背景:跟骨骨折的微创治疗具有相同的结果和较少的并发症。然而,他们在技术上要求很高,并且缺乏减少工具。为了克服这些问题,开发了一种跟骨交锁钉系统,可以使复位和固定微创和有效。我们回顾性研究了术中跟骨骨折的变量,并进行了随访,以评估使用跟骨交锁钉系统治疗的患者的预后。
方法:回顾性分析2020年10月至2021年5月7个机构的所有跟骨交锁钉治疗的跟骨骨折患者。病人的特点,包括年龄,性别,损伤机制,桑德斯类型分类,吸烟状况,并记录了糖尿病。介绍了跟骨交锁钉和标准手术技术。术中变量,包括等待手术的日子,手术时间,失血,切口长度,和透视时间,被记录下来。并发症的结果,记录AOFAS评分和VAS评分,并与其他类似研究进行比较。
结果:59名患者参与了这项研究;54名男性;5名女性;他们的平均年龄为47.5±9.2岁(范围为25-70岁)。这些骨折中有2个是桑德斯I型,这些骨折中有28个是桑德斯II型,这些骨折中有27个是桑德斯III型,其中2个是SandersIV型.手术时间平均131.9±50.5(30~240)分钟。失血量为36.9±41.1(1-250)ml。平均切口长度为3.5±1.8(1-8)cm;57个为关节窦切口;2个为闭合固定,无切口。手术期间的平均透视时间为12.3±3.6(10-25)秒。患者术后当天的VAS评分为2.4±0.7(1-3)。随访12个月的患者的AOFAS踝足-后足评分为93.3±3.6(85-99)。在后续行动中,所有患者的功能结局均良好.一名患者患有浅表感染。59例患者的并发症发生率为1.7%(1/59)。
结论:跟骨交锁系统在跟骨骨折中可以获得满意的复位和固定,即使是SandersIV型.随访结果显示良好的功能。跟骨交锁钉可能是微创跟骨骨折固定的替代方法。
BACKGROUND: Minimally invasive treatments for calcaneous fractures have the same outcomes and fewer complications. However, they are technically demanding, and there are a lack reduction tools. To overcome these problems, a calcaneous interlocking nail system was developed that can make reduction and fixation minimally invasive and effective. We retrospectively studied the calcaneous fracture variables intraoperatively and followed up to evaluate the outcomes of patients treated with the calcaneous interlocking nail system.
METHODS: All patients in 7 institutions between October 2020 and May 2021 who had calcaneous fractures treated with calcaneous interlocking nails were retrospectively analyzed. The patient characteristics, including age, sex, injury mechanism, Sanders type classification, smoking status, and diabetes were recorded. The calcaneous interlocking nail and standard surgical technique were introduced. The intraoperative variables, including days waiting for surgery, surgery time, blood loss, incision length, and fluoroscopy time, were recorded. The outcomes of complications, AOFAS scores and VAS scores were recorded and compared with other similar studies.
RESULTS: Fifty-nine patients were involved in this
study; 54 were male; 5 were female; and they had an average age of 47.5 ± 9.2 years (range 25-70). 2 of these fractures were Sanders type I, 28 of these fractures were Sanders type II, 27 of these fractures were Sanders type III, and 2 of these were Sanders type IV. The surgery time was 131.9 ± 50.5 (30-240) minutes on average. The blood loss was 36.9 ± 41.1 (1-250) ml. The average incision length was 3.5 ± 1.8 (1-8) cm; 57 were sinus tarsi incisions; and 2 were closed fixations without incisions. The average fluoroscopy time was 12.3 ± 3.6 (10-25) seconds during the surgery. The VAS score of patients on the day after surgery was 2.4 ± 0.7 (1-3). The AOFAS ankle-hindfoot score in patients who had a follow-up of at 12 months was 93.3 ± 3.6(85-99). During the follow-up, all patients\' functional outcomes were good. One patient had a superficial infection. The rate of complications of the 59 patients was 1.7% (1/59).
CONCLUSIONS: The calcaneous interlocking nail system can have satisfactory reduction and fixation in calcaneous fractures, even in Sanders type IV. The outcomes of follow-up showed good function. The calcaneous interlocking nail could be an alternative method for minimally invasive calcaneous fracture fixation.