127 KB19 KB192920262004Brilej, DragoČetina, DimitrijKomadina, RadkoVlaović, Miodragštevilka:4letnik:73str. 285-288ISSN:1318-0347COBISSID_HOST:17860313URN:URN:NBN:SI:doc-0LFJFVRFslSlovensko zdravniško društvoZdravniški vestnikAdultBone PlatesBone ScrewsBone WiresCalcaneusFracture Fixation, InternalFractures, ComminutedInjuriesKalkaneusKostne ploščiceKostne žiceKostni vijakiOdrasliTreatment OutcomeZdravljenje, izidZlom, fiksacija internaZlomi z zdrobitvijo kostiAnaliza operativnega zdravljenja dislociranih zlomov petnice pri odraslih| Operative treatment of calcaneal fractures in adults|Background. Most researches prove that surgery is the only way to a successfultreatment result of calcaneal fractures despite poor quality of existing data. However, complications are still frequent Rehabilitation is rather lengthy and even if the surgery is successful, there is no guarantee for successful final treatment results. Patients and methods. 48 patients with52 calcaneal fractures operatively treated in General hospital Celje in the 3 year period were analysed. Plates and screws were used in 67% or wires in 27% of the cases involved. All the patients were reexamined on average 27 months after the injury. The results were evaluated according to the Maryland Foot Score (MFS). Results. The average MFS result was 72 (SD 20). In 28 cases (58.3%) the results were excellent or good and in 13 cases (27.1%) the resultswere satisfactory. Only in 7 cases (14.6%) the results were unsatisfactory. The method of treatment, the fragment reduction and the wound healing complications did not show the statistical influence on the final treatment results. After the accidents only 30 of them (71.5%) were still working. They went back to work in approximately 6 months. 18 patients (42.9%)went back to the same position as they had before the accident. Conclusions. Operative treatment of comminuted calcaneal fractures is accompanied by several complications. Constant use of the up-to-date diagnostic tools (CT) for evaluation of the injury and the treatment, appropriate surgical technique and the experience of the surgeon can reduce the number of the complications and their consequences. As high quality data show that operative treatment as a whole provides no improvement over nonoperative treatment in displaced intra-articular fractures, selection of the patient for surgery is crucial. Calcaneal fractures have a strong and important effect on a patient's health as well as on his/her employmentIzhodišča. Večina raziskav dokazuje, da lahko le operativna oskrba zlomljene petnice pripelje do dobrega rezultata. Toda zapleti pri zdravljenju so pogosti, rehabilitacija je dolga in tudi dober končni rezultat ni zagotovljen.Preverili smo rezultate operativnega zdravljenja zlomov petnice v Splošni bolnišnici Celje (SB Celje) in jih primerjali s podatki iz literature.Poškodovanci in metode. Analizirali smo 48 poškodovancev z zlomom petnice, ki smo jih zdravili operativno v 3-letnem obdobju. Zlome smo stabilizirali s ploščico in vijaki (67%) ali s Kirschnerjevimi iglami (27). Poškodovance smo ponovno pregledali povprečno 27 mesecev po poškodbi. Rezultatsmo ocenjevali po lestvici Maryland Foot Score (MFS). Rezultati. Povprečni rezultat po lestvici MFS je bil 72. Odličen in dober rezultat je imelo 58,3% poškodovancev, zadovoljiv rezultat 27,1% in slab rezultat 14,6%. Statistična analiza, s katero smo ugotavljali vpliv metode zdravljenja, uspešnosti uravnave odlomkov in zapletov pri celjenju rane, ni pokazala značilnega vpliva na končni rezultat. Po poškodbi je bilo zaposlenih 71,5% prej zaposlenih poškodovancev. Na delo so se vrnili po povprečno 6 mesecih. 42,9% se jih je vrnilo na enako delovno mesto. Zaključki. Dokaj enotno sprejeto operativno zdravljenje dislociranih zlomov petnice je povezano s številnimi zapleti. Naši rezultati zdravljenja so povsem primerljivi s podatkiiz literature. Toda razen kirurške oskrbe na rezultat zdravljenja vplivajo številni drugi dejavniki, ki niso povezani s samo oskrbo zloma. Zato je pomembno izbrati poškodovance, ki imajo od operativnega posega korist. Poleg pomembnega vpliva na zdravje poškodovancev imajo zlomi petnice močan negativen vpliv na njihovo zaposlitevTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo