수술 후 컴퓨터 단층촬영을 이용한 관절 내 종골 골절의 정복과 임상 결과 간의 연관성 분석

• Published in: 대한족부족관절학회지 Vol. 18; no. 4; pp. 165 - 172
• Main Authors: 엄준상, 주영득, 김성준, 신민호, 이동오, 정홍근, Eom, Joon-Sang, Joo, Young-Deuk, Kim, Seong-Jun, Shin, Min-Ho, Lee, Dong-Oh, Jung, Hong-Geun
• Format: Journal Article
• Language: Korean
• Published: 대한족부족관절학회 01.12.2014
• Subjects: 정형외과학; Computed tomography; Articular step-off; Articular gap; Calcaneal fracture
• ISSN: 1738-3757; 2288-8551
• DOI: 10.14193/jkfas.2014.18.4.165

Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, B${\ddot{O}}$hler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. Results: The average postoperative AOFAS score and VAS score was $84.1{\pm}8.5$ and $2.2{\pm}2.2$. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average B${\ddot{O}}$hler angle was restored from $11.1^{\circ}$ to $24.7^{\circ}$(p<0.05), Gissane angle was changed from $121.0^{\circ}$ to $119.0^{\circ}$ (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, B${\ddot{O}}$hler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. Conclusion: The clinical outcome did not show correlation with B${\ddot{O}}$hler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.