Basile Attilio, Albo Francesco, Via Alessio Giai
General Orthopaedic and Trauma Surgeon, Foot and Ankle Surgeon, Department of Orthopaedics and Traumatology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
General Orthopaedic and Trauma Surgeon, Foot and Ankle Surgeon, Department of Orthopaedics and Traumatology, Ospedale Padre Pio, Bracciano, Italy.
J Foot Ankle Surg. 2016 May-Jun;55(3):513-21. doi: 10.1053/j.jfas.2015.11.008. Epub 2016 Jan 23.
The purpose of our investigation was to prospectively review and compare the early outcomes of Sanders II and III closed displaced intra-articular calcaneal fractures (DIACFs) in a group of patients treated by open reduction and internal fixation with plate and screws using the extended lateral approach or the sinus tarsi approach (STA). Thirty-eight patients with DIACFs were prospectively enrolled and operatively treated using either the extended lateral approach or the STA. Patients underwent a careful clinical and radiographic examination and were evaluated according to the American Orthopaedic Foot and Ankle Society score, visual analog scale, and the Foot Function Index. The results from our study showed similar clinical and radiographic outcomes between the 2 groups. In our series, Sanders II and III DIACFs were sufficiently exposed using the STA to achieve anatomic reduction and stable fixation. The STA group had a lower incidence of wound complications (p ≥ .05), the surgical procedure was faster, and the waiting time to surgery was shorter (p ≤ .05). Despite the limited number of patients and the short follow-up period, our results suggest that the STA is a useful method for the treatment of DIACFs, with a low incidence of complications and results comparable to those for patients treated using the extended lateral approach.
我们研究的目的是前瞻性地回顾和比较采用延长外侧入路或跗骨窦入路(STA)切开复位钢板螺钉内固定治疗的一组Sanders II型和III型闭合性关节内跟骨骨折(DIACF)患者的早期疗效。38例DIACF患者被前瞻性纳入研究,并采用延长外侧入路或STA进行手术治疗。患者接受了仔细的临床和影像学检查,并根据美国矫形足踝协会评分、视觉模拟量表和足部功能指数进行评估。我们的研究结果显示两组患者的临床和影像学结果相似。在我们的系列研究中,采用STA可充分显露Sanders II型和III型DIACF,以实现解剖复位和稳定固定。STA组伤口并发症发生率较低(p≥0.05),手术操作更快,手术等待时间更短(p≤0.05)。尽管患者数量有限且随访期较短,但我们的结果表明,STA是治疗DIACF的一种有效方法,并发症发生率低,结果与采用延长外侧入路治疗的患者相当。