Department of Orthopaedic Surgery, Orthopaedic Physiotherapy, Ege University, Faculty of Medicine, Izmir, Turkey.
Department of Sports Medicine, Ege University, Faculty of Medicine, Izmir, Turkey.
Acta Orthop Traumatol Turc. 2024 Jan;58(1):45-56. doi: 10.5152/j.aott.2024.23031.
This study aimed to determine the frequency of low back pain after calcaneal fractures treated with open reduction internal fixation (ORIF) and the risk factors that cause this condition.
Thirty-one patients (27 males and 4 females) who underwent surgery for a unilateral calcaneal fracture between 2016 and 2020 and had no complaints of low back pain before fracture surgery were included in the study. The patients were divided into 2 groups: those who developed low back pain after the operation and those who did not. Patients were evaluated with the Life Quality Short Form SF-36, the Oswestry Disability Index (ODI), and American Orthopedic Foot-Ankle Association Score (AOFAS). Sanders' fracture type, joint range of motion (ROM) measurements of injured and uninjured limbs, maximal isometric muscle strength measurements, balance on 1 leg with pedobarographic measurements, and walking time were evaluated. The obtained data were compared among the 2 groups.
Low back pain was observed in 71% of the patients and was detected after an average of 6 months from the operation. In ODI, 59.1% of the patients reported that low back pain limited their lives slightly. Patients with low back pain have lower AOFAS scores and worse SF-36 physical functionality than those without low back pain (P < .001, P=.016). Balance time on 1 foot in pedobarographic measurements, foot in ROM, ankle in ankle active, passive plantar flexion, inversion, active hip, passive internal, external rotation, muscle is the foot eversion force. In these measurements, the values of the injured side are intact. It was statistically significantly lower than the other side (interaction P < .1).
Low back pain may occur after unilateral calcaneal fractures treated by ORIF. This may be caused by decreased angles of ankle dorsi and plantar flexion, foot inversion, hip abduction, and internal and external rotation. In the rehabilitation program, not only the ankle region but also the hip joint of the affected side should be included, and the kinetic chain that describes the interaction mechanism of the human body should not be forgotten.
Level IV, Prognostic Study.
本研究旨在确定接受切开复位内固定（ORIF）治疗的跟骨骨折后腰痛的发生率，以及导致这种情况的危险因素。
本研究纳入了 2016 年至 2020 年间接受单侧跟骨骨折手术且骨折前无腰痛症状的 31 名患者（男 27 例，女 4 例）。将患者分为两组：术后发生腰痛的患者和未发生腰痛的患者。采用简明健康状况调查问卷 SF-36、Oswestry 功能障碍指数（ODI）和美国矫形足踝协会评分（AOFAS）对患者进行评估。评估内容包括 Sanders 骨折分型、患侧和健侧肢体关节活动度（ROM）测量、最大等长肌力测量、足印测量的单腿平衡以及行走时间。比较两组患者的各项评估结果。
71%的患者出现腰痛，平均在术后 6 个月后发现腰痛。在 ODI 中，59.1%的患者报告腰痛对其日常生活有轻微影响。腰痛患者的 AOFAS 评分和 SF-36 躯体功能维度评分均低于无腰痛患者（P<0.001，P=0.016）。足印测量的单腿平衡时间、踝关节 ROM、踝关节主动背屈、被动跖屈、内翻、主动髋关节、被动内旋、外旋、足外翻肌力等指标，患侧的数值与健侧相比均完整，但统计学上明显低于健侧（交互 P<0.1）。
接受切开复位内固定治疗的单侧跟骨骨折后可能会发生腰痛，这可能是由踝关节背屈和跖屈角度减小、足内翻、髋关节外展以及内旋和外旋引起的。在康复计划中，不仅要包括踝关节区域，还要包括患侧髋关节，并且不要忘记描述人体相互作用机制的运动链。
IV 级，预后研究。
