Maccagnano Giuseppe, Noia Giovanni, Cassano Giuseppe Danilo, Sarni Antonio Luciano, Quitadamo Raffaele, Stigliani Costantino, Liuzza Francesco, Vitiello Raffaele, Pesce Vito
Orthopaedics Unit, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Foggia, Policlinico Riuniti di Foggia, Foggia, Italy.
Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, Faculty of Medicine and Surgery, University of Bari, Policlinico di Bari, Bari, Italy.
Adv Orthop. 2021 Jun 8;2021:5530620. doi: 10.1155/2021/5530620. eCollection 2021.
Calcaneal fractures are a challenging clinical problem. Management of this type of injury remains controversial, especially in the context of intra-articular fractures. Surgical treatment with open reduction and internal synthesis (ORIF) is considered the standard treatment for CF, but it is associated with many complications. Several minimally invasive techniques such as balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation have been proposed to avoid the frequent and recurrent postoperative problems related to these fractures. We retrospectively examined 20 patients (mean age was 54.5), all undergoing minimally invasive calcaneoplasty surgery at our Department of Orthopaedics and Traumatology between 2012 and 2016. X-ray and CT scan were performed preoperatively and at 5 years of follow-up (57.9 ± 6 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical examination, and the Short-Form (36) Health Survey (SF-36) score and Visual Analogue Scale (VAS) were used to assess the Health-Related Quality of Life (HRQoL). All 20 patients were available at the final follow-up. The mean AOFAS score was 82.25/100. The VAS results attest an overall average of 2.7/10 (0-9). The average of the parameters "Physical Health" and "Mental Health" was, respectively, 81.25 and 83.55. In terms of postoperative complications, we observed no cases of superficial or deep infections. Clinical response after balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation has shown a comparable or better outcome according to the AOFAS and VAS score. Quality-of-life scores, obtained according to the SF-36 questionnaire, are considered high. From both a clinical and quality-of-life point of view, our study highlights that there is not gender distinction. Further comparative studies with a higher number of patients are needed which assess the quality of life in the various techniques used to treat calcaneal fractures.
跟骨骨折是一个具有挑战性的临床问题。这类损伤的治疗仍存在争议，尤其是在关节内骨折的情况下。切开复位内固定术（ORIF）的手术治疗被认为是跟骨骨折的标准治疗方法，但它会引发许多并发症。为避免与这些骨折相关的常见且反复出现的术后问题，人们提出了几种微创技术，如球囊辅助复位、克氏针固定和磷酸三钙增强术。我们回顾性研究了20例患者（平均年龄54.5岁），他们于2012年至2016年间在我们的创伤骨科均接受了微创跟骨成形术。术前及随访5年（57.9±6个月）时进行了X线和CT扫描。采用美国矫形足踝协会（AOFAS）评分进行临床检查，采用简明健康调查问卷（SF-36）评分和视觉模拟量表（VAS）评估健康相关生活质量（HRQoL）。所有20例患者均完成了最终随访。AOFAS平均评分为82.25/100。VAS结果显示总体平均分为2.7/10（0 - 9）。“身体健康”和“心理健康”参数的平均值分别为81.25和83.55。在术后并发症方面，我们未观察到浅表或深部感染病例。根据AOFAS和VAS评分，球囊辅助复位、克氏针固定和磷酸三钙增强术后的临床反应显示出相当或更好的结果。根据SF-36问卷获得的生活质量评分较高。从临床和生活质量的角度来看，我们的研究表明不存在性别差异。需要进行更多患者的进一步对比研究，以评估用于治疗跟骨骨折的各种技术的生活质量。
