Department of Orthopaedics, Zhoupu Hospital of Pudong, Shanghai 201318, China.
Int J Surg. 2013;11(10):1087-91. doi: 10.1016/j.ijsu.2013.09.017. Epub 2013 Oct 5.
According to characteristic of anatomical structure of calcaneus and sinus tarsi approach, the minimally invasive plate for treatment of displaced intra-articular calcaneal fractures had been designed. Here we aimed to review the effect of this treatment. Forty intra-articular calcaneal fractures in 38 patients from September 2006 to September 2008 were treated with percutaneous plate via sinus tarsi approach under the monitoring of C-shaped arms. All calcaneal anatomical parameters, including height, width, length, Böhlers angle and Gissane angle were measured by X-ray before and after surgery. Postoperative lateral wound healing was also evaluated and clinical functional outcomes were graded using the Maryland foot score. All patients had been followed up for an average of 12 months ranged from 3 months to 24 months. X-ray indicated satisfactory restoration of the calcaneal height, width, length, Böhlers angle and Gissanes angle. Maryland foot score demonstrated that excellent result was achieved in 32 cases, good in 6 cases, fair in 2 cases, and the excellent and good rate was 95%. Postoperative complications were not found in all fractured feet. Our results suggest that this minimally invasive sinus tarsi approach with new designed plate and screw fixation technique for the treatment of intra-articular calcaneal fractures can not only obtain the satisfactory outcomes, but also can effectively prevent surgical complications.
根据跟骨解剖结构特点及跗骨窦入路,设计了微创钢板治疗移位关节内跟骨骨折。我们旨在评估这种治疗方法的效果。2006 年 9 月至 2008 年 9 月,采用经跗骨窦微创钢板治疗 38 例 40 例关节内跟骨骨折,术中在 C 臂机监测下进行。所有患者术前及术后均行 X 线检查测量跟骨解剖参数,包括高度、宽度、长度、Böhlers 角和 Gissane 角。还评估了术后外侧伤口愈合情况,并采用 Maryland 足部评分进行临床功能评定。所有患者平均随访 12 个月,随访时间 3 至 24 个月。X 线片显示跟骨高度、宽度、长度、Böhlers 角和 Gissane 角恢复满意。Maryland 足部评分显示:优 32 例,良 6 例,可 2 例,优良率 95%。所有骨折足均未发现术后并发症。我们的结果表明,这种微创跗骨窦入路结合新型钢板螺钉固定技术治疗关节内跟骨骨折,不仅可以获得满意的效果,而且可以有效预防手术并发症。