The necessity of bone grafting in the surgical treatment of severely comminuted calcaneus fractures

Year 2019, Volume: 44 Issue: 1, 27 - 32, 31.03.2019

Mustafa Caner Okkaoğlu Ahmet Ateş Yüksel Uğur Yaradılmış , İsmail Demirkale , Ali Teoman Evren , Murat Altay

https://doi.org/10.17826/cumj.448853

Cited By: 2

Abstract

Purpose: The aim of this study was to evaluate the effect of grafting on postoperative radiological and clinical outcomes and complications of intra-articular calcaneal fractures treated with open reduction internal fixation. 

Materials and Methods: Two groups as allograft used [Group 1 (n = 21)] and non-grafted [Group 2 (n = 31)] were compared for American Orthopedic Foot and Ankle Score (AOFAS), Bohler’s angles, calcaneal heights, subtalar arthrosis, Sudeck’s atrophy and infection rates.

Results: There were no statistically significant differences between the two groups in terms of last AOFAS, postoperative and last Bohler’s angles and calcaneal heights.  Although a statistically significant difference was not observed between the two groups for subtalar arthrosis and Sudeck’s atrophy, there was a significant difference in infection rate. 

Conclusion: In calcaneal fractures, the space which is created after anatomic reduction and fixation will be filled with new callus tissue thanks to the spongious nature of calcaneus, and there is no need for additional grafting. 

Keywords

Key words: Calcaneal fractures, allograft, Böhler angle

Çok parçalı kalkaneus kırıkların cerrahi tedavisinde kemik greftlemenin gerekliliği

Abstract

Amaç: Bu çalışmada açık redüksiyon internal fiksasyon ile tedavi edilen eklem içi kalkaneus kırıklarında greftlemenin ameliyat sonrası radyolojik ve klinik sonuçlara katkısını ve olası komplikasyonlara etkisi araştırılmıştır. 

Gereç ve Yöntem: Greftleme yapılanlar [Grup 1 (n:21)] ve greftleme yapılmayanlar [Grup 2 (n:31)] hastalar klinik olarak Amerikan Ortopedik Ayak ve Bilek Skoru (AOFAS), radyolojik olarak  Böhler açıları ve kalkaneal yükseklikleri komplikasyon olarak  subtalar artroz, Sudeck atrofisi ve enfeksiyon oranları karşılaştırıldı.

Bulgular: Her iki grup arasında kontrol AOFAS, ameliyat sonrası ve kontrol böhler açıları ve kalkaneal yükseklikleri açısından istatistiksel olarak fark gözlenmedi. Komplikasyon olarak subtalar artroz ve Sudeck  atrofisi açısından istatistiksel bir fark gözlenmez iken enfeksiyon oranında anlamlı fark gözlendi. Kalkaneus kırıklarında redüksiyon sonrası posterior faset altında oluşan boşluğun greftlenmesinin klinik ve radyolojik iyileşmeye katkısı tartışmalıdır. Çalışmamızda klinik ve radyolojik iyileşmeye greflemenin ek katkısı olmadığını bulduk. 

Sonuç: Spongiyoz ve iyi kanlanan bir kemik olan kalkaneusun iyi bir redüksiyon ve tespit ardından oluşan boşluğu yeni kallus dokusu ile dolmaktadır ve ek olarak greftlemeye gerek yoktur. 

Keywords

Allogreft, Böhler açısı, kalkaneus kırıkları

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