The use of subtalar arthroscopy in open reduction and internal fixation of intra-articular calcaneal fractures

被引:149
作者
Gavlik, JM [1 ]
Rammelt, S [1 ]
Zwipp, H [1 ]
机构
[1] Univ Hosp Carl Gustav Carus, Dept Trauma & Reconstruct Surg, D-01307 Dresden, Germany
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2002年 / 33卷 / 01期
关键词
D O I
10.1016/S0020-1383(01)00077-8
中图分类号
R4 [临床医学];
学科分类号
1002 [临床医学]; 100602 [中西医结合临床];
摘要
Congruency of the subtalar joint is a major predictor of outcome after intra-articular calcaneal fractures. Because of the irregular shape of the posterior joint facet, minor steps may be overlooked,kith direct vision or intra-operative fluoroscopy during open reduction and internal fixation (ORIF). In a preliminary series of 15 subtalar arthroscopies during hardware removal after ORIF of intra-articular calcaneal fractures, patients with visible steps of 1 mm or more had significantly inferior functional results compared to those with an intact subtalar joint (117 vs. 158 points with the 200-point score, 71.3 vs. 91.2 points with the Maryland Foot Score, P < 0.01). Congruency of the posterior facet was controlled arthroscopically in 47 intra-articular calcaneus fractures after open reduction and temporary K-wire-fixation. In 12 cases (25.5%), despite seemingly correct reduction as judged fluoroscopically, incongruencies in the posterior calcaneal facet were detected and reduction was repeated. temporarily removing the K-wires. After anatomical reduction a standard AO calcaneal plate was fixed to the lateral wall. Intra-operative arthroscopy appears to be useful in detecting minor incongruencies after ORIF of intra-articular calcaneus fractures. In the hands of an experienced surgeon it is less time demanding than intra-operative X-rays and more precise than fluoroscopy. (C) 2002 Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:63 / 71
页数:9
相关论文
共 35 条
[1]
[Anonymous], FOOT ANKLE SURG
[2]
BEZES H, 1993, CLIN ORTHOP RELAT R, P55
[3]
[4]
Buckley RE, 1992, MAJOR FRACTURES PILO, P195
[5]
BURDEAUX BD, 1983, CLIN ORTHOP RELAT R, P87
[6]
Arthroscopic arthrodesis of the ankle joint [J].
Cameron, SE ;
Ullrich, P .
ARTHROSCOPY, 2000, 16 (01) :21-26
[7]
CARR JB, 1994, ORTHOP CLIN N AM, V25, P665
[8]
COMPUTERIZED-TOMOGRAPHY SCANNING OF ACUTE INTRAARTICULAR FRACTURES OF THE CALCANEUS - A NEW CLASSIFICATION-SYSTEM [J].
CROSBY, LA ;
FITZGIBBONS, T .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1990, 72A (06) :852-859
[9]
Intra-articular fractures of the calcaneum: Why such controversy? [J].
Eastwood, DM ;
Phipp, L .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 1997, 28 (04) :247-259
[10]
Subtalar arthroscopy for persistent subfibular pain after calcaneal fractures [J].
Elgafy, H ;
Ebraheim, NA .
FOOT & ANKLE INTERNATIONAL, 1999, 20 (07) :422-427