Zhou Junjie, Yu Guangrong, Cao Chengfu
Department of Orthopedics, the Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Mar;21(3):285-8.
To evaluate the clinical results of subtalar arthrodesis and calcaneal thalamus reconstruction for malunion of calcaneal fractures and to discuss the indications and its advantages of the management.
From December 1994 to January 2006, 84 cases (96 feet) of malunion of calcaneal fractures were treated with subtalar arthrodesis and calcaneal thalamus reconstruction. The L-shaped approach lateral to calcaneus was used. The bone autograft was harvested from iliac crest. Fifty-one cases were male and 33 cases were female, aging from 21 to 58 years (mean 38.5 years). One side was in volved in 72 cases and two sides in 12 cases. The injury was caused by falling from height in 57 cases, by traffic accident in 22 cases and other in 5 cases. It was 6-31 months from injury to operation (mean 9.5 months).
Among the patients, all cases were followed up 1 to 132 months. The total excellent and good rate was 87.5% including excellent in 31 feet, good in 53 feet and fair in 12 feet,according to Hindfoot scores system (American Orthopaedics Foot and Ankle Society). The Bohler's and Gissane's angles, the height of calcaneal thalamus and width of calcaneus were significant different from those of preoperation (P < 0.01).
The treatment by bone autograft combined with subtalar arthrodesis and calcaneal thalamus reconstruction is an effective operation for malunion of calcaneal fractures, with advantages of correcting deformity, restoring the function of hindfoot and relieving the pain of walking.
评估距下关节融合术联合跟骨丘部重建治疗跟骨骨折畸形愈合的临床效果，并探讨该治疗方法的适应证及优势。
1994年12月至2006年1月，采用距下关节融合术联合跟骨丘部重建治疗84例（96足）跟骨骨折畸形愈合患者。采用跟骨外侧L形入路。取自体髂骨植骨。男51例，女33例，年龄21～58岁（平均38.5岁）。单侧受累72例，双侧受累12例。高处坠落伤57例，交通事故伤22例，其他伤5例。受伤至手术时间为6～31个月（平均9.5个月）。
所有患者均获随访，随访时间1～132个月。根据后足评分系统（美国足踝外科协会），优良率为87.5%，其中优31足，良53足，可12足。跟骨Bohler角、Gissane角、跟骨丘部高度及跟骨宽度与术前比较差异有统计学意义（P < 0.01）。
自体骨移植联合距下关节融合术及跟骨丘部重建是治疗跟骨骨折畸形愈合的有效手术方法，具有矫正畸形、恢复后足功能及缓解行走疼痛等优点。
