Nanynetc V. Diagnostics and surgical treatment of sequelae of the os calcis fractures

Dissertation is devoted to the actual problem of modern traumatology and orthopedics - treatment of patients wuth os galcis fractures. This problem is decided by improved diagnostics and results of surgical treatment of patients with sequelae of the os calcis fractures on a basis of differential approach to the operative treatment. First the diagnostic unreliability of B?hler's angle as a diagnostic sign for the assessement of preasens and severity of the posterior facet displacement in os calcis fractures II and III types by Sanders has been argued. The specifity of B?hler's angle is 1,0 and sensitivity - 0,8. First on a base of regression analysis established that on the foot function in patients wuth malunited os calcis fractures the anterior equines (positive meanings of talo-metatarsal angle) and severity of pain syndrome are influence; the first factor determines the preasence of anatomic changes, second - the functional decompensation of the deformity. The established dependence is confirmed by respective regression model (R = 0,6; R 2 = 0,4; p <0,05). First established the foot deformity in malunated os calcis fractures is multicomponental and characterized the anterior equines, hibdfoot varus, extension position of os talus; this made it similar to the cavus deformity. The reliability of this findings made it possible the scientific background of bone grafting using at subtalar arthrodesis in patients with malunated os calcis fractures.