نویسندگان
1 دانشگاه علوم پزشکی هندوستان
2 دانشگاه علوم پزشکی سارات
چکیده
خلاصه
پیشزمینه: با وجود مطالعات متعددی که در سال‌های متمادی انجام شده‌است، اما همچنان روش بهینه‌ای برای ترمیم شکستگی‌های درون مفصلی پاشنه‌ی پا وجود ندارد. هدف این مقاله مقایسه‌ی خروجی ها و نتایج درمان‌های جراحی و غیرجراحی برای شکستگی‌های جابجا شده‌ی درون مفصلی پاشنه‌ی پا در طول یک سال است.
روش: مطالعه‌ی حاضر از نوع آینده‌نگر بوده و به مدت دو سال (2018-2017) در بیمارستان عالی مراقبت‌های ویژه در شهر سورات واقع در ایالت گوجارات هندوستان صورت گرفته است. در این مدت، از بین 49 شکستگی، 25 عدد به صورت غیر جراحی و 24 عدد (11 نفر با روش جراحی باز ORIF و 13 نفر هم با روش جراحی با حداقل تهاجم MIS) نیز به صورت جراحی ترمیم شده‌اند. نتایج با استفاده از سیستم امتیازدهی AOFAS تصاویر رادیوگرافی نیز به مدت یک سال پس از جراحت ثبت شدند. اجرای این مقایسه نیز با استفاده از روش ANOVA صورت گرفت.
نتایج: در سه ماه ابتدایی درمان، روش جراحی ترمیم شکستگی درون مفصلی پاشنه‌ی پا نتایج به مراتب بهتری (رضایت 95درصدی) را نسبت به روش غیرجراحی داشته است. در حالی که در ماه‌های بین 6 تا 12، تفاوت محسوسی بین دو روش وجود ندارد. البته روش غیرجراحی نسبت به روش جراحی، عوارض بیشتری را دارا بوده است.
نتیجه‌گیری: با توجه به امتیازات داده شده توسط سیستم AOFAS و تصاویر رادیوگرافی، در سه ماهه‌ی نخست، روش ترمیم جراحی شکستگی‌های جابجا شده‌ی درون مفصلی پاشنه‌ی پا در مقایسه با روش غیر جراحی، حتی درمورد افراد حاذق، از نتایج بهتری برخوردار بوده است. در ماه‌های بین ۶ تا ۱۲، نتایج دو روش مشابه یکدیگر هستند.
کلیدواژه‌ها
عنوان مقاله [English]
Operative Versus Non-Operative Treatment for Closed Displaced intra-articular Fractures of the Calcaneum
نویسندگان [English]
- Kushal Parikh 1
- Mitesh Patel 2
- Shalin Shah 2
- Akarsh Patel 2
1
2
چکیده [English]
Background: Despite years of study, there is no consensus on the best method for treatment of intraarticular calcaneum fracture. This study aims to compare the outcome of operative versus nonoperative modality of management in intraarticular displaced calcaneum fractures over one year.
Method: This is a prospective study carried out at a tertiary care hospital over a period of 2 years: 2017 to 2018 in Surat, Gujarat, India. In this period, out of 49 fractures 25, were treated non-operatively and 24 by operative method (11 Open Reduction Internal Fixation ORIF plating, 13 Minimally Invasive Surgery – (MIS). The outcome was recorded using American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographs up to 1-year post injury. The assessment was made using Analysis of Variance (ANOVA) method.
Result: Operative method of management of intraarticular calcaneal fractures had a significantly better (95% confidence) functional outcome at 3 month compared to non-operative management. However, at 6 and 12 months follow ups the difference between them become insignificant. Non-operative management, however, had more complications as compared to operative management.
Conclusion: Operative modality even in experienced hands has better outcome in terms of AOFAS score and radiographically compared to non-operative method in treatment of intraarticular displaced calcaneal fractures only in first few months. At 6 and 12 months follow up, the functional outcomes become similar.
کلیدواژه‌ها [English]
- Key words: Intraarticular calcaneal fractures
- ST pin calcaneum
- ORIF plating calcaneum
- Non-Operative calcaneum
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دوره هفدهم، شماره 1 (شماره مسلسل 64)، زمستان 1397، صفحه‌های 13-6 بررسی نتایج بالینی ادکتور تناتومی و جااندازی بسته در درمان ...
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