Department of Orthopaedics, Hôpital Saint Antoine, Paris, France.
Int Orthop. 2013 May;37(5):905-10. doi: 10.1007/s00264-013-1865-x. Epub 2013 Mar 23.
Balloon reduction and cement fixation of displaced articular fractures of the calcaneus have been described elsewhere but support for it lacks clinical evidence. We have been performing the technique since October 2006 and describe here our clinical experience including three to five-year follow up of our first ten cases with no patient lost to follow up.
From September 2006 to September 2009, ten patients were admitted with a calcaneus fracture, six were female and four male, one case was bilateral (11 fractures). Patients were operated upon in the prone position according to the technique we have described. Reduction was obtained in all cases. Patients were discharged after an average of four days postoperatively and were allowed weight bearing after two to three months. All patients were followed up regularly and were examined by an independent observer at the latest follow up. The clinical results were assessed using the AOFAS ankle score, the Babin score and the RAND-36 physical components score. A CT scan was obtained in all patients before, after the operation and at the latest follow up.
After a minimal follow up of 36 months (three to five years), no patient was lost to follow up and none required further surgery. The AOFAS clinical results were rated good or excellent in 81.8 % of cases (nine fractures, eight patients), and the physical component of the RAND-36 was 74.6. One patient only (one fracture) had a bad clinical result and evidence of subtalar arthritis on the CT scan and was offered a subtalar fusion; she refused. All patients had returned to their former professional activities at the same level as before the fracture except one who had retired but had resumed leisure walking.
Balloon reduction and cement fixation of fresh calcaneal fractures ("balloon calcaneoplasty") appears a safe and effective procedure in a variety of calcaneal fractures with lasting and excellent clinical results. More studies are needed to further refine the indications and the limits of the procedure.
球囊复位和水泥固定移位关节内跟骨骨折已有相关描述，但该技术的临床证据不足。我们自 2006 年 10 月以来一直采用该技术，在此介绍我们的临床经验，包括最初 10 例患者的 3 至 5 年随访，随访过程中无患者失访。
2006 年 9 月至 2009 年 9 月，收治 10 例跟骨骨折患者，其中 6 例为女性，4 例为男性，1 例为双侧（11 处骨折）。所有患者均按照我们描述的技术采用俯卧位进行手术。所有病例均获得复位。术后平均住院 4 天，术后 2 至 3 个月开始负重。所有患者均定期随访，由独立观察者进行随访。采用美国足踝外科协会（AOFAS）踝评分、Babin 评分和 RAND-36 物理成分评分评估临床结果。所有患者均获得术前、术后和末次随访的 CT 扫描。
随访时间 36 个月（3 至 5 年），无患者失访，无一例患者需要再次手术。81.8%（9 处骨折，8 例患者）的病例临床结果评为良好或优秀，RAND-36 物理成分评分为 74.6。仅 1 例（1 处骨折）患者临床结果较差，CT 扫描显示距下关节炎证据，建议行距下融合术，但患者拒绝。除 1 例已退休但恢复休闲步行外，所有患者均恢复到骨折前的职业活动水平。
新鲜跟骨骨折的球囊复位和水泥固定（“球囊跟骨成形术”）是一种安全有效的方法，适用于各种跟骨骨折，具有持久和优异的临床效果。需要更多的研究进一步细化该技术的适应证和局限性。
