Wang Ye-ming, Wei Wan-fu
Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
Orthop Surg. 2015 Feb;7(1):31-6. doi: 10.1111/os.12160.
The purpose of this study was to compare the clinical results of percutaneous reduction and Steinman pin fixation for Sanders II calcaneal fractures with those of operative management through an extensile lateral approach.
Fifty-three patients treated with standard open reduction and internal fixation (ORIF group) and 54 patients who had undergone percutaneous reduction and Steinman pin fixation (CRIF group) were retrospectively reviewed. There were no differences between the groups regarding sex, age or fracture classification. Pain and functional outcome were evaluated with a visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Wound complications and radiological results were compared.
At a mean follow-up of 40.4 months (24 to 56 months), there were no differences between the two groups in mean AOFAS score, VAS score or radiologically determined variables. Two cases of deep infection and six of poor wound healing occurred in the ORIF group and none in the CRIF group. Subtalar and ankle motion was found to be better in the CRIF group.
Percutaneous reduction and Steinman pin fixation minimizes complications and achieves functional outcomes comparable to those of the open techniques in patients with Sanders II calcaneal fractures.
本研究旨在比较经皮复位与斯氏针固定治疗Sanders II型跟骨骨折的临床结果与经外侧扩大入路手术治疗的临床结果。
回顾性分析53例行标准切开复位内固定术的患者(切开复位内固定组)和54例行经皮复位与斯氏针固定术的患者(经皮复位内固定组)。两组患者在性别、年龄或骨折分型方面无差异。采用视觉模拟评分法(VAS)和美国足踝外科协会(AOFAS)评分评估疼痛及功能结果。比较伤口并发症及影像学结果。
平均随访40.4个月(24至56个月),两组患者的平均AOFAS评分、VAS评分或影像学测定变量无差异。切开复位内固定组发生2例深部感染和6例伤口愈合不良,经皮复位内固定组无此类情况。发现经皮复位内固定组距下关节和踝关节活动度更佳。
对于Sanders II型跟骨骨折患者,经皮复位与斯氏针固定可将并发症降至最低,并取得与开放手术相当的功能结果。