Bulut Tugrul, Gursoy Merve, Ozturk Tahir, Ozcan Cem, Sener Muhittin
Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey,
Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.
Ther Clin Risk Manag. 2018 Sep 11;14:1665-1670. doi: 10.2147/TCRM.S146530. eCollection 2018.
The aim of this study was to determine whether tri-cortical iliac bone autografting provided extra benefit for the stabilization in Sanders Type 3-4 calcaneal fractures fixed with locking plate.
The study included 29 calcaneal fractures (Sanders Type 3/4=15/14). All fractures were fixed with locking plate using the extended lateral approach. Bone grafts were used in 16 (Group A; Sanders Type 3/4=7/9) and not used in 13 (Group B; Sanders Type 3/4=8/5) calcaneal fractures. As a grafting material, only tri-cortical iliac crest bone autograft was used. All operations were performed by the same surgeon. The same locking plate was used in all fractures. Calcaneal height and angle of Bohler and Gissane were measured in early postoperative and final control radiographs in both groups. Clinical evaluations were performed using the American Orthopedic Foot and Ankle Society ankle hind foot scale.
There was no difference between the groups in terms of clinical results. Radiologically, the degree of change in Bohler's angle, Gissane's angle, and calcaneal height was not different between the groups.
Bone grafting does not affect the clinical and radiologic outcomes in Sanders Type 3-4 calcaneal fractures fixed with locking plate, and they provide no extra benefit to the stabilization. We think that fixation using locking plate is adequate and there is no need for bone grafting.
本研究旨在确定三皮质髂骨自体骨移植对于使用锁定钢板固定的Sanders 3 - 4型跟骨骨折的稳定性是否能提供额外益处。
本研究纳入29例跟骨骨折（Sanders 3/4型分别为15/14例）。所有骨折均采用延长外侧入路，使用锁定钢板固定。16例跟骨骨折使用了骨移植（A组；Sanders 3/4型分别为7/9例），13例未使用（B组；Sanders 3/4型分别为8/5例）。作为移植材料，仅使用了三皮质髂嵴自体骨。所有手术均由同一位外科医生进行。所有骨折均使用相同的锁定钢板。在两组术后早期和最终复查的X线片上测量跟骨高度以及Bohler角和Gissane角。使用美国矫形足踝协会踝后足评分进行临床评估。
两组在临床结果方面无差异。在影像学上，两组间Bohler角、Gissane角和跟骨高度的变化程度无差异。结论：骨移植对使用锁定钢板固定的Sanders 3 - 4型跟骨骨折的临床和影像学结果无影响，且对稳定性无额外益处。我们认为使用锁定钢板固定已足够，无需进行骨移植。
