Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture

종골의 관절 함몰 골절에서 6.5 mm 해면골 나사와 Steinmann 핀을 이용한 치료의 유용성

  • Lee, Gi-Soo (Department of Orthopedic Surgery, Konyang University College of Medicine) ;
  • Kang, Chan (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Hwang, Deuk-Soo (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Noh, Chang-Kyun (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Lee, Gi-Young (Department of Orthopedic Surgery, Chungnam National University School of Medicine)
  • 이기수 (건양대학교 의과대학 정형외과학교실) ;
  • 강찬 (충남대학교 의과대학 정형외과학교실) ;
  • 황득수 (충남대학교 의과대학 정형외과학교실) ;
  • 노창균 (충남대학교 의과대학 정형외과학교실) ;
  • 이기영 (충남대학교 의과대학 정형외과학교실)
  • Received : 2014.10.24
  • Accepted : 2015.02.09
  • Published : 2015.03.15
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Abstract

Purpose: To report the radiographic and clinical results of 6.5 mm cancellous full threaded buttress screw or Steinmann pin fixation to maintain a reduction of calcaneal posterior facet depression fracture. Materials and Methods: From June 2009 to June 2012, 50 consecutive cases with calcaneal joint depression fracture that underwent open reduction and screw or pin fixation were enrolled in this study. A 6.5 mm cancellous full threaded screw was inserted from the posteroinferior aspect of the calcaneal tuberosity to the posterior facet (group A) or Steinman pin was inserted from the posterosuperior aspect of the calcaneal tuberosity to the calcaneocuboidal joint (group B). Both preoperative and postoperative Bohler and Gissane angles were measured radiographically, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were assessed. Results: The mean age of patients was 44.1 years, and the mean follow-up period was 27.2 months. According to the Sanders classification, 28 cases were type II and 22 cases were type III. In Sanders type II, Bohler and Gissane angles improved significantly from $10.1^{\circ}$ and $126.2^{\circ}$ preoperatively to $27.2^{\circ}$ and $117.1^{\circ}$, respectively, in the immediate postoperative radiograph, and at the final follow-up, $26.6^{\circ}$ and $118.6^{\circ}$, respectively. In Sanders type III, Bohler and Gissane angles improved significantly from $5.0^{\circ}$ and $129.8^{\circ}$ to $29.9^{\circ}$ and $119.3^{\circ}$, respectively, in the immediate postoperative radiograph, and $26.9^{\circ}$ and $120.2^{\circ}$ at the final follow-up. All cases achieved bony union, and the average period until complete union was 13.3 weeks. AOFAS ankle-hindfoot scale was 82.6 in Sanders type II and 77.3 in Sanders type III at the final follow-up. Conclusion: A 6.5 mm cancellous full threaded buttress screw or Steinman pin fixation is a noninvasive treatment method with a merit of being able to maintain the bearing capacity of the posterior facet comparable to plate fixation.

Keywords

References

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