Takeuchi Naohide, Mae Takao, Fukushi Jun-Ichi, Tsukamoto Nobuaki, Mizu-Uchi Hideki, Momii Kenta, Nakashima Yasuharu
Orthopedist, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan.
Orthopedist, Department of Trauma and Orthopaedic Surgery, Saga-ken Medical Centre Koseikan, Saga City, Japan.
J Foot Ankle Surg. 2017 Sep-Oct;56(5):1025-1030. doi: 10.1053/j.jfas.2017.04.026.
The purpose of the present study was to examine the clinical results of surgery for intra-articular calcaneal fractures using a calcaneal locking plate and a bone spreader as a reduction tool. Ten patients with intra-articular calcaneal fractures were treated. An extended lateral approach was used. The reduction of the intra-articular fragments of the posterior facet was temporarily held using a bone spreader and Kirschner wires. Internal fixation was achieved with a locking calcaneal plate. Böhler's angle and Preiss' angle were assessed on the day of injury and the day of the final follow-up examination. The step off and gap of the posterior facet were assessed on the day of injury and the first week after surgery. The functional outcome was evaluated using the American Orthopaedic Foot and Ankle Society ankle hindfoot scale score. The mean Böhler's angle ranged from 2.1° ± 11.0° to 30.4° ± 5.0° (p < .0001), the mean Preiss' angle ranged from 23.5° ± 4.5° to 15.5° ± 2.9° (p < .0001), the mean step off ranged from 4.0 ± 1.9 mm to 0.1 ± 0.2 mm (p = .0002), and the mean gap ranged from 2.6 ± 1.0 mm to 1.2 ± 0.6 mm (p = .0035). The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score was 89.2 (range 85 to 100) at a mean of 14.3 months after surgery. Our results suggest that a locking calcaneal plate can be used to restore and reduce an intra-articular calcaneal fracture and achieve good clinical results.
本研究的目的是探讨使用跟骨锁定钢板和撑开器作为复位工具治疗关节内跟骨骨折的临床效果。对10例关节内跟骨骨折患者进行了治疗。采用延长外侧入路。使用撑开器和克氏针临时固定后关节面的关节内骨折块。用跟骨锁定钢板进行内固定。在受伤当天和最终随访检查当天评估Böhler角和Preiss角。在受伤当天和术后第一周评估后关节面的台阶和间隙。使用美国矫形足踝协会踝后足评分系统评估功能结果。平均Böhler角从2.1°±11.0°到30.4°±5.0°（p <.0001），平均Preiss角从23.5°±4.5°到15.5°±2.9°（p <.0001），平均台阶从4.0±1.9mm到0.1±0.2mm（p =.0002），平均间隙从2.6±1.0mm到1.2±0.6mm（p =.0035）。术后平均14.3个月时，美国矫形足踝协会踝后足评分系统的平均得分是89.2（范围85至100）。我们的结果表明，跟骨锁定钢板可用于恢复和复位关节内跟骨骨折，并取得良好的临床效果。
