经皮空心螺钉治疗移位跟骨关节内骨折:一项前瞻性研究

Hossam El-Azab, Khalaf Fathy Elsayed Ahmed, Abdelrahman Hafez Khalefa, Ashraf Rashad Marzouk
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摘要

背景:移位性跟骨关节内骨折(DIACFs)的治疗对骨科医生来说仍然存在争议和挑战。治疗DIACFs采用了几种方法。没有一种方法可以普遍适用于所有diacf。目的:本前瞻性研究的目的是评估闭合复位和经皮空心螺钉固定治疗Sanders II型和III型DIACFs的功能和影像学结果。患者和方法:2020年6月至2022年4月,Sohag大学医院骨科对14名(17英尺)患有Sanders II型或III型DIACFs的患者(17英尺)进行了一项前瞻性研究,采用闭合复位和空心螺钉固定治疗。采用AOFAS评分和疼痛VAS评分进行功能评估。影像学评估通过测量三个跟骨角(Gissane角、Böhler角和后关节面倾角)和三个跟骨距离(跟骨高度、长度和宽度)完成。结果:患者手术时平均年龄34.8岁。绝大多数患者为男性(78.6%)。右侧受累占57.1%。平均手术时间为57分钟。平均AOFAS分数为85.9分。平均x线愈合时间8.9周。结论:该技术避免了ORIF的伤口并发症,缩短了住院时间。患者满意,距下关节炎发生率较低。
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PERCUTANEOUS CANNULATED SCREWS FOR TREATMENT OF DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES: A PROSPECTIVE STUDY
Background : Treatment of displaced intra-articular calcaneal fractures (DIACFs) remains controversial and challenging to orthopaedic surgeons. Several procedures were used to treat DIACFs. There is no single approach that is universally applicable to all DIACFs. Objective:-The aim of this prospective study was to evaluate functional and radiographic outcomes of closed reduction and percutaneous cannulated screws fixation in treatment of Sanders type II & III DIACFs. Patients and methods : A prospective study was conducted on 14 patients (17 feet) with Sanders’ type II or III DIACFs, treated by closed reduction and fixation using cannulated screws, at orthopedics department of Sohag university hospital, between June 2020 and April 2022. Functional assessment was done by AOFAS score and VAS for pain. Radiographic assessment was done by measurement of three calcaneal angles (Gissane, Böhler’s and posterior facet inclination angles) and three calcaneal distances (height, length and width of calcaneus). Results : The mean age of patients at time of operation was 34.8 years. Vast majority of patients were males (78.6%). Involvement of right side was 57.1%. Mean operative time was 57 minutes. Mean AOFAS score was 85.9 points. Mean time of radiographic union was 8.9 weeks. Conclusion : The technique avoided wound complications associated with ORIF with advantage of shorter hospital stay. Patients are satisfied and had lower rate of subtalar arthritis.
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