Ali Ayman M, Elsaied Mohamed A, Elmoghazy Nabil
Orthopaedic Department, Mansoura University, Egypt.
Acta Orthop Belg. 2009 Feb;75(1):51-6.
Twenty five intra-articular fractures of the calcaneus in 25 patients were reduced through a minimal incision and fixed with an Ilizarov external fixator. The average age of patients was 38.6 years (range: 17 to 62 years). According to the Sanders CT classification, 10 (40%) were type II, 9 (36%) type III, and 6 (24%) type IV. The average follow-up was 30 months (range: 24-40 months). According to the AOFAS scale for ankle and hind foot there were 6 (24%) excellent, 11 (44%) good, 6 (24%) fair, and two (8%) poor results. The average score was 68 with a range of 48 to 92. The average length of the treatment period with the fixator was 9.7 weeks (range, 8 to 12 weeks). Radiological assessment revealed reduction malalignment < 5 degrees in 22 cases and > 10 degrees in 3 cases. The calcaneal width averaged 112% of the contralateral side. The calcaneal height was restored to 92% of the normal side, the mean (+/- SD) Böhler angle was changed from 11 degrees +/- 9 degrees preoperatively to 24 degrees +/- 5 degrees postoperatively. The most common complication was superficial skin infection at wire insertion sites. The results with this technique in a small number of non randomised cases with an average follow-up of 2.5 years seem to indicate that it could be a good alternative to traditional methods for management of intraarticular calcaneus fractures, with fewer secondary problems.
25例患者的25例跟骨关节内骨折通过小切口复位，并用伊里扎洛夫外固定器固定。患者平均年龄为38.6岁（范围：17至62岁）。根据Sanders CT分类，II型10例（40%），III型9例（36%），IV型6例（24%）。平均随访30个月（范围：24 - 40个月）。根据AOFAS踝与后足评分标准，结果为优6例（24%），良11例（44%），可6例（24%），差2例（8%）。平均评分为68分，范围为48至92分。固定器治疗期平均长度为9.7周（范围：8至12周）。影像学评估显示，22例复位对线不良<5度，3例>10度。跟骨宽度平均为对侧的112%。跟骨高度恢复至正常侧的92%，平均（±标准差）Böhler角从术前的11度±9度变为术后的24度±5度。最常见的并发症是钢丝插入部位的浅表皮肤感染。在少数非随机病例中，平均随访2.5年的该技术结果似乎表明，对于跟骨关节内骨折的治疗，它可能是传统方法的一个很好的替代方法，继发性问题较少。
