Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt.
Assistant Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt.
J Foot Ankle Surg. 2021 Jan-Feb;60(1):55-60. doi: 10.1053/j.jfas.2020.06.017. Epub 2020 Jun 25.
This prospective study sought to assess the functional and radiological outcomes of minimally invasive osteosynthesis using cannulated screws and to examine the effect of different parameters on the functional outcome. The Maryland foot score and the visual analog scale of pain were used to assess the functional outcomes and postoperative patient's satisfaction rate. Preoperative and postoperative Böhler's angle, angle of Gissane, calcaneal width, and height, were compared. The study included 46 fractures in 40 patients; 38 (95%) males and 2 (5%) females with a mean age of 34.8 ± 3 years. The mean time lapse to surgery was 3.2 ± 2.1 days. The mean duration of surgery was 39.8 ± 9.3 minutes. The mean follow-up period was 29.2 months. At final follow-up, the mean Maryland foot score was 85 ± 6.3. Satisfactory results were achieved in 91.3% of fractures, while unsatisfactory in 8.7%. The mean visual analog scale score of pain decreased from 7.3 ± 05 preoperatively to 1.2 ± 0.7 at the final follow-up, p <.001. Postoperatively, there was significant improvement of Böhler's angle, angle of Gissane, calcaneal width, and height, p < .001. Factors associated with better functional outcomes included reduced time lapse to surgery, p = .032, and more accurate restoration of the calcaneal parameters. Management of intra-articular calcaneal fractures by minimally invasive osteosynthesis using cannulated screws can achieve satisfactory functional and radiological outcomes. Better outcomes are associated with reduced time lapse to surgery, and accurate reduction and restoration of calcaneal angles, height, and width.
本前瞻性研究旨在评估使用空心螺钉微创接骨术的功能和影像学结果，并研究不同参数对功能结果的影响。采用马里兰足部评分和疼痛视觉模拟评分评估功能结果和术后患者满意度。比较术前和术后的 Böhler 角、Gissane 角、跟骨宽度和高度。该研究纳入 40 名患者的 46 例骨折，男性 38 例（95%），女性 2 例（5%），平均年龄 34.8 ± 3 岁。手术平均延迟时间为 3.2 ± 2.1 天，手术平均持续时间为 39.8 ± 9.3 分钟，平均随访时间为 29.2 个月。最终随访时，平均 Maryland 足部评分为 85 ± 6.3。91.3%的骨折获得满意结果，8.7%的骨折结果不满意。疼痛视觉模拟评分从术前的 7.3 ± 0.5 平均降低至最终随访时的 1.2 ± 0.7，p <.001。术后 Böhler 角、Gissane 角、跟骨宽度和高度均显著改善，p <.001。与更好的功能结果相关的因素包括手术延迟时间缩短，p = .032，以及更准确地恢复跟骨参数。使用空心螺钉微创接骨术治疗关节内跟骨骨折可获得满意的功能和影像学结果。更好的结果与手术延迟时间缩短以及跟骨角度、高度和宽度的准确复位有关。
