Despite the relative prevalence of intra-articular calcaneal fractures, definitive management is controversial. The goal of this study is to evaluate the clinical and radiological outcome of percutaneous reduction and fixation of 20 patients with intraarticular calcaneal fractures Sanders type II, III or IV by k wires, Steinmann pins or cannulated screws subjectively and objectively over 8 months . Twenty-two ( 22) percutaneous fixation of calcaneal fractures in 20 patients were included in this study. This study included closed intra-articular calcaneal fractures type II , III and IV in adult patients and excluded open, extra-articular, type I fractures. The American Orthopaedic Foot and Ankle Score (AOFAS) was used for evaluation. The excellent and good results were considered satisfactory while the poor and fair results were considered unsatisfactory. The results at the end of this study were satisfactory in 86.3% of patients (AOFAS score more than 75 in 19 fractures) and unsatisfactory in 13.6% of patients (AOFAS score less than 75 in 3 fractures). All patients included in this study showed normal range of motion of the ankle joint (active dorsiflexion and planter flexion) with variable decrease in the subtalar range of motion (active inversion and eversion) when compared with the normal side. .Percutaneous reduction and fixation had been found to be satisfactory in reduction of Böhler's angle, Gissane angle and Sarrafian angle with avoiding open reduction surgical and postoprtative complications and avoiding conservative management bad functional outcome.
Low level laser has been conducted for treatment of bone fracture on animal and had shown positive results. If laser energy is delivered at optimal dose with appropriate parameters, it might get best results however a little research in the literature has conducted on the effect of low level laser on human bone fracture. The aim of the study was to assess the radiological and clinical difference of the effect of low level laser therapy on the delayed bone healing of patients with different bone fractures. This was a prospective study conducted in Benha university hospital on 33 patients with delayed and non-union of bone fractures via low level laser diode laser with a wavelength 905nm. There were 27 male 5 female patients, mean age group ±34.43 range (24 years to 67 years), the mean delayed of union was ± 6,68 range (3 months to 15 months ). At the end of the study, union is achieved in mean period±1,7( 1 month to 4,1 month)which led to success of about 70% improvement of the treated group, union mean number of sessions used ±23,375 (range 15 sessions to 50 sessions), Mean Visual Analog Scale (VAS) ± 1,3 range from (0 to 6). the present study indicate that Low level laser therapy is an effective modality for treatment of delayed bone fracture, can relieve pain and increase range of motion of the associated stiff joints with no adverse effect provided that adequate patient selection has conducted.
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