The Treatment of Concomitant Spine and Hindfoot Injuries

Abstract

To analyze diagnosis and treatment results of 38 patients with concomitant injuries to the spine and hindfoot. Material and Methods. Thirty eight patients with concomitant injury to the spine and hindfoot were treated. One group of patients received surgical treatment of injured segments, and another was treated conservatively. All patients have undergone X-ray examination of the injured foot in two planes, estimation of calcaneostragaloid angle and Boehler angle. The spine was studied for the presence of muscle strain and kyphosis. Spondylography in two planes was performed for the assessment of kyphotic deformity, compression degree, and fracture stability. Results. Complete correction of kyphosis was achieved in 86.0% of the second group patients; and in 80.0 % of the first group patients. The mean value of Boehler angle was 21° ± 3° in surgery group and 4° ± 6° in conservative group. In the group of patients with conservatively treated calcaneus fractures the events of posttraumatic arthritis were detected in 9 (64.2%) cases, in the group of operated patients they were detected in 2 (67.0%) cases. Conclusion. Concomitant spine and hindfoot injuries are in most cases the result of catatrauma. The most efficient and reasonable technique of hindfoot fracture treatment is open reduction and fusion with plate and screw instrumentation with utmost accurate reconstruction of joint surfaces.