Functional Outcomes Comparing Open Reduction and Internal Fixation With and Without Bone Graft Substitute for Sanders Type III Calcaneus Fractures.

IF 1.3 4区 医学 Q2 Medicine
K C Athish, Raju Karuppal, Khayas Omer Kunheen, Karthik Raj
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引用次数: 0

Abstract

Background: Sanders Type III fractures of the calcaneus present a challenging injury often treated with open reduction and internal fixation (ORIF). The benefit of adding bone graft substitutes to enhance healing and outcomes remains uncertain.

Purpose: To compare the clinical and radiological results of ORIF performed with versus without the use of bone graft substitutes in patients with Sanders Type III calcaneal fractures.

Study design: A prospective cohort study.

Methods: Fifty adult patients diagnosed with Sanders Type III calcaneal fractures were prospectively divided into two groups. Group 1 received ORIF combined with bone graft substitute implantation, while Group 2 underwent ORIF alone. Radiographic evaluation involved measuring Bohler's and Gissane's angles preoperatively and at intervals immediately post-surgery, 3 months, and 6 months afterward. Functional outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score.

Results: Both groups showed marked improvement in Bohler's and Gissane's angles postoperatively (p < 0.05). Functional scores improved over time with no significant difference in AOFAS hindfoot scores between groups at 6 months (p > 0.05). Patients treated with bone graft substitutes reported more early postoperative discomfort and serous wound discharge.

Conclusion: Although bone graft substitutes may assist in filling bone voids and provide initial mechanical support, their routine use may not be required for satisfactory outcomes when stable fixation is achieved in Sanders Type III calcaneal fractures.

Sanders III型跟骨骨折的切开复位和内固定与骨移植替代物的功能结果比较。
Sanders III型跟骨骨折是一种具有挑战性的损伤,通常采用切开复位内固定(ORIF)治疗。添加骨移植替代物以促进愈合和结果的益处仍不确定。目的:比较Sanders III型跟骨骨折患者使用骨移植代用物与不使用骨移植代用物进行ORIF的临床和影像学结果。研究设计:前瞻性队列研究。方法:50例确诊为Sanders III型跟骨骨折的成年患者前瞻性分为两组。组1采用ORIF联合骨移植替代植入术,组2单独采用ORIF。影像学评估包括术前、术后、术后3个月和6个月分别测量Bohler角和Gissane角。使用美国矫形足踝协会(AOFAS)后足评分评估功能结果。结果:两组术后Bohler’s、Gissane角度均有明显改善(p < 0.05)。功能评分随时间推移而改善,6个月时两组间AOFAS后足评分无显著差异(p < 0.05)。接受骨移植替代物治疗的患者报告更多的术后早期不适和严重的伤口排出。结论:虽然骨移植替代物可以帮助填充骨空隙并提供初始的机械支持,但当Sanders III型跟骨骨折实现稳定固定时,常规使用骨移植替代物可能不需要获得满意的结果。
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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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