Pradana Ananto Satya, Mustamsir Edi, Breilyan Sulung, Putra Domy Pradana, Phatama Krisna Yuarno, Hidayat Mohamad
Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia.
Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia.
Int J Surg Case Rep. 2022 May;94:107131. doi: 10.1016/j.ijscr.2022.107131. Epub 2022 Apr 29.
Intraarticular Calcaneal fracture treatment nowadays is still up for debate. Surgical plating treatment is favorable because of the rapid healing process and better anatomical reduction despite the invasive intervention. Hence, clinical evaluation is needed to assess the quality-of-life index from foot and ankle by the American orthopaedics Foot and Ankle Society (AOFAS) score postoperatively. Then, the outcome evaluation of reduction in calcaneal plating of intraarticular calcaneal fracture with Böhler angle and Gissane angle to see if the calcaneal plating technique is a recommended treatment for the calcaneal fracture.
We treated six patients from December 2020-July 2021 with a calcaneal fracture that underwent surgical plating, mainly by one surgeon. A calcaneal fracture is classified according to sanders classification. In this study, four patients are above the age of 40, and two are under 25. Pre-operative Böhler angle ranged from 8 to 65°, and Gissane angle ranged from 134 to 158°.
Surgical plating was performed on all six patients. From clinical evaluation using the AOFAS score, we got satisfactory results on all patients who underwent calcaneal plating surgery. Three patients achieved excellent range outcomes with 95% and 99% of AOFAS Scores, and three patients reported AOFAS score good range outcomes with the lowest score of 88%. From the radiological outcome, most of the patient's Böhler and Gissane angles achieved normal value after surgical plating.
The calcaneal plating technique gives better anatomical reduction depending on Bohler and Gissane angle. These results promise that anatomical reduction can improve clinical outcomes based on the AOFAS score. Thus, the plating method can be used effectively to treat an intraarticular calcaneal fracture.
目前,跟骨关节内骨折的治疗仍存在争议。手术钢板固定治疗虽属于侵入性干预,但因其愈合过程快且解剖复位效果更好而备受青睐。因此,需要通过美国足踝外科协会(AOFAS)评分对术后足踝的生活质量指数进行临床评估。然后,通过跟骨结节角(Böhler角)和跟骨交叉角(Gissane角)对跟骨关节内骨折钢板固定复位的结果进行评估,以确定跟骨钢板固定技术是否为跟骨骨折的推荐治疗方法。
2020年12月至2021年7月,我们对6例跟骨骨折患者进行了手术钢板固定治疗,主要由一名外科医生操作。跟骨骨折根据Sanders分类法进行分类。本研究中,4例患者年龄在40岁以上,2例患者年龄在25岁以下。术前Böhler角范围为8°至65°,Gissane角范围为134°至158°。
所有6例患者均接受了手术钢板固定治疗。通过使用AOFAS评分进行临床评估,我们发现所有接受跟骨钢板固定手术的患者均取得了满意的结果。3例患者AOFAS评分达到95%和99%,获得了极佳的疗效,另外3例患者AOFAS评分良好,最低分为88%。从影像学结果来看,大多数患者术后钢板固定后Böhler角和Gissane角达到正常值。
根据Böhler角和Gissane角,跟骨钢板固定技术能实现更好的解剖复位。这些结果表明,解剖复位可根据AOFAS评分改善临床疗效。因此,钢板固定方法可有效用于治疗跟骨关节内骨折。