Aşik Mehmet, Sen Cengiz
University of Istanbul, Medical Faculty of Istanbul, Istanbul, Turkey.
Arch Orthop Trauma Surg. 2002 Jul;122(6):354-9. doi: 10.1007/s00402-002-0407-6. Epub 2002 Apr 16.
In this study we evaluated the interim results of surgical management of intraarticular calcaneal fractures in 26 feet in 19 patients. The mean age of the 15 male and 4 female patients in our series was 28.3 (range 17-54) years. There were 7 bilateral and 12 unilateral fractures. We obtained anteroposterior (AP), lateral, and skyline views and computed tomography (CT) scans of all patients preoperatively. According to Sanders CT classification, we detected type II, III, and IV fractures in 12, 10, and 4 cases, respectively. We performed extended lateral incisions in all patients but one and used Sherman plate, screw, and staples to achieve anatomic reduction. The mean follow-up period was 38.2 (range 18-50) months. Patients were evaluated by X-ray, CT, and Maryland foot score. We found that anatomic reduction had been achieved in 20 cases as confirmed by X-ray and CT postoperatively. With regard to the Maryland foot score, excellent, good, fair, and poor results were obtained in 9, 11, 4, and 2 cases, respectively. None of our patients required secondary intervention. We conclude that in order to obtain satisfactory results in the management of intraarticular calcaneal fractures, anatomic reduction must be achieved and maintained using strength hardware.
在本研究中，我们评估了19例患者26足关节内跟骨骨折手术治疗的中期结果。我们系列中的15例男性和4例女性患者的平均年龄为28.3岁（范围17 - 54岁）。有7例双侧骨折和12例单侧骨折。我们在术前获得了所有患者的前后位（AP）、侧位和跟骨轴位视图以及计算机断层扫描（CT）。根据Sanders CT分类，我们分别在12例、10例和4例中检测到II型、III型和IV型骨折。除1例患者外，我们对所有患者均进行了外侧延长切口，并使用Sherman钢板、螺钉和吻合钉来实现解剖复位。平均随访期为38.2个月（范围18 - 50个月）。通过X线、CT和马里兰足部评分对患者进行评估。我们发现术后X线和CT证实20例实现了解剖复位。关于马里兰足部评分，分别在9例、11例、4例和2例中获得了优、良、可和差的结果。我们的患者均无需二次干预。我们得出结论，为了在关节内跟骨骨折的治疗中获得满意的结果，必须使用坚固的内固定物实现并维持解剖复位。
