다공성 폴리에틸렌판(Medpor)을 이용한 안와파열골절의 재건

Abstract

A retrospective study was performed on 64 patients who underwent orbital blow-out fracture reconstruction with autogenous or Medpor implant following blunt facial trauma between 1992 and 1997. Hospital records were reviewed especially for preoperative and postoperative diplopia, enopthalmos and extraocular muscle movement limitations between the autogenous material group and Medpor implant group. The autogenous material used was mostly conchal cartilage graft. The average follow-up period was 36 months with a range of 5 to 64 months. There was no significant statistical difference between both groups on incidence of postoperative complications of diplopia, enophthalmos and extraocular muscle movement limitations. Postoperative infection, ectropion, implant extrusion and migration were absent in both groups. The use of Medpor implant for orbital blow-out fracture reconstruction was associated with a low incidence of complication. In addition, the Medpor implant is readily available, easy to use, cut, contour, position, fixate and has no potential for graft resorption, and precludes the need to harvest an autogeneous graft. In conclusion, Medpor is a stable and reliable substitute for autogeneous graft reconstruction of the orbital blow-out fracture.

안와파열골절에 있어 다공성 폴리에틸렌(Medpor)의 사용은 비교적 손쉽게 국내에서 구할 수 있고 생체적합성을 가지며 원하는대로 모양을 다듬을 수 있고 연골이식편이나 골이식편 채취에 따른 공여부의 이환을 피할 수 있으며 다공성 구조이므로 섬유성 조지고가 혈관 조직이 자라 들어가 감염, 이동, 돌출의 합병증이 없었다. 복시, 안구운동장애, 안구함몰 등의 합병증 발생율을 자가조직편 삽입군과 비교한 본 연구에서 양군간의 합병증 발생율에 큰 차이가 없어 다공성 폴리에틸렌판은 안와파열골절에서 자가이식물질을 대체하여 안전하게 사용할 수 있으며 수술시간을 단출시킬 수 있고 골결손부가 큰 경우에도 손쉽게 재건할 수 있는 유용한 재료임을 확인하였다.