종골 골절의 제한적 후방 접근법 수술적 치료 후 조기 운동 및 재활 치료의 결과
Result of the Early Exercise and Rehabilitation after Limited Posterior Operative Treatment of the Calcaneal Fractures
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.
Abstract
Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.
참고문헌 (40)
- Barnard L, "Nonoperative treatment of fractures of the calcaneus", J Bone joint Surg, 45(A), pp.865~867 (1963)
- Baron JA, "Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age", Epidemiology, 7, pp.612~618 (1996)
- Benirschke SK, "Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures", Clin Orthop, 292, pp.128~134 (1993)
- Bohler L, "Diagnosis, pathology and treatment of fractures of the os calcis", J Bone Joint Surg, 13(A), pp.75~89 (1931)
- Burdeaux BD, "Reduction of calcaneus fractures by the McReynolds medial approach technique and its experimental basis", Clin Orthop, 177, pp.87~103 (1983)
- Cave EF, "Fractures of the Os Calcis: The problem in general", Clin Orthop, 30, pp.64~66 (1963)
- Chapman MW, "calcaneus fractures. In: Chapman MW ed. Chapman’s orthopedic surgery. 3rd. ed.", pp.2966~2979 (2001), Lippincott Williams and Wilkins
- Choi JC, "Open reduction and internal fixation of intraarticular calcaneal fractures by the extened lateral approach", J Korean Orthop Assoc, 32, pp.370~375 (1997)
- Deyerle WM, "Long term follow-up of fractures of the os calcis. Diagnostic peroneal synoviagram", Orthop Clin North Am, 4, pp.213~227 (1973)
- Essex-Lopresti P, "The mechanism, reduction technique and results in fractures of the os calcis", Br J Surg, 39, pp.395~419 (1952)
- Folk JW, "Early wound complications of operative treatment of calcaneus fractures: analysis of 190 fractures", J Orthop Trauma, 13, pp.369~372 (1999)
- Giannestra NJ, "Fracures and dislocations in the foot. In Fractures. Rockwood and Green. 2nd ed.", pp.1411~1443 (1975), JB Lippincott Co
- Guyer BH, "Computed-tomography of calcaneal fractures: Anatomy, pathology dosimetry, and clinical relevance", American Journal of Roentgenology, 145, pp.911~919 (1985)
- Harold BK, "Clinical rating systems for the anklehindfoot, midfoot, hallux and lesser toes", Foot Ankle Int, 15, pp.349~353 (1994)
- Heckman JD, "Fracture and dislocations of the foot. In fractures in adult. Rockwood and Green. 3rd ed.", pp.2103~2131 (1991), JB Lippincott Co
- Hildebrand KA, "Functional outcome measures after outcome measures after displaced intra-articular calcaneal fracture", J Bone Joint Surg, 78(B), pp.119~123 (1996)
- Kim HJ, "Usefulness of CT Scan in treatment of calcaneal fracture", J Korean Fracture Soc, 16, pp.526~533 (2003)
- Kundel K, "Calcaneal fractures: operative versus nonoperative treatment", J Trauma, 41, pp.839~845 (1996)
- Lance EM, "Factures of the os calcis. Treatment by early mobilization", Clin Orthop, 30, pp.76~90 (1963)
- Letournel E, "Open reduction and internal fixation of calcaneus fractures. In Spiege PG ed. Topics in orthopedic trauma. 1st ed.", pp.173~192 (1984), Baltimore, University Parkpress
- Letoournel E, "Open treatment of acute calcaneal fractures", ClinOrhop Relat Res, 290, pp.60~67 (1993)
- Leung KS, "Operative treatment of displaced intra-articular fracture of the calcaneum. Medium-term results", J Bone Joint Surg, 75(B), pp.196~201 (1993)
- Lowery RB, "Foot Ankle", 17, pp.230~ (1996)
- McLaughlin HL, "Treatment of late complications after os calcis fractures", ClinOrthop, 30, pp.111~115 (1963)
- Noble J, "Early posterior subtalar fusion in the treatment of the os calcis", J Bone Joint Surg, 61(B), pp.90~93 (1979)
- O’Connell F, "Evaluation of modern management of fracture of the os calcis", Clin Orthop RelatRes, 83, pp.214~223 (1972)
- Paley D, "Intra-articular fractures of the calcaneus. A critical analysis of results and prognostic factors", J Bone Joint Surg, 75(A), pp.342~354 (1993)
- Pannal GF, "Operative treatment of comminuted fractures of the Os calcis", Orthop Clin North Am, 4, pp.197~211 (1973)
- Park BM, "A clinical study of the fractures of the calcaneus", J Korean Orthop Assos, 17, pp.697~703 (1982)
- Park IH, "Displaced intra-articular calcaneal fracture treatment surgically with limited posterior incision", Foot Ankle Int, 21, pp.195~205 (2000)
- Pozo JL, "The long-term results of conservative management of severely displaced fractures of the calcaneus", JBone Joint Surg, 66(B), pp.386~390 (1984)
- Ross ERS, "Current controversies in intraarticular calcaneal fractures", Inter J of Orthop Trauma, 4, pp.52~56 (1994)
- Rowe CR, "Fractures of the Os calcis: a long-term follow-up study of 146 patients", J.A.M.A, 184, pp.920~923 (1963)
- Salama R, "Fuctional treatment of intra-articular fracture of the calcaneus", Clin Orthop Relat Res, 115, pp.236~240 (1976)
- Sanders R, "Displaced intra-articular fractures of the calcaneus", J Bone Joint Surg, 82(A), pp.225~250 (2000)
- Sanders R, "Trauma to calcaneus and its tendon. In Disorders of the foot and ankle. Jahss, MH.(ed).", pp.2333~2338 (1991), WB Saunders Co
- Sangeorzan BJ, "Surgical management of fractures of the os calcis", Instr Course Lect, 44, pp.359~370 (1995)
- Shim JI, "The classification and management of intraarticular calcaneal fracture based on computed tomography", J Korean Fracture Soc, 9, pp.742~749 (1996)
- Stephenson JR, "Treatment of displaced intra-articular fracture of the calcaneus using medial and lateral approaches, internal fixation, and early motion", Bone joint Surg, 69(A), pp.115~130 (1987)
- Zwipp H, "Osteosynthesis of displaced intraarticular fractures of the calcaneus. Results in 123 cases", Clin Orthop Realat Res, 290, pp.76~86 (1993)