Li Ming, Lian Xiaodong, Yang Weijie, Ding Kai, Jin Lin, Jiao Zhenqin, Ma Lijie, Chen Wei
Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, China (mainland).
Med Sci Monit. 2020 Nov 4;26:e926833. doi: 10.12659/MSM.926833.
BACKGROUND We investigated the outcomes of displaced intra-articular calcaneal fractures (DIACFs) treated by percutaneous reduction and hollow screw fixation (PRHCF) versus open reduction and internal fixation (ORIF). MATERIAL AND METHODS Seventy-one patients were randomly allocated to group A (by PRHCF) and group B (by ORIF). Operative time, visual analogue scale (VAS) score, time from injury to operation, postoperative hospital stay, preoperative and postoperative radiographic measurements, and complications were recorded. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scores. RESULTS Finally, 59 patients were followed up for at least 12 months (range, 12-24 months). Group A showed significantly more advantages than group B in term of operative time, intraoperative blood loss, time to operation, postoperative hospital stay, and postoperative pain relief during the first 3 days (P<0.001). However, more intraoperative fluoroscopy was required in group A than in group B (P<0.001). The calcaneal width, height, length, Böhler angle, and Gissane angle in each group were significantly improved postoperatively (all P<0.001), although not significantly different in the postoperative comparisons between both groups. The AOFAS scores were slightly superior in group A than in group B (88.3 vs. 86.4, P=0.08). The rate of incidence of postoperative complications was lower in group A than in group B (3.2% vs. 10.8%, respectively; OR, 0.28, 95% CI, 0.03 to 2.84), although there was no significant difference (P=0.337). CONCLUSIONS PRHCF showed comparable clinical and radiological outcomes as ORIF, demonstrating it is a safe and effective alternative in treating DIACFs.
我们研究了经皮复位空心螺钉固定术（PRHCF）与切开复位内固定术（ORIF）治疗移位性关节内跟骨骨折（DIACFs）的疗效。材料与方法：71例患者被随机分为A组（采用PRHCF）和B组（采用ORIF）。记录手术时间、视觉模拟评分（VAS）、受伤至手术时间、术后住院时间、术前和术后影像学测量结果以及并发症。使用美国足踝外科协会（AOFAS）评分评估功能结局。结果：最后，59例患者至少随访12个月（范围为12 - 24个月）。A组在手术时间、术中出血量、手术时机、术后住院时间以及术后前3天的疼痛缓解方面比B组具有显著优势（P<0.001）。然而，A组比B组需要更多的术中透视（P<0.001）。每组的跟骨宽度、高度、长度、Böhler角和Gissane角术后均有显著改善（均P<0.001），尽管两组术后比较无显著差异。AOFAS评分A组略高于B组（88.3对86.4，P = 0.08）。A组术后并发症发生率低于B组（分别为3.2%对10.8%；OR，0.28，95%CI，0.03至2.84），尽管差异无统计学意义（P = 0.337）。结论：PRHCF在临床和影像学结果方面与ORIF相当，表明它是治疗DIACFs的一种安全有效的替代方法。
