Ortop Poliklinika, Ul. Kosinskiego 16, PL 61-519 Poznan, Poland.
Foot Ankle Surg. 2011 Sep;17(3):128-30. doi: 10.1016/j.fas.2010.03.001. Epub 2010 May 6.
The most frequent problem following intra-articular calcaneal fracture is pain from the subtalar joint. Subtalar arthrodesis is not considered to be an optimal solution because it can lead to degenerative changes in the ankle joint. The aim of this study was to evaluate patients with such fractures treated by triple arthrodesis. The treated group consisted of 12 patients (5 female, 7 male) with no bilateral fractures. The mean age at injury was 36 years (22-54). The patients had surgery 2 years on average after injury. In all cases the arthrodesis was stabilized with Kirschner wires. The follow-up ranged from 1 to 5 years (average 2.9 ± 1.4). In 2 feet the calcaneal fracture was associated with a fracture of the talus. At clinical evaluation the Ankle-Hindfoot Scale (AOFAS) was applied. From the 100 point scale the question concerning movement in the subtalar joint was removed which made the scale range from 0 to 94 points. Postoperative scoring ranged from 19 to 92 points (mean 57.3 ± 25.1). The patients also evaluated the result of treatment on a visual analogue scale from 0 to 10 points which gave a mean score of 7.7 ± 2.2. Early results of the treatment of calcaneal fractures by triple arthrodesis show that this is valuable method for the prevention of significant foot pain.
跟骨关节内骨折后最常见的问题是距下关节疼痛。距下关节融合术并不被认为是一种理想的解决方案，因为它会导致踝关节退行性改变。本研究旨在评估接受三关节融合术治疗的此类骨折患者。治疗组包括 12 名患者（5 名女性，7 名男性），无双侧骨折。平均年龄为 36 岁（22-54 岁）。患者平均在受伤后 2 年接受手术。所有病例均采用克氏针固定融合。随访时间为 1 至 5 年（平均 2.9 ± 1.4 年）。在 2 只脚上，跟骨骨折与距骨骨折有关。临床评估采用踝关节-后足评分（AOFAS）。在 100 分制中，去除了距下关节活动度的问题，使评分范围从 0 到 94 分。术后评分从 19 分到 92 分（平均 57.3 ± 25.1 分）。患者还使用 0 到 10 分的视觉模拟评分法对治疗结果进行评估，平均得分为 7.7 ± 2.2。三关节融合术早期治疗跟骨骨折的结果表明，这是预防严重足部疼痛的有效方法。
