Basile Attilio
Department of Orthopaedics and Traumatology, Ospedale San Giovanni-Addolorata Roma (Italia), Rome, Italy.
J Foot Ankle Surg. 2010 Jan-Feb;49(1):25-32. doi: 10.1053/j.jfas.2009.08.001.
We compared the outcomes of displaced intra-articular calcaneal fractures in 33 patients aged 65 to 75 years, who were treated either operatively (n = 18) or nonsurgically (n = 15), between December 2001 and December 2005. The operative treatment group scored higher on the American Orthopaedic Foot & Ankle Society ankle-hindfoot score and had less pain as measured with the 10-cm visual analog scale than did the nonsurgically treated group, with the differences being statistically significant (P < or = .05), suggesting that results can be improved by operative treatment. Böhler's angle, the quality of operative reduction, subtalar joint motion, gender, and the Sanders type of fracture were also analyzed and compared between the treatment groups. The results confirmed that Böhler's angle, the quality of the reduction, and subtalar joint motion were important prognostic factors related to outcome, regardless of treatment; whereas gender and Sanders type had less influence on the results at the 2-year follow-up evaluation. The prevalence of complications observed in the surgically treated group was similar to that reported in prior publications, except for subtalar arthritis (38.9%), which may have been higher because of the age of our patients and the duration of follow-up.
我们比较了2001年12月至2005年12月期间33例65至75岁的关节内移位跟骨骨折患者的治疗结果，这些患者分别接受了手术治疗（n = 18）或非手术治疗（n = 15）。手术治疗组在美国矫形足踝协会踝 - 后足评分中得分更高，并且与非手术治疗组相比，在10厘米视觉模拟量表测量下疼痛更少，差异具有统计学意义（P≤0.05），这表明手术治疗可以改善结果。我们还对治疗组之间的Böhler角、手术复位质量、距下关节活动度、性别以及Sanders骨折类型进行了分析和比较。结果证实，无论治疗方式如何，Böhler角、复位质量和距下关节活动度都是与结果相关的重要预后因素；而在2年随访评估中，性别和Sanders骨折类型对结果的影响较小。除距下关节炎（38.9%）外，手术治疗组观察到的并发症发生率与先前发表的报告相似，距下关节炎发生率可能较高，这可能是由于我们患者的年龄和随访时间所致。
