Wu Junguo, Chai Yimin, Dong Youhai, Gu Wenqi, Huang Hanwei, Jiang Haiying, Chen Jian, Chen Xujun, Qian Guang, Huang Peiyan
Department of Orthopaedics, the Fifth People's Hospital of Shanghai, Fudan University, Shanghai, 200240, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Sep;27(9):1057-60.
To summarize the preliminary effectiveness of I.T.S. locking plate for intra-articular calcaneal fractures.
Between July 2010 and July 2011, 18 cases of intra-articular calcaneal fractures were treated. There were 10 males and 8 females with an average age of 46 years (range, 25-64 years). According to Sanders classification system, there were 3 cases of type II, 9 cases of type III, and 6 cases of type IV. The disease duration was 5-11 days (mean, 6 days). Open reduction and internal fixation with I.T.S. locking plate were performed via an L-shaped lateral extending incision.
Superficial infection occurred in 1 case, and was cured after dressing changing; healing of incision by first intention was obtained in the other cases. Sixteen cases were followed up 14 months on average (range, 12-18 months). X-ray films demonstrated the bone union in all cases with an average union time of 12 weeks (range, 10-14 weeks). No implant failure or irritation of peroneal tendon occurred during follow-up. X-ray films showed subtalar post-traumatic arthritis with mild pain in 1 case at 11 months after operation, which was relieved by conservative treatment. At last follow-up, the Böhler angle was improved from (12.9 +/- 3.2) degrees preoperatively to (33.8 +/- 4.0) degrees postoperatively, showing significant difference (t = 22.78, P = 0.00); the Gissane angle was improved from (83.6 +/- 6.4) degrees preoperatively to (119.9 +/- 8.5) degrees postoperatively, showing significant difference (t = 17.02, P = 0.00). The visual analogue scale (VAS) score was 1.3 +/- 1.2, and the ankle and hindfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS) was 80.3 +/- 7.9 at last follow-up.
Treatment of intra-articular calcaneal fracture with I.T.S. locking plate can obtain a stable fixation, which is a safe and effective method.
总结I.T.S.锁定钢板治疗跟骨关节内骨折的初步疗效。
2010年7月至2011年7月，治疗18例跟骨关节内骨折患者。其中男性10例，女性8例，平均年龄46岁（范围25 - 64岁）。根据Sanders分类系统，II型3例，III型9例，IV型6例。病程5 - 11天（平均6天）。采用L形外侧延长切口，应用I.T.S.锁定钢板进行切开复位内固定。
1例发生浅表感染，经换药后治愈；其余病例切口均一期愈合。16例患者平均随访14个月（范围12 - 18个月）。X线片显示所有病例均骨愈合，平均愈合时间12周（范围10 - 14周）。随访期间未发生内固定失败或腓骨肌腱激惹。1例患者术后11个月X线片显示距下创伤性关节炎伴轻度疼痛，经保守治疗后缓解。末次随访时，Böhler角由术前的(12.9±3.2)°改善至术后的(33.8±4.0)°，差异有统计学意义（t = 22.78，P = 0.00）；Gissane角由术前的(83.6±6.4)°改善至术后的(119.9±8.5)°，差异有统计学意义（t = 17.02，P = 0.00）。末次随访时视觉模拟评分（VAS）为1.3±1.2，美国矫形足踝协会（AOFAS）踝与后足评分80.3±7.9。
应用I.T.S.锁定钢板治疗跟骨关节内骨折可获得稳定固定，是一种安全有效的方法。
