Author/Editor		Andoljšek, Matej; Brodnik, Branko; Lah, Tone
Title		Pozni funkcionalni rezultati operativno zdravljenih dislociranih zlomov petnice
Translated title		Late functional results of operative treated dislocated fractures of calcaneus
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. 1
Publication year		1995
Volume		str. 13-6
Language		slo
Abstract		Background. Autors advocate operative treatment of dislocated para and intraarticular fractures of calcaneus. Results are dependent on reconstruction of calcaneus. Methods. 60 dislocated fractures of calcaneus were treated operativly (57 intraarticular, 2 paraarticular and one fracture of sustentaculum). 59 fractured calcaneus were reconstructed (58 adaptive and one stable plate osteosynthesis), one primary reconstructive arthrodesis was done. Two years postinjury 43 operated fractures of calcaneus (71,6 percent) were evaluated according to modified 18-points Seyfarth's protocol. Results. Fracture of sustentaculum and 2 paraarticular fractures of the calcaneus were without functional disturbances. Among 40 intraarticular fractures of the calcaneus 13 excellent (32,5 percent), 21 good (52,5 percent), 5 fair (12,5 percent) and one bad (2,5 percent) results were achived. Average score of B3.1 fractures was 15,17+/-3.47, of B3.2 14,40+/-1,92 and of B3.3 12.14+/-4.78. Comminutive calcaneal fractures (B3.3) have had important worse functional results (p = 0.0049). Conclusion. Reconstruction of fractured calcaneus is prerequisite for good functional result. With "minimal osteosynthesis" good functional results of dislocated fractures of calcaneus were achived. Comminution of posterior talocalcanear articular surface deteriorated prognosis.
Summary		Izhodišča. Dislocirane sklepne in obsklepne zlome petnice zdravimo operativno, saj lahko le na ta način zlomljeno petnico uspešno rekonstruiramo. Metode. Avtorji so operativno zdravili 60 dislociranih zlomov petnice (57 intraartikularnih, dva paraartikularna in en zlom sustentakuluma). 59 zlomljenih petnic so rekonstruirali (58 adaptacijskih učvrstitev, ena gibalno-stabilna osteosinteza s ploščico), le enkrat so zaradi močne kominucije napravili primarno rekonstrukcijsko artrodezo. Dve leti po poškodbi so po prilagojeni 18-točkovni Seyfarthovi shemi ocenili funkcionalni rezultat 43 operiranih zlomov petnice (71,6 odst.). Rezultati. Trije ocenjeni dislocirani obsklepni zlomi (zlom sustentakuluma in dva paraartikularna zloma) so brez funkcionalnih motenj. Med 40 intraartikularnimi zlomi petnice (18 B3.1, 15 B3.2 in 7 B3.3) ima 13 zlomov zelo dober (32,5 odst.), 21 dober (52,5 odst.) in pet zlomov zadovoljiv (12,5 odst.) funkcionalni rezultat. V enem primeru je rezultat slab (2,5 odst.). Povprečni funkcionalni rezultat skupine B3.1 je 15,17+/-3,47, B3.2 14,40+/-1,92 in B3.3 12,4+/-4,78 točk. Med intraartikularnimi zlomi petnice imajo kominutivni zlomi (B3.3) pomembno slabše funkcionalne rezultate (p = 0.0049). Zaključki. Popolna rekonstrukcija dislocirane zlomljene petnice je pogoj dobre funkcije stopala. Z "minimalno osteosintezo" uspešno zdravimo dislocirane zlome petnice. Kominucija v subtalarnem sklepu poslabšuje prognozo.
Descriptors		CALCANEUS FRACTURES