应用Calcanail®治疗移位性跟骨关节内骨折的疗效观察

Dawid Lisowski
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摘要

介绍。自2011年引入Calcanail®以来,越来越多的外科医生使用该方法治疗跟骨骨折。这主要是因为它在伤口愈合和最终结果方面的安全性与ORIF相当。本文将展示外科医生在开始使用这种方法时可能遇到的术中问题,以及与更有经验的操作员和其他方法相比的最终结果。材料和方法。2015年11月至2018年4月使用Calcanail®治疗11例移位的跟骨关节内骨折的研究。使用AOFAS后足评分对所有患者进行评估。采用11分tvas量表对疼痛、鞋合脚和足部外观进行评价。术后3、6个月分别测量Böhler角度。仔细记录所有术中及术后并发症。结果。平均AOFAS后脚得分为79.75分。VAS疼痛2.0,鞋合脚1.5,脚的外观1.25。Böhler的平均角度恢复为17.77,随时间无明显下降。无术中及术后并发症。粉碎性骨折越少,复位越好,最终效果越好。结论。与其他手术相比,用Calcanail®治疗移位的跟骨骨折是一种安全且良好的选择。关节面修复一方面是手术中最困难的阶段,另一方面也是获得良好结果的关键。
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Results and observations in operative treatment of displaced intra- articular calcaneal fractures with use of Calcanail®
Introduction. Since the introduction of the Calcanail® in 2011 more and more surgeons have been treating calcaneal fractures with use of this method. It is mainly because of its safety concerning wound healing and final outcomes comparable to ORIF. This paper is to show the intraoperative problems the surgeon may encounter beginning with this method as well as final results in comparison to more experienced operators and other methods. Material and methods. Study of eleven displaced intra-articular calcaneal fractures operated between November 2015 and April 2018 with the use of the Calcanail®. All patients were evaluated with use of the AOFAS Hindfoot score. Pain, shoe fit and look of the foot were evaluated in 11 pointVAS scale. Böhler’s angle was measured before, after operation and in 3 and 6 month-time. All intra and post-operative complications were carefully noted. Results. Average AOFAS Hindfoot score was 79.75. VAS pain 2.0, shoe fit 1.5, look of the foot 1.25. Average Böhler’s angle restoration was 17.77 with no significant decrease with time. No intraor post-operative complications were observed. Patients with less comminuted fractures and better reduction got better final results. Conclusions. Treatment of displaced calcaneal fractures with the Calcanail® is a safe and good alternative for other procedures. Restoration of articular surface is on one hand the most difficult stage of the procedure and on the other a key to a good final outcome.
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