Basile Attilio, Lanzetti Riccardo Maria, Giai Via Alessio, Venditto Teresa, Spoliti Marco, Sessa Pasquale, Tortora Mauro, Maffulli Nicola
Orthopaedic and Traumatology Unit, Department Emergency and Acceptance, San Camillo-Forlanini Hospital, 00153 Rome, Italy.
Department of Primary Care, Rehabilitation and Prosthetic, AUSL Latina, 04100 Latina, Italy.
J Clin Med. 2023 Mar 4;12(5):2039. doi: 10.3390/jcm12052039.
To assess whether delaying operative fixation through the sinus tarsi approach resulted in a decreased wound complications rate or could hinder the quality of reduction in subjects with Sanders type II and III displaced intra-articular calcaneus fractures.
From January 2015 to December 2019, all polytrauma patients were screened for eligibility. We divided patients into two groups: Group A, treated within 21 days after injury; Group B, treated more than 21 days after injury. Wound infections were recorded. Radiographic assessment consisted of serial radiographs and CT scans: postoperatively (T0) and at 12 weeks (T1) and at 12 months after surgery (T2). The quality of reduction of the posterior subtalar joint facet and calcaneal cuboid joint (CCJ) was classified as anatomical and non-anatomical. A post hoc power calculation was performed.
A total of 54 subjects were enrolled. Four wound complications (three superficial, one deep) were identified in Group A; two wound complications (one superficial one deep) were identified in Group B. According to "mean interval between trauma and surgery" and "duration of intervention", there was a significant difference between the groups ( < 0.001). There were no significant differences between Groups A and B in terms of wound complications or quality of reduction.
The sinus tarsi approach is a valuable approach for the surgical treatment of closed displaced intra-articular calcaneus fractures in major trauma patients who need delayed surgery. The timing of surgery did not negatively influence the quality of the reduction and the wound complication rate.
level II, prospective comparative study.
评估通过跗骨窦入路延迟手术固定是否会降低伤口并发症发生率，或者是否会妨碍Sanders II型和III型关节内移位跟骨骨折患者的复位质量。
2015年1月至2019年12月，对所有多发伤患者进行筛选以确定其是否符合条件。我们将患者分为两组：A组，在受伤后21天内接受治疗；B组，在受伤后21天以上接受治疗。记录伤口感染情况。影像学评估包括术后（T0）、术后12周（T1）和术后12个月（T2）的系列X线片和CT扫描。距下后关节面和跟骰关节（CCJ）的复位质量分为解剖复位和非解剖复位。进行了事后效能计算。
共纳入54例患者。A组发现4例伤口并发症（3例表浅，1例深部）；B组发现2例伤口并发症（1例表浅，1例深部）。根据“创伤与手术之间的平均间隔”和“干预持续时间”，两组之间存在显著差异（<0.001）。A组和B组在伤口并发症或复位质量方面无显著差异。
跗骨窦入路是需要延迟手术的重大创伤患者闭合性移位关节内跟骨骨折手术治疗的一种有价值的入路。手术时机对复位质量和伤口并发症发生率没有负面影响。
II级，前瞻性比较研究。
