Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, Beijing, China.
Department of Joint Surgery, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
BMC Musculoskelet Disord. 2022 Oct 13;23(1):911. doi: 10.1186/s12891-022-05871-z.
Minimally invasive treatments for calcaneous fractures have the same outcomes and fewer complications. However, they are technically demanding, and there are a lack reduction tools. To overcome these problems, a calcaneous interlocking nail system was developed that can make reduction and fixation minimally invasive and effective. We retrospectively studied the calcaneous fracture variables intraoperatively and followed up to evaluate the outcomes of patients treated with the calcaneous interlocking nail system.
All patients in 7 institutions between October 2020 and May 2021 who had calcaneous fractures treated with calcaneous interlocking nails were retrospectively analyzed. The patient characteristics, including age, sex, injury mechanism, Sanders type classification, smoking status, and diabetes were recorded. The calcaneous interlocking nail and standard surgical technique were introduced. The intraoperative variables, including days waiting for surgery, surgery time, blood loss, incision length, and fluoroscopy time, were recorded. The outcomes of complications, AOFAS scores and VAS scores were recorded and compared with other similar studies.
Fifty-nine patients were involved in this study; 54 were male; 5 were female; and they had an average age of 47.5 ± 9.2 years (range 25-70). 2 of these fractures were Sanders type I, 28 of these fractures were Sanders type II, 27 of these fractures were Sanders type III, and 2 of these were Sanders type IV. The surgery time was 131.9 ± 50.5 (30-240) minutes on average. The blood loss was 36.9 ± 41.1 (1-250) ml. The average incision length was 3.5 ± 1.8 (1-8) cm; 57 were sinus tarsi incisions; and 2 were closed fixations without incisions. The average fluoroscopy time was 12.3 ± 3.6 (10-25) seconds during the surgery. The VAS score of patients on the day after surgery was 2.4 ± 0.7 (1-3). The AOFAS ankle-hindfoot score in patients who had a follow-up of at 12 months was 93.3 ± 3.6(85-99). During the follow-up, all patients' functional outcomes were good. One patient had a superficial infection. The rate of complications of the 59 patients was 1.7% (1/59).
The calcaneous interlocking nail system can have satisfactory reduction and fixation in calcaneous fractures, even in Sanders type IV. The outcomes of follow-up showed good function. The calcaneous interlocking nail could be an alternative method for minimally invasive calcaneous fracture fixation.
跟骨骨折的微创治疗具有相同的疗效，且并发症更少。然而，微创治疗技术要求较高，且缺乏复位工具。为了克服这些问题，开发了跟骨锁定钉系统，可实现微创、有效的复位和固定。我们回顾性研究了 7 家机构在 2020 年 10 月至 2021 年 5 月间采用跟骨锁定钉系统治疗的跟骨骨折患者的术中变量，并进行随访以评估患者的治疗结果。
回顾性分析了采用跟骨锁定钉治疗的 7 家机构的 59 例跟骨骨折患者的资料。记录患者的特征，包括年龄、性别、损伤机制、Sanders 分型、吸烟状况和糖尿病。介绍了跟骨锁定钉和标准手术技术。记录术中变量，包括手术等待时间、手术时间、失血量、切口长度和透视时间。记录并发症、AOFAS 评分和 VAS 评分的结果，并与其他类似研究进行比较。
本研究共纳入 59 例患者；男 54 例，女 5 例；平均年龄 47.5±9.2 岁（25-70 岁）。其中 Sanders Ⅰ型骨折 2 例，Ⅱ型骨折 28 例，Ⅲ型骨折 27 例，Ⅳ型骨折 2 例。手术时间平均为 131.9±50.5（30-240）分钟。失血量平均为 36.9±41.1（1-250）ml。切口长度平均为 3.5±1.8（1-8）cm；57 例为外踝切口，2 例为闭合固定无切口。术中透视时间平均为 12.3±3.6（10-25）秒。术后第 1 天患者的 VAS 评分为 2.4±0.7（1-3）。12 个月随访时 AOFAS 踝关节-后足评分 93.3±3.6（85-99）。随访期间，所有患者的功能结果均良好。1 例患者发生浅表感染。59 例患者的并发症发生率为 1.7%（1/59）。
跟骨锁定钉系统可在 Sanders Ⅳ型跟骨骨折中获得满意的复位和固定效果，随访结果显示功能良好。跟骨锁定钉可能是一种微创治疗跟骨骨折的替代方法。
