General Hospital of Heraklion "Venizeleio and Pananio", Leoforos Knossou 44, 71409, Heraklion Crete, Greece.
General Hospital of Heraklion "Venizeleio and Pananio", Leoforos Knossou 44, 71409, Heraklion Crete, Greece.
Injury. 2023 Oct;54(10):110966. doi: 10.1016/j.injury.2023.110966. Epub 2023 Jul 27.
To evaluate the outcome of displaced intraarticular calcaneal fractures (DIACFs) of a case series of patients who were treated with a percutaneous fixation technique.
Eight patients were operated for DIACFs and they were evaluated for the outcome and complications in a mean follow up of 9 months (range: 6 - 12 months). At the last follow up the AOFAS score, the Boehlers' angle and the presence of any complication were noted. The time from injury to surgery was also reported. The correlation of the AOFAS score and the development of post traumatic subtalar arthritis to the type of fracture, to the post operative Boehler's angle and to the time from injury to surgery were investigated.
The overall mean AOFAS (Americal Orthopaedic Foot and Ankle Society) score was 84,625 (Range: 73 - 96). The mean AOFAS score of type II and type III fractures was 87,667 and 75,500 respectively. The mean AOFAS score for fractures with a postoperative Boehler's angle of less than 10° and more or equal to 10° was 76,750 and 92,500 respectively. This difference was found to be statistically significant. The mean AOFAS score for fractures who were treated less or equal to six days and more than six days post injury was 91,250 and 78 respectively. Two out of four patients with a post operative Boehler's angle less than 10° developed post traumatic subtalar arthritis. No patient out of four for whom a Boehler's angle of more than 10° has been achieved, developed subtalar arthritis. No infection occurred in any of the patients.
Percutaneous fixation is a safe and effective way of treating DIACFs. The outcome is directly related to the quality of reduction, which is significantly dependent to the timing of surgery. The earlier the fracture is operated the better the reduction by closed means is.
评估采用经皮固定技术治疗的一系列患者的关节内移位跟骨骨折（DIACF）的治疗结果。
对 8 例 DIACF 患者进行了手术治疗，并在平均 9 个月（6-12 个月）的随访中对其结果和并发症进行了评估。在最后一次随访时，记录了 AOFAS 评分、Boehlers 角以及任何并发症的存在情况。还报告了从受伤到手术的时间。研究了 AOFAS 评分和创伤后距下关节炎的发展与骨折类型、术后 Boehlers 角以及从受伤到手术的时间之间的相关性。
总体平均 AOFAS（美国矫形足踝协会）评分为 84.625（范围：73-96）。II 型和 III 型骨折的平均 AOFAS 评分为 87.667 和 75.500。术后 Boehlers 角小于 10°和大于或等于 10°的骨折的平均 AOFAS 评分为 76.750 和 92.500，差异有统计学意义。受伤后 6 天以内和 6 天以上接受治疗的骨折的平均 AOFAS 评分为 91.250 和 78。术后 Boehlers 角小于 10°的 4 例患者中有 2 例发生创伤后距下关节炎。术后 Boehlers 角大于 10°的 4 例患者无一例发生距下关节炎。所有患者均未发生感染。
经皮固定是治疗 DIACF 的一种安全有效的方法。治疗结果与复位质量直接相关，而复位质量又与手术时机密切相关。骨折越早接受手术，闭合复位的效果就越好。
