Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Orthopedics, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):2309499020979095. doi: 10.1177/2309499020979095.
To evaluate the quality of reduction and clinical outcomes by using Percutaneous Distractor and Subtalar Arthroscopy Closed Reduction followed by Internal Fixation (PDSA-CRIF) in the intra-articular calcaneal fracture.
A consecutive case series of 453 patients with 507 displaced intra-articular calcaneal fractures was recruited in this retrospective study. We performed PDSA-CRIF to treat intra-articular calcaneal fractures. The quality of reduction was assessed by early postoperative Computed Tomography (CT) scans and measurement of serial Bohler's angles during follow-ups. Clinical outcomes were evaluated by Visual Analogue Scale (VAS) and the American Foot & Ankle Society ankle-hind foot scale (AOFAS) scoring system.
Fifty-nine patients (68 fractures) who had complete clinical data and follow-up of at least 12-months (mean: 14 months, range: 12-59 months) were finally included. Anatomical and near-anatomical reduction in subtalar articular surface which had less than 2 mm gap or step-off was found in 93% fractures. Unsatisfactory reduction was found in 7%.
Arthroscopic-assisted percutaneous fixation using a distraction device is effective in achieving positive short-term results in the displaced intra-articular calcaneal fractures. A multicenter, large sample, randomized control trial is needed to fully evaluate the long-term effects of PDSA-CRIF in comparison to other methods.
通过经皮牵开器和跗骨下关节镜闭合复位内固定（PDSA-CRIF）治疗关节内跟骨骨折，评估复位质量和临床结果。
本回顾性研究连续纳入了 453 例 507 处移位关节内跟骨骨折患者。我们采用 PDSA-CRIF 治疗关节内跟骨骨折。通过术后早期 CT 扫描和随访时连续测量 Bohler 角来评估复位质量。采用视觉模拟评分（VAS）和美国足踝外科协会踝-后足评分系统（AOFAS）评估临床结果。
最终纳入了 59 例（68 处骨折）具有完整临床资料和至少 12 个月随访（平均 14 个月，范围 12-59 个月）的患者。93%的骨折在距下关节面达到解剖或近乎解剖复位，只有 2mm 以内的间隙或台阶。7%的骨折复位不满意。
关节镜辅助下使用牵开器的经皮固定在治疗移位的关节内跟骨骨折方面可获得良好的短期效果。需要进行多中心、大样本、随机对照试验，以充分评估 PDSA-CRIF 与其他方法相比的长期效果。
