Polat Enes, Afacan Muhammed Yusuf, Karaismailoglu Bedri, Botanlioglu Huseyin, Seker Ali
Cerrahpasa Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Eur J Trauma Emerg Surg. 2025 Jan 14;51(1):15. doi: 10.1007/s00068-024-02687-5.
The standard approach for addressing intra-articular calcaneal fractures involves open reduction with plate and screw fixation, with ongoing discourse regarding the application of grafts to address bone gaps. The aim of this study is the temporal comparison of the radiological and functional outcomes in patients undergoing surgery for intra-articular calcaneal fractures, with a specific focus on the use of bone grafts.
Thirty patients, comprising 13 with iliac grafts and 17 without, were enrolled in the study. Preoperative and postoperative assessments included Gissane and Böhler angles, Visual Analog Scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot scale, and Kellgreen-Lawrance subtalar arthrosis stages. The average follow-up period was 6.7 years, ranging from a minimum of 3.5 to a maximum of 10 years.
The Böhler angle exhibited a significant increase (p < 0.001), while the Gissane angle did not show significant changes in the early postoperative period across the entire study group (p = 0.1). Graft-treated patients demonstrated a significantly higher Böhler angle in the early and late postoperative periods compared to preoperative values (p = 0.04, p = 0.05). Similarly, patients without grafts exhibited a significantly higher Böhler angle in the early and late postoperative periods compared to preoperative values (p = 0.004, p = 0.002). No significant differences were observed between periods in Gissane measurements (p = 0.3), VAS scores, AOFAS scores, and the development of subtalar arthrosis in both grafted and non-grafted patients.
Evaluation of patients with calcaneal fractures, both with and without grafts, was conducted using Böhler and Gissane angles, VAS scores, AOFAS scores, and the development of fracture union and subtalar arthrosis, assessing preoperative, early, and late postoperative periods. No significant differences were found between the two groups in terms of clinical and radiological outcomes during mid-to long-term follow-up.
A retrospective cohort study.
治疗关节内跟骨骨折的标准方法包括切开复位钢板螺钉固定，关于应用植骨来处理骨缺损的讨论仍在继续。本研究的目的是对接受关节内跟骨骨折手术患者的影像学和功能结果进行时间上的比较，特别关注骨移植的使用情况。
30例患者纳入研究，其中13例使用髂骨移植，17例未使用。术前和术后评估包括吉萨尼角（Gissane角）和博勒角（Böhler角）、视觉模拟评分（VAS）分数、美国矫形足踝协会（AOFAS）踝后足评分以及凯尔格林 - 劳伦斯距下关节病分期。平均随访期为6.7年，最短3.5年，最长10年。
博勒角显著增加（p < 0.001），而在整个研究组中，术后早期吉萨尼角无显著变化（p = 0.1）。与术前值相比，接受植骨治疗的患者在术后早期和晚期的博勒角显著更高（p = 0.04，p = 0.05）。同样，未接受植骨的患者在术后早期和晚期的博勒角也显著高于术前值（p = 0.004，p = 0.002）。在吉萨尼角测量值（p = 0.3）、VAS分数、AOFAS分数以及植骨和未植骨患者距下关节病的发展方面，各时期之间未观察到显著差异。
使用博勒角和吉萨尼角、VAS分数、AOFAS分数以及骨折愈合和距下关节病的发展情况，对有植骨和无植骨的跟骨骨折患者进行术前、术后早期和晚期的评估。在中长期随访期间，两组在临床和影像学结果方面未发现显著差异。
一项回顾性队列研究。
