El Shazly Ossama, Nassar Wael, El Badrawy Ahmed
Department of Orthopaedics, Ain Shams University, Cairo, Egypt.
Arthroscopy. 2009 Jul;25(7):783-7. doi: 10.1016/j.arthro.2008.12.017. Epub 2009 Mar 17.
The purpose of this study was to determine the results of arthroscopic subtalar posterior facet fusion for subtalar arthritis after calcaneal fracture.
This is a retrospective case series on 10 patients (8 men and 2 women) who had isolated subtalar arthritis after calcaneal fracture. All patients were treated conservatively, but pain was not controlled. Only patients without hardware in the calcaneus were chosen for inclusion in the study. Patients were treated by posterior subtalar arthroscopic fusion. Fixation was done by percutaneous cannulated screws. Bone graft was not needed. All patients were evaluated preoperatively and postoperatively by the American Orthopaedic Foot & Ankle Society scoring system for the ankle and hind foot. The mean follow-up period was 28.4 months; only 1 case was missed during follow-up.
There was statistically significant improvement in total American Orthopaedic Foot & Ankle Society score after 2 years' follow-up (P < .05). There was statistically significant improvement in pain and walking distance after follow-up (P < .05). The mean time for fusion was 11.44 weeks. Only 1 case had painful neuroma at the site of the anterolateral portal.
Arthroscopically assisted posterior facet fusion of the subtalar joint is an effective method for management of subtalar arthritis after calcaneal fracture.
Level IV, therapeutic case series.
本研究旨在确定关节镜下距下后关节面融合术治疗跟骨骨折后距下关节炎的效果。
这是一项回顾性病例系列研究，纳入10例（8例男性和2例女性）跟骨骨折后出现单纯距下关节炎的患者。所有患者均接受过保守治疗，但疼痛未得到控制。仅选择跟骨内无金属植入物的患者纳入本研究。患者接受距下后关节镜融合术治疗。采用经皮空心螺钉固定。无需植骨。所有患者术前和术后均采用美国矫形足踝协会踝与后足评分系统进行评估。平均随访时间为28.4个月；随访期间仅1例失访。
随访2年后，美国矫形足踝协会总分有统计学意义的改善（P < .05）。随访后疼痛和步行距离有统计学意义的改善（P < .05）。平均融合时间为11.44周。仅1例患者在前外侧入路部位出现疼痛性神经瘤。
关节镜辅助下距下关节后关节面融合术是治疗跟骨骨折后距下关节炎的有效方法。
IV级，治疗性病例系列。
