종골의 관절내 골절 후 발생한 불유합의 수술적 치료
Operative Treatment of Nonunion after Intra-articular Calcaneal Fracture
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Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9∼7.6 cm) preoperatively and 7.34 cm (range, 6.0∼8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6∼8 degrees) preoperatively and 13.1 degrees (range, 5.7∼21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14∼36) and 4 (range, 3∼6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54∼68) and 3 (range, 2∼4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.
Abstract
Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9∼7.6 cm) preoperatively and 7.34 cm (range, 6.0∼8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6∼8 degrees) preoperatively and 13.1 degrees (range, 5.7∼21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14∼36) and 4 (range, 3∼6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54∼68) and 3 (range, 2∼4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.
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