RESUMO
Objective To compare the effects of arthroscopic surgery plus one or more posterior small incisions and the sinus tarsi approach in the treatment of calcaneal fracture.Methods A retrospective analysis was conducted of the 85 patients with calcaneal fracture who had been treated from January 2017 to June 2017 at Department of Foot & Ankle Surgery,Guangzhou Orthopaedic Hospital.They were 43 men and 42 women,32 to 58 years of age (average,46.0 years).Arthroscopic surgery plus one or more posterior small incisions was performed in 40 of them while the sinus tarsi approach was used in the other 45 cases.The 2 groups were compared in terms of operation time,fracture healing time,incision complications and functions of the affected foot by the American Orthopedic Foot Ankle Society (AOFAS) ankle-hindfoot scores.Results There were no significant differences in the preoperative general data between the 2 groups,showing they were comparable (P ＞ 0.05).The average follow-up period for all the patients was 8 months (from 6 to 12 months).For the arthroscopic surgery group and sinus tarsi approach group,the fracture healing time was 8.6 ± 2.4 weeks and 8.9 ± 1.8 weeks,and the AOFAS ankle-hindfoot scores were 82.5 ± 5.6 and 85.1 ± 4.0,respectively,showing no significant differences between them (P ＞ O.05).The operation time in the arthroscopic surgery group (43.6 ±5.4 min) was significantly less than in the sinus tarsi approach group (56.5 ±6.4 minutes),and the rate of complications in the former[2.5％ (1/40)] significantly lower than in the latter[15.6％ (7/45)] (P ＜0.05).Conclusion Arthroscopic surgery plus one or more posterior small incisions may be a fine treatment for calcaneal fractures because postoperative incision complications can be reduced.
RESUMO
Objective To explore the outcomes of open reduction and internal fixation ( ORIF ) with transarticular screws for Lisfranc injuries and the postoperative incidence of symptomatic tarsometatarsal os-teoarthritis ( OA ) . Methods This retrospective study involved 28 patients who had been treated surgically at our institution between January 2009 and January 2015 for Lisfranc injuries. They were 18 males and 10 females, with an average age of 36. 1 years ( from 19 to 54 years ) . According to the Quenu-Kuss classifica-tion, 5 patients had type-A injury, 10 type-B injury ( 4 cases of type-B1 and 6 ones of type-B2 ) , and 13 type-C injury ( 8 cases of type-C1 and 5 ones of type-C2 ) . The patients underwent ORIF with screws for the 1st to the 3rd tarsometatarsal joints and ORIF with Kirschner wires for the 4th to the 5th tarsometatarsal joints within 2 weeks. After the Kirschner wires were removed 8 to 10 weeks postoperatively, progressive weight-bearing began. Functional outcomes were assessed according to the American Orthopaedic Foot and Ankle Society ( AOFAS ) midfoot scores and visual analog scale ( VAS ) at final follow-ups. Results The mean duration of follow-up was 29. 9 months ( from 26 to 72 months ) . AOFAS scores revealed one excellent case, 22 good ones and 5 poor ones with an excellent to good rate of 82. 1％. The mean VAS score was 2. 8. Radiographic evidence of OA was noted in 20 patients ( 71. 4％, 20/28 ) , in 18 of whom ( 90. 0％) symp-tomatic OA was observed. There was no significant difference ( P=0. 399 ) in the incidence of symptomatic OA either between the patients with anatomic reduction ( 60. 9％, 14/23 ) and those without anatomical re-duction ( 80. 0％, 4/5 ) . Conclusions ORIF with transarticular screws can lead to good therapeutic outcomes for Lisfranc injuries. The incidence of symptomatic OA may not be related to the injury type or re-duction quality.
