Service de chirurgie orthopédique, centre hospitalier territorial de Nouméa, BP J5, Noumea, New Caledonia.
Orthop Traumatol Surg Res. 2013 Nov;99(7):829-36. doi: 10.1016/j.otsr.2013.06.008. Epub 2013 Oct 4.
The balloon kyphoplasty approach to the treatment of vertebral fractures can be adapted to achieve the reduction and cement stabilisation of intra-articular compression fractures at other sites, such as the calcaneus.
We studied six patients with a median follow-up of 12 months (range, 6-30 months). Fluoroscopy guidance was used to obtain optimal balloon positioning under the joint depression site. Reduction was achieved by expanding the balloon and stabilisation by injecting the cavity with resorbable tricalcium-phosphate cement in the younger patients and polymethyl-metacrylate cement in the two elderly patients with osteoporosis. No internal fixation was used.
No intra-operative, postoperative, or delayed complications were recorded. Median hospital stay length was 4.5 days (range, 3-7 days). All the fractures healed within the usual timeframe, without loss of reduction. Median time to full weight-bearing ambulation was 52.5 days (range, 15-75 days). The functional outcomes correlated with the good anatomic results, with a median American Orthopaedic Foot and Ankle Society score of 87.0 (range, 86-97).
This preliminary study shows that balloon reduction and cement fixation of intra-articular calcaneal fractures is easy to perform, reproducible, and devoid of specific complications. Good-quality reduction and stabilisation until fracture healing were achieved, and time to recovery of self-sufficiency was short, even in elderly patients with osteoporosis. These results support the use of this minimally invasive technique.
Level IV, retrospective study.
球囊扩张椎体后凸成形术可用于治疗其他部位（如跟骨）的关节内压缩骨折，实现骨折复位和骨水泥稳定。
我们研究了 6 例患者，中位随访时间为 12 个月（6-30 个月）。在关节凹陷部位，透视引导下获取最佳球囊位置。在年轻患者中，通过扩张球囊实现复位，在骨质疏松的 2 名老年患者中，使用可吸收磷酸三钙骨水泥或聚甲基丙烯酸甲酯骨水泥填充空腔进行稳定。未使用内固定。
无术中、术后或迟发性并发症。中位住院时间为 4.5 天（3-7 天）。所有骨折均在通常时间内愈合，无复位丢失。完全负重行走的中位时间为 52.5 天（15-75 天）。功能结果与良好的解剖结果相关，美国矫形足踝协会评分中位数为 87.0（86-97）。
这项初步研究表明，关节内跟骨骨折的球囊复位和骨水泥固定易于操作、可重复且无特定并发症。达到了良好的复位和固定效果，直至骨折愈合，且恢复自理能力的时间较短，即使是骨质疏松的老年患者也是如此。这些结果支持使用这种微创技术。
IV 级，回顾性研究。
