Department of Pediatric Orthopedics, Wuhan Fourth Hospital (Puai Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).
Nursing Department, Wuhan Fourth Hospital (Puai Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).
Med Sci Monit. 2018 Nov 3;24:7862-7868. doi: 10.12659/MSM.910610.
BACKGROUND Displaced intra-articular calcaneal fractures (DIACF) are a serious injury and are clinically considered to be an important source of disability. This study investigated therapeutic effects of internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision in pediatric DIACF. MATERIAL AND METHODS This retrospective study included pediatric DIACF patients admitted to our department from June 2010 to February 2014. Patients were divided into Sanders II, Sanders III, and Sanders IV groups. Patients were also divided into pre-operation and post-operation groups. All patients underwent the internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision operation. Bohler angles, Gissane angles, and modified American Orthopedic Foot and Ankle Society Score (AOFAS) were evaluated. RESULTS Four weeks after surgery, all patients had clinical healing and no complications appeared. According to CT and X-ray results, the operation had satisfactory reduction effects for pediatric DIACF of childhood and adolescence. The operation significantly enhanced the Bohler angle of patients in Sanders II, III, and IV patients in the post-operation group compared to the pre-operation group (p<0.05). The operation significantly increased Gissane angle in the post-operation group compared to the pre-operation group in Sanders II, III, and IV patients (p<0.05). The operation significantly improved AOFAS scores of patients in the Sanders II, III, and IV groups (p<0.05). CONCLUSIONS Internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision approach is safe and effective for pediatric DIACF. This approach exhibited advantages of satisfactory reduction for articular surface, solid fixation, and no complications due to infection or tissue necrosis.
关节内跟骨骨折（DIACF）是一种严重的损伤，临床上被认为是残疾的重要来源。本研究探讨了经跗骨窦有限切口克氏针内固定植骨治疗儿童 DIACF 的疗效。
本回顾性研究纳入 2010 年 6 月至 2014 年 2 月我院收治的儿童 DIACF 患者。患者分为 Sanders II、III 和 IV 组。患者还分为术前和术后组。所有患者均行经跗骨窦有限切口克氏针内固定植骨术。评估 Bohler 角、Gissane 角和改良美国矫形足踝协会评分（AOFAS）。
术后 4 周，所有患者均临床愈合，无并发症发生。根据 CT 和 X 线结果，该手术对儿童和青少年儿童 DIACF 具有满意的复位效果。与术前组相比，术后组 Sanders II、III 和 IV 型患者的 Bohler 角明显升高（p<0.05）。与术前组相比，术后组 Sanders II、III 和 IV 型患者的 Gissane 角明显升高（p<0.05）。术后组 Sanders II、III 和 IV 型患者 AOFAS 评分明显提高（p<0.05）。
经跗骨窦有限切口克氏针内固定植骨治疗儿童 DIACF 安全有效。该方法具有关节面复位满意、固定牢固、无感染或组织坏死等并发症的优点。
