Biplane osteotomy to treat malunion of Stephens-Sanders type Ⅱ calcaneal fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To evaluate the clinical efficacy of biplane osteotomy in the treatment of malunion of Stephens-Sanders type Ⅱ calcaneal fracture.Methods:A retrospective study was conducted to analyze the clinical data of 31 patients who had been treated by biplane osteotomy at Sports Medicine Center, The First Affiliated Hospital of Army Medical University for malunion of Stephens-Sanders type Ⅱ calcaneal fracture from January 2019 to January 2022. There were 21 males and 10 females, with an age of (41.4±13.9) years and a duration from injury to diagnosis of (12.8±8.9) months. Functional and image scores were compared before surgery, 6 months after surgery, and at the last follow-up. Functional scores included the visual analogue scale (VAS) score, the American Orthopedic Foot and Ankle Society (AOFAS) score, and the pain interference (PI) and physical function (PF) indices in the Patient-Reported Outcomes Measurement Information System (PROMIS). Image scores included the Gissane angle, B?hler's angle, calcaneal pitch angle, length of the calcaneus, absolute foot height, and axial calcaneal width as measured on X-rays.Results:The operation time was (106.6±29.9) minutes for this cohort. All the 31 patients were followed up for (18.4±5.8) months. At 6 months after surgery and the last follow-up, the VAS scores [3 (2, 3), 2 (1, 3)], AOFAS scores [83 (76, 87), 85 (83, 87)], PI scores [(57±9), (48±6)], PF scores [53 (39, 61), 56 (54, 66)], Gissane angles (109.6°±14.1°, 109.3°±14.9°), B?hler angles (26.5°±11.6°, 26.9°±11.8°), calcaneal pitch angles [19.1° (14.5°, 23.9°), 19.9° (14.5°, 23.9°)], absolute foot heights [(76.5±9.6) mm, (76.0±9.9) mm], and axial calcaneal widths [(38.5±4.1) mm, (38.3±4.1) mm] were all significantly improved compared to the preoperative values [5 (4, 6), 62 (56, 67), (62±6), 47 (38, 51), 126.8°±13.1°, 11.8°±10.9°, 13.8° (8.2°, 18.7°), (71.0±9.1) mm, (42.8±5.5) mm] (all P<0.05). However, there was no statistically significant difference in the length of the calcaneus among pre-surgery, 6 months after surgery, and the last follow-up ( P>0.05). Conclusion:Biplane osteotomy is a surgical technique that demonstrates good clinical efficacy in the treatment of malunion of Stephens-Sanders type Ⅱ calcaneal fracture so that it should be promoted in clinic.