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改良经皮固定治疗移位的关节内跟骨骨折。

Modified percutaneous fixation for displaced intra-articular calcaneal fractures.

作者信息

Baca Emre, Koluman Alican

机构信息

Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34147 Bakırköy, İstanbul, Turkey.

出版信息

Eklem Hastalik Cerrahisi. 2019 Aug;30(2):168-74. doi: 10.5606/ehc.2019.66386.

Abstract

OBJECTIVES

This study aims to review the results of surgically treated displaced intra-articular calcaneal fractures with a fast, less complicated, and modified percutaneous technique.

PATIENTS AND METHODS

This retrospective study included 114 patients (86 males, 28 females; mean age 39 years; range, 16 to 66 years) admitted to our clinic for calcaneal fractures between May 2012 and June 2016 and operated using closed reduction and percutaneous fixation with two crossed Schanz pins. Trauma type, additional injuries, medical comorbidities, pre- and postoperative period, duration of operation, time to bone healing, complications, postoperative functional and radiological results were evaluated.

RESULTS

The increase in the postoperative Bohler's angle measurements was statistically significant compared to preoperative values (p=0.001; p<0.01). According to Sanders classification, seven feet (5.3%) were type II, 76 feet (57.57%) were type III, and 49 feet (37.12%) were type IV. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 80.4 (range, 47 to 92). According to Sanders classification, the mean AOFAS scores were 81.25 for type II, 81.88 for type III, and 80.19 for type IV. Mean duration of operation was 8±1.5 minutes.

CONCLUSION

Modified percutaneous fixation can give good results, even when open reduction is contraindicated. Maintaining the alignment and elevating the depressed intra-articular fragment may be sufficient for good mid-term results without anatomic reduction.

摘要

目的

本研究旨在回顾采用快速、简单且改良的经皮技术手术治疗移位性关节内跟骨骨折的结果。

患者与方法

这项回顾性研究纳入了2012年5月至2016年6月期间因跟骨骨折入住我院并采用两枚交叉斯氏针进行闭合复位和经皮固定手术的114例患者(86例男性,28例女性;平均年龄39岁;年龄范围16至66岁)。评估了创伤类型、其他损伤、合并症、术前和术后情况、手术时长、骨愈合时间、并发症、术后功能及影像学结果。

结果

与术前相比,术后博勒角测量值的增加具有统计学意义(p = 0.001;p < 0.01)。根据桑德斯分类法,7足(5.3%)为II型,76足(57.57%)为III型,49足(37.12%)为IV型。美国矫形足踝协会(AOFAS)平均评分为80.4(范围47至92)。根据桑德斯分类法,II型的AOFAS平均评分为81.25,III型为81.88,IV型为80.19。平均手术时长为8 ± 1.5分钟。

结论

即使在切开复位禁忌的情况下,改良经皮固定也能取得良好效果。维持对线并抬高凹陷的关节内骨折块可能足以获得良好的中期结果,而无需解剖复位。

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