Fan Wenchuang, Zuo Haining, Lu Xing, Zhang Xinglin, Zhou Zhiyong, Jiang Chuanqiang
Orthopedics Department of Yantaishan Hospital, Yantai, China.
Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, China.
Sci Rep. 2025 Mar 11;15(1):8367. doi: 10.1038/s41598-025-92639-9.
Sustentacular fragment displacement is not uncommon in calcaneal fractures. The factors that suggest a possible displacement of sustentacular fragment are still unclear. Displaced intra-articular calcaneal fractures with calcaneocuboid joint involvement are the most common type of calcaneal fracture. The purpose of this study is to investigate whether there is a correlation between calcaneocuboid joint involvement and sustentacular fragment displacement in displaced intra-articular calcaneal fractures. We collected basic data and CT scans of male patients with displaced intra-articular calcaneal fractures who were hospitalized in the north district of our hospital from July 2021 to June 2024. Three different logistic regression models were employed to analyze the relationship between calcaneocuboid joint involvement and sustentacular fragment displacement. Additionally, stratification analyses and their interactions were further carried out. 144 calcaneal fractures in 131 male patients were included in our study. 63 cases, accounting for 43.75%, exhibited sustentacular fragment displacement. In logistic regression analysis, a favorable association was noted between calcaneocuboid joint involvement and sustentacular fragment displacement (OR = 2.33, 95% CI: 1.18-4.59, P < 0.05). In model 2, the association retained statistical significance after adjusting for confounding factor (OR = 2.27, 95% CI: 1.15-4.51, P < 0.05). In model 3, further adjustment for all potential confounding factors also showed a statistically significant association (OR = 2.31, 95% CI: 1.14-4.68, P < 0.05).Similar results were obtained in stratified analyses. Among male patients with displaced intra-articular calcaneal fractures, it was initially discovered that calcaneocuboid joint involvement can significantly increase the risk of sustentacular fragment displacement, particularly in Sanders type 3 and 4 fractures and when the proportion of the posterior facet in sustentacular fragment is less than 50%.
跟骨骨折中载距突骨折块移位并不少见。提示载距突骨折块可能移位的因素仍不明确。累及跟骰关节的移位性关节内跟骨骨折是最常见的跟骨骨折类型。本研究的目的是探讨在移位性关节内跟骨骨折中，跟骰关节受累与载距突骨折块移位之间是否存在相关性。我们收集了2021年7月至2024年6月在我院北区住院的移位性关节内跟骨骨折男性患者的基本资料和CT扫描结果。采用三种不同的逻辑回归模型分析跟骰关节受累与载距突骨折块移位之间的关系。此外，还进一步进行了分层分析及其交互作用分析。本研究纳入了131例男性患者的144例跟骨骨折。63例（占43.75%）出现载距突骨折块移位。在逻辑回归分析中，发现跟骰关节受累与载距突骨折块移位之间存在显著相关性（OR = 2.33，95%CI：1.18 - 4.59，P < 0.05）。在模型2中，调整混杂因素后该相关性仍具有统计学意义（OR = 2.27，95%CI：1.15 - 4.51，P < 0.05）。在模型3中，进一步调整所有潜在混杂因素后也显示出统计学显著相关性（OR = 2.31，95%CI：1.14 - 4.68，P < 0.05）。分层分析也得到了类似结果。在移位性关节内跟骨骨折男性患者中，最初发现跟骰关节受累可显著增加载距突骨折块移位的风险，尤其是在Sanders 3型和4型骨折以及载距突骨折块中后关节面比例小于50%时。
