Stark Matthias, Popp Domenik, Schmoelz Lukas, Doering Kevin, Stark Kerstin, Nia Arastoo
Department of Orthopedic Surgery, Krankenhaus Neunkirchen, Danube Private University, Neunkirchen, Niederösterreich, Austria.
Department of Orthopedic and Trauma Surgery, Krankenhaus Wiener Neustadt, Wiener Neustadt, Niederösterreich, Austria.
Wien Klin Wochenschr. 2024 Dec 2. doi: 10.1007/s00508-024-02476-5.
Displaced intra-articular calcaneal fractures are a complication-ridden injury to treat and there are various treatment techniques to address this injury. The aim of this study was to evaluate the mid-term outcome of a percutaneous two-point distractor technique in patients with displaced intra-articular calcaneal fractures.
A retrospective data analysis of patients with intra-articular calcaneal fractures treated in a level 1 trauma center was conducted. The patients were subsequently invited for a follow-up visit to assess the mid-term outcome. The Böhler's and Gissane's angles, the American Orthopaedic Foot & Ankle Society hindfoot score, the Maryland foot score and a visual analog scale for pain were measured preoperatively and postoperatively and after at least 6 years to assess the radiological and functional outcome.
Of the patients 59 completed the study with a mean follow-up of 76 months after surgery. The mean American Orthopedic Foot and Ankle Society hindfoot score at the last follow-up visit was 81, the mean Maryland foot score was 78. There were three cases (5%) of superficial wound complications and secondary arthrodesis of the subtalar joint was performed in five patients (8%).
The low rates of postoperative infections and secondary arthrodesis in this study underline the good to excellent mid-term functional results for a minimally invasive technique.
移位的关节内跟骨骨折是一种治疗起来并发症较多的损伤，针对这种损伤有多种治疗技术。本研究的目的是评估经皮两点撑开器技术治疗移位关节内跟骨骨折患者的中期疗效。
对在一级创伤中心接受治疗的关节内跟骨骨折患者进行回顾性数据分析。随后邀请患者进行随访以评估中期疗效。术前、术后以及至少6年后测量跟骨角（Böhler角和Gissane角）、美国足踝外科协会后足评分、马里兰足部评分以及疼痛视觉模拟量表，以评估影像学和功能结果。
59例患者完成了研究，术后平均随访76个月。最后一次随访时，美国矫形足踝协会后足评分的平均值为81分，马里兰足部评分的平均值为78分。有3例（5%）出现表浅伤口并发症，5例（8%）患者进行了距下关节二期融合术。
本研究中术后感染和二期融合术的发生率较低，这表明一种微创技术能取得良好至优异的中期功能结果。
