Amani Alireza, Shakeri Vahid, Kamali Alireza
Department of Orthopedic, Arak University of Medical Sciences, Arak, Iran.
Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran.
Eur J Transl Myol. 2018 Apr 26;28(2):7352. doi: 10.4081/ejtm.2018.7352. eCollection 2018 Apr 24.
Surgical management of calcaneal fractures has various complications. In recent years, minimally invasive surgeries have been utilized for a wide range of surgical procedures on different body parts significantly declining complications. This paper compares surgical outcomes of calcaneal fracture management between the open reduction and internal fixation technique (ORIF) and the MIS technique. In this randomized clinical trial forty patients with calcaneus fractures were randomly assigned to two equal groups; ORIF group and MIS group. Patients were followed for 1 year post-operatively. Gissane and Bohler's angles, AOFAS questionnaire, pain intensity, ability to conduct previous activities and various complications like wound healing complications and irritation with shoe wear were assessed in the final post-operative visit. Eventually data obtained from the two groups were compared. All patients obtained fracture union. Bohler's and Gissane angles significantly increased and decreased, respectively, after the operation in both groups (p˂0.05), however, no significant difference was found between the two research groups. AOFAS scores and pain intensity was similar in both groups, however, surgical duration in the MIS group was significantly less than the ORIF group (P=0.021). Only one patient from the ORIF group was not able to resume his previous occupation. 12 patients from the ORIF group and five patients from the MIS group experienced irritation from shoe wear (p=0.025). In the ORIF group, 4 patients suffered from wound healing complications, however, none of the patients of the MIS group had wound complications (p=0.035). In conclusion, based on the results, it can be concluded that the MIS technique demonstrated better functional and radiographic outcomes as well as a more favorable complication profile, thus, it is recommended for the management of calcaneus fractures.
跟骨骨折的手术治疗存在多种并发症。近年来，微创手术已被广泛应用于不同身体部位的各类手术，显著降低了并发症的发生率。本文比较了切开复位内固定技术（ORIF）和微创技术（MIS）治疗跟骨骨折的手术效果。在这项随机临床试验中，40例跟骨骨折患者被随机分为两组，每组人数相等，即ORIF组和MIS组。术后对患者进行了1年的随访。在末次术后随访时，评估了吉萨尼角和博勒角、美国足踝外科协会（AOFAS）问卷、疼痛强度、进行既往活动的能力以及各种并发症，如伤口愈合并发症和鞋磨引起的刺激。最终对两组获得的数据进行了比较。所有患者均实现了骨折愈合。两组术后博勒角均显著增大，吉萨尼角均显著减小（p<0.05），然而，两个研究组之间未发现显著差异。两组的AOFAS评分和疼痛强度相似，然而，MIS组的手术时间显著短于ORIF组（P=0.021）。ORIF组只有1例患者无法恢复其先前的工作。ORIF组有12例患者和MIS组有5例患者出现鞋磨刺激（p=0.025）。在ORIF组，4例患者出现伤口愈合并发症，然而，MIS组的患者均未出现伤口并发症（p=0.035）。总之，根据结果可以得出结论，MIS技术显示出更好的功能和影像学结果以及更有利的并发症情况，因此，推荐用于跟骨骨折的治疗。
