PDF(Pubmed)
Abstract：
OBJECTIVE: The current rehabilitation for patients with surgically treated displaced intra-articular calcaneal fractures (DIACFs) consists of non-weightbearing for 8-12 weeks. The purpose of the present survey was to investigate the current pre-, peri- and post-operative practices among Dutch foot and ankle surgeons. Moreover, it aims to analyze whether surgeons comply to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) guidelines and which decision criteria were used in the determination of the start of weightbearing.
METHODS: A survey was distributed among Dutch trauma and orthopaedic surgeons to determine the most common practices in postoperative weightbearing in patients with DIACFs.
RESULTS: 75 surgeons responded to the survey. 33% of the respondents adhered to the AO guidelines. 4% of the respondents strictly followed non-weightbearing guidelines, while 96% interpret the AO guidelines or their local protocol freely, in any frequency. When respondents tended to deviate from the AO guidelines or local protocol, a good patients\' compliance to therapy was expected. 83% of the respondents started weightbearing on the fracture, based on reported patient complaints. 87% of the respondents did not see any relation between early weightbearing and the occurrence of complications, including loosening of osteosynthesis materials.
CONCLUSIONS: This study demonstrates that there is limited consensus on the rehabilitation for DIACFs. Moreover, it shows that most surgeons are inclined to interpret the current (AO) guideline or their own local protocol freely. New guidelines, supported with well-founded literature, could help surgeons in a more appropriate daily practice in weightbearing for the rehabilitation of calcaneal fractures.
METHODS: A survey was distributed among Dutch trauma and orthopaedic surgeons to determine the most common practices in postoperative weightbearing in patients with DIACFs.
RESULTS: 75 surgeons responded to the survey. 33% of the respondents adhered to the AO guidelines. 4% of the respondents strictly followed non-weightbearing guidelines, while 96% interpret the AO guidelines or their local protocol freely, in any frequency. When respondents tended to deviate from the AO guidelines or local protocol, a good patients\' compliance to therapy was expected. 83% of the respondents started weightbearing on the fracture, based on reported patient complaints. 87% of the respondents did not see any relation between early weightbearing and the occurrence of complications, including loosening of osteosynthesis materials.
CONCLUSIONS: This study demonstrates that there is limited consensus on the rehabilitation for DIACFs. Moreover, it shows that most surgeons are inclined to interpret the current (AO) guideline or their own local protocol freely. New guidelines, supported with well-founded literature, could help surgeons in a more appropriate daily practice in weightbearing for the rehabilitation of calcaneal fractures.
摘要：
目的：目前手术治疗移位的跟骨关节内骨折（DIACFs）患者的康复包括8-12周的非负重治疗。本次调查的目的是调查当前的前，荷兰足踝外科医生的围手术期和术后实践。此外，它旨在分析外科医生是否遵守ArbeitsgemeinschaftfürOsteosynthesefragen（AO）指南，以及在确定开始负重时使用了哪些决策标准。
方法：在荷兰创伤和骨科医生中进行了一项调查，以确定DIACFs患者术后负重的最常见做法。
结果：75名外科医生回答了调查。33%的受访者遵守AO指南。4%的受访者严格遵循非承重准则，而96%的人自由解释AO指南或他们的本地协议，在任何频率。当受访者倾向于偏离AO指南或当地协议时，预期患者对治疗的依从性良好。83％的受访者开始对骨折进行称重，根据报告的患者投诉。87%的受访者没有看到早期负重与并发症发生之间的任何关系，包括骨接合材料的松动。
结论：这项研究表明，对DIACF的康复有有限的共识。此外，这表明大多数外科医生倾向于自由解释当前(AO)指南或他们自己的本地协议.新的指导方针,有充分的文献支持，可以帮助外科医生在更合适的日常实践中进行跟骨骨折的康复。
方法：在荷兰创伤和骨科医生中进行了一项调查，以确定DIACFs患者术后负重的最常见做法。
结果：75名外科医生回答了调查。33%的受访者遵守AO指南。4%的受访者严格遵循非承重准则，而96%的人自由解释AO指南或他们的本地协议，在任何频率。当受访者倾向于偏离AO指南或当地协议时，预期患者对治疗的依从性良好。83％的受访者开始对骨折进行称重，根据报告的患者投诉。87%的受访者没有看到早期负重与并发症发生之间的任何关系，包括骨接合材料的松动。
结论：这项研究表明，对DIACF的康复有有限的共识。此外，这表明大多数外科医生倾向于自由解释当前(AO)指南或他们自己的本地协议.新的指导方针,有充分的文献支持，可以帮助外科医生在更合适的日常实践中进行跟骨骨折的康复。
