Lee Dong-Oh, Kang Ho Won, Kim Dae-Yoo, Park Gil Young, Hwang Il Ung, Lee Dong Yeon
Department of Orthopedic Surgery, SNU Seoul Hospital, Gangseo-gu, Seoul, South Korea.
Department of Orthopedic Surgery, Ewha Women's University Mokdong Hospital, Yangcheon-gu, Seoul, South Korea.
J Foot Ankle Surg. 2023 May-Jun;62(3):422-425. doi: 10.1053/j.jfas.2022.10.006. Epub 2022 Oct 27.
There are no clinical studies about treatment of distal tibia fractures using far cortical locking (FCL) screws, even though it has been shown to be superior to standard locking screws in biomechanical studies. We compared the efficacy of FCL screws to that of traditional locking screws. Twenty-five distal tibia fractures were treated with minimally invasive plate osteosynthesis using traditional locking screws, whereas 20 were treated using FCL screws. We retrospectively compared time taken for callus formation and radiographic bone union between 2 groups. The effect of age, sex, diabetes, and smoking history on bone healing was analyzed. Complications were also noted. As a result, there was no significant difference in age (p = .292), sex (p = 1.0), diabetes (p = 1.0), or smoking history (p = .704) between 2 groups. Time to callus formation was 77.5 days in the FCL group, and 96 days in the traditional group (p = .023). Average time to bone union was 134.8 days, and 163.1 days in the FCL group and the traditional group, respectively (p = .017). There was one case of screw loosening in the FCL group, and one case of screw breakage in the traditional group. This study suggests that FCL screws promote quicker healing of distal tibia fractures than traditional locking screws.
尽管在生物力学研究中已表明远皮质锁定(FCL)螺钉优于标准锁定螺钉,但目前尚无关于使用FCL螺钉治疗胫骨干骺端骨折的临床研究。我们比较了FCL螺钉与传统锁定螺钉的疗效。25例胫骨干骺端骨折采用传统锁定螺钉进行微创钢板接骨术治疗,而20例采用FCL螺钉治疗。我们回顾性比较了两组之间骨痂形成和影像学骨愈合所需的时间。分析了年龄、性别、糖尿病和吸烟史对骨愈合的影响。同时也记录了并发症情况。结果,两组之间在年龄(p = 0.292)、性别(p = 1.0)、糖尿病(p = 1.0)或吸烟史(p = 0.704)方面无显著差异。FCL组骨痂形成时间为77.5天,传统组为96天(p = 0.023)。FCL组和传统组的平均骨愈合时间分别为134.8天和163.1天(p = 0.017)。FCL组有1例螺钉松动,传统组有1例螺钉断裂。本研究表明,FCL螺钉比传统锁定螺钉能促进胫骨干骺端骨折更快愈合。