관절 내 종골 골절의 수술적 치료에 있어 관절 내시경 사용의 유용성

The Usefulness of Arthroscopy in the Operative Treatment of Intra-Articular Calcaneal Fracture

  • 정경칠 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 곽희철 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 김창완 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 김정한 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 박대현 (인제대학교 의과대학 부산백병원 정형외과학교실)
  • Chung, Kyung-Chil (Department of Orthopedic Surgery, College of Medicine, University of Inje, Busan Paik Hospital) ;
  • Gwak, Heui-Chul (Department of Orthopedic Surgery, College of Medicine, University of Inje, Busan Paik Hospital) ;
  • Kim, Chang-Wan (Department of Orthopedic Surgery, College of Medicine, University of Inje, Busan Paik Hospital) ;
  • Kim, Jung-Han (Department of Orthopedic Surgery, College of Medicine, University of Inje, Busan Paik Hospital) ;
  • Park, Dae-Hyun (Department of Orthopedic Surgery, College of Medicine, University of Inje, Busan Paik Hospital)
  • 발행 : 2009.06.15

초록

Purpose: We tried to evaluate the usefulness of the arthroscopy in the operative treatment of intra-articular calcaneal fracture. Materials and Methods: Between March 2005 and May 2008, 9 patients with intra-articular calcaneal fractures(Tongue type or Sanders type IIC) were treated with arthroscopically assisted percutaneous reduction and screw fixation. American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), preoperative and postoperative Bohler's angle and the rate of complication were evaluated. Results: AOFAS score at postoperative 1 year was 88.2 (range, 71-92), and mean VAS score was 2.8 (range, 1-4). Bohler angle was improved from preoperative mean $16.2^{\circ}$ to postoperative mean $29.7^{\circ}$. There were no complications such as wound problem, infection or nerve injury. Conclusion: Subtalar arthroscopy provides precise view of posterior facet during the operation. Therefore, it can be a useful tool in treating intra-articular calcaneus fractures, especially tongue type and Sanders type IIC fractures.

키워드

참고문헌

  1. Barla J, Buckley R, McCormack R, et al: Displaced intraarticular  calcaneal fractures: Long-term outcome in women. Foot Ankle Int, 25: 853-856, 2004.
  2. Benirschke SK and Kramer PA: Wound healing complications in closed and open calcaneal fractures. J Orthop Trauma, 18: 1-6, 2004. https://doi.org/10.1097/00005131-200401000-00001
  3. Bezes H, Massart P, Delvaux D, Fourquet JP and Tazi F: The operative treatment of intraarticular calcaneal fractures. Indications, technique, and results in 257 cases. Clin Orthop, 290: 55-61, 1993.
  4. Buckley R, Tough S, McCormack R, Pate G and Leighton R: Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg, : 1733- 1744, 2002.
  5. Crosby LA and Fitzgibbons T: Computerized tomography scanning of acute intra-articular fractures of the calcaneus. A new classification system. J Bone Joint Surg, 72-A: 852-859, 1990.
  6. Essex-Lopresti P: Results of reduction in fractures of the calcaneus. J Bone Joint Surg, 33-B: 284-291, 1951.
  7. Folk JW, Starr AJ and Early JS: Early wound complications of operative treatment of calcaneus fractures: analysis of 190 fractures. J Orthop Trauma, 13: 369-372, 1999. https://doi.org/10.1097/00005131-199906000-00008
  8. Giachino AA and Uhthoff HK: Intraarticular fractures of the calcaneus. J Bone Joint Surg, 71-A: 784-787, 1989.
  9. Harding D and Waddell JP: Open reduction in depressed fractures of the os calcis. Clin Orthop, 199: 124-131, 1985.
  10. Harris RI: Fractures of os calcis: Treatment by early subtalar arthrodesis. Clin Orthop, 30: 100-110, 1963.
  11. Jerosch J: Subtalar arhroscopy - indications and surgical technique. Knee Surg Sports Traumatol Arthrosc, 6:122-128, 1998. https://doi.org/10.1007/s001670050084
  12. King R: Axial pin fixation of fractures of the Os calcis (method of Essex-Lopresti). Orthop Clin North Am, 4: 185-188, 1973.
  13. Lance EM, Carey EJ Jr and Wade PA: Fractures of the os calcis: Treatment by early mobilization. Clin Orthop, 30: 76- 90, 1963.
  14. Mittlmeier T, Morlock MM, Hertlein H, et al: Analysis of morphology and gait function after intraarticular calcaneal fracture. J Orthop Trauma, 7: 303-310, 1993. https://doi.org/10.1097/00005131-199308000-00002
  15. Mulcahy DM, McCormack DM and Stephens MM: Intraarticular calcaneal fractures: effect of open reduction and internal fixation on the contact characteristics of the subtalar joint. Foot Ankle Int, 19: 842-848, 1998. https://doi.org/10.1177/107110079801901209
  16. Noble J and McQuillan WM: Early posterior subtalar fusion in the treatment of fractures of the os calcis. J Bone Joint Surg, 61-B: 90-93, 1979.
  17. Paley D and Hall H: Intraarticular fractures of the calcaneus. A critical analysis of results and prognostic factors. J Bone Joint Surg, 82-A: 342-354, 1993.
  18. Palmer I: The mechanism and treatment of fractures of the calcaneus. Open reduction with the use of cancellous grafts. J Bone Joint Surg, 30-A: 2-8, 1948.
  19. Parisien JS and Vangness T: Arthroscopy of the subtalar joint: an experimental approach. Arthroscopy, 1: 53-59, 1985. https://doi.org/10.1016/S0749-8063(85)80079-7
  20. Rammelt S, Gavlik JM and Zwipp H: The value of subtalar arthroscopy in the management of intra-articular calcaneus fractures. Foot Ankle Int, 23: 906-916, 2002.
  21. Sanders R, Fortin P, DiPasquale A, et al: Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computerized tomography scan classification. Clin Orthop, 290 : 87-95, 1993.
  22. Sangeorzan BJ, Aananthakrishman D and Tencer AF: Contact characteristics of the subtalar joint after calcaneal fracture. J Orthop Trauma, 9: 251-258, 1995.