METHODS: This is a retrospective observational study of all calcaneal fractures undergoing operative fixation at a single major trauma centre in the UK. The primary outcome was pre- and post-operative assessment of the deformity correction using radiographic parameters (angle of Gissane and Bohler\'s angle). Secondary outcomes included fracture configuration, complications and re-operation rate.
RESULTS: Between 01/01/2009 and 31/12/2019, 152 calcaneal fractures in 134 patients underwent operative management via either an open or percutaneous approach. One-way ANOVA testing of the pre- and post-operative radiographic parameters demonstrated that an open approach offered superior post-operative correction of Bohler\'s angle when compared to percutaneous alone (p < 0.05); however, there was no difference in post-operative angle of Gissane (p > 0.05). The mean follow-up for complication and re-operation data was 3.5 years (range 0.1-12.4). Overall complication rate following all surgical fixation was 7.2% with a further 32.2% requiring further long-term surgical intervention for subtalar arthritis or removal of metalwork.
CONCLUSIONS: Arthroscopically assisted percutaneous fixation does not offer superior radiographic deformity correction compared to percutaneous technique alone. Open fixation yielded improved correction of Bohler\'s angle when compared to percutaneous alone; however, there was no difference in post-operative angle of Gissane.
METHODS: III.
方法:这是一项回顾性观察性研究,对英国单一主要创伤中心的所有跟骨骨折进行手术固定。主要结果是使用影像学参数(Gissane角度和Bohler角度)对畸形矫正进行术前和术后评估。次要结果包括骨折构型,并发症和再次手术率。
结果:在2009年1月1日至2019年12月31日之间,134例患者的152例跟骨骨折接受了开放或经皮手术治疗。术前和术后影像学参数的单因素方差分析测试表明,与单独经皮相比,开放入路对Bohler角度的术后矫正效果更好(p<0.05);然而,Gissane术后角度无差异(p>0.05)。并发症和再次手术数据的平均随访时间为3.5年(范围0.1-12.4)。所有手术固定后的总并发症发生率为7.2%,另外32.2%需要对距下关节炎进行进一步的长期手术干预或去除金属制品。
结论:与单纯经皮技术相比,关节镜辅助经皮内固定术不能提供更好的影像学畸形矫正。与单独经皮固定相比,开放固定改善了Bohler角度的矫正;然而,Gissane术后角度无差异。
方法:III.