분하여 각 군의 방사선학적, 임상적 소견의 차이 및 기능적 결과를 분석하였다.
결과: 추락 높이는 A군에서 더 높았다 (P<0.01). 양군 모두 흉요추부 이행부 (T11-L2)의 손상이 가장 흔하였으나A군의 경우 하요추부에서의 골절이 상대적으로 많았다 (p=0.03). 후만변형은 B 군에서 심하였으나 (p=0.01) 그 외 설상각, 척추관의 침범 정도, 전방주의 압박정도는 양 군에서 통계학적 차이를보이지 않았다 (p=0.08, 0.46, 0.76). 유합분절의 수는 B군에서 더 많았다 (P=0.04). 신경학적 손상은 B군에서 더 흔하였지만(p=0.03) A군에서는 족부 족관절 골절과 관련된 합병증이 많았다(38%). 최종 추시시 기능적 결과는 양군에서 의미있는 차이를 보이지 않았다(동통 점수p=0.48, 작업 점수p=1.00).
결론: 족부 족관절 골절이 동반된 흉요추부 방출성 골절 환자에서 하부요추 골절의 빈도가 상대적으로 증가하는 경향을 보였다. 이 군의 환자에게서 신경학적 손상은 덜 발생하였으나 기능적 결과의 차이는 없었다.

참고문헌 (Reference)

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