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对Sanders III型和IV型关节内跟骨骨折不使用植骨进行锁定钢板接骨术的结果评估。

An evaluation of the results of locked plate osteosynthesis applied without the use of bone graft in Sanders type III and IV intra-articular calcaneus fractures.

作者信息

Akalin Yavuz, Cansabuncu Gökhan, Çevik Nazan, Avci Özgür, Akinci Orhan, Öztürk Alpaslan

机构信息

Department of Orthopedics and Traumatology, Bursa Yüksek Ihtisas Training and Research Hospital, Health Sciences University, 16300, Yıldırım, Bursa, Turkey.

Department of Orthopedics and Traumatology, Turkish Ministry of Health Bartın State Hospital, 74000, Bartın, Turkey.

出版信息

Int Orthop. 2020 Dec;44(12):2753-2760. doi: 10.1007/s00264-020-04691-x. Epub 2020 Jul 16.

DOI:10.1007/s00264-020-04691-x
PMID:32676777
Abstract

PURPOSE

The clinical and radiological results of locked plate osteosynthesis with an extensive lateral approach without bone graft in Sanders type III and IV intra-articular calcaneus fractures and the factors affecting these results were evaluated retrospectively.

METHODS

A total of 61 patients with Sanders type 3 and 4 calcaneus fractures who underwent a lateral approach with locked plate osteosynthesis were included in the study. The mean follow-up was 44.8 months.

RESULTS

The mean pre- and post-operative Gissane and Bohler's angles were 113.5° ± 13.9° and 106.7° ± 13.6° (p = 0.006) and 2.8° ± 14.1° and 19.6° ± 13.1° (p < 0.001), respectively. The mean post-operative AOFAS scores, SF-36, and Maryland were 80.5 ± 13.6 in type IIIAB, 89.4 ± 6.3 in IIIAC, and 82.4 ± 12.5 in IV; 58.6 ± 14.5 in type IIIAB, 60.3 ± 11.7 in IIIAC, and 58.0 ± 15.6 in IV; and 63.8 ± 7.2 in type IIIAB, 64.3 ± 7.1 in IIIAC, and 62.8 ± 11.7 in IV (p = 0.173, p = 0.932, p = 0.824, respectively). Wound problems were observed in 15 (28.6%) patients. Deep infection was not observed in any patient.

CONCLUSION

The clinical results were similar in type III and IV intra-articular calcaneus fractures applied with locked plate osteosynthesis in an extensive lateral approach and without the use of bone graft. Intra-articular calcaneus fracture fixation with a lateral locked plate is an effective treatment method.

摘要

目的

回顾性评估采用广泛外侧入路且不植骨的锁定钢板接骨术治疗SandersⅢ型和Ⅳ型关节内跟骨骨折的临床及影像学结果,以及影响这些结果的因素。

方法

本研究纳入了61例行外侧入路锁定钢板接骨术治疗的Sanders 3型和4型跟骨骨折患者。平均随访时间为44.8个月。

结果

术前和术后Gissane角和Bohler角的平均值分别为113.5°±13.9°和106.7°±13.6°(p = 0.006),以及2.8°±14.1°和19.6°±13.1°(p < 0.001)。术后AOFAS评分、SF - 36评分和Maryland评分在ⅢAB型中分别为80.5±13.6、ⅢAC型中为89.4±6.3、Ⅳ型中为82.4±12.5;ⅢAB型中为58.6±14.5、ⅢAC型中为60.3±11.7、Ⅳ型中为58.0±15.6;ⅢAB型中为63.8±7.2、ⅢAC型中为64.3±7.1、Ⅳ型中为62.8±11.7(p分别为0.173、0.932、0.824)。15例(28.6%)患者出现伤口问题。未观察到任何患者发生深部感染。

结论

采用广泛外侧入路且不植骨的锁定钢板接骨术治疗Ⅲ型和Ⅳ型关节内跟骨骨折,临床结果相似。外侧锁定钢板固定关节内跟骨骨折是一种有效的治疗方法。

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