A Prospective Randomized Controlled Trial of a Bioresorbable Calcium Phosphate Paste (α-BSM) in Treatment of Displaced Intra-Articular Calcaneal Fractures

Johal, Herman; Buckley, Richard; Le, Ian; Leighton, Ross

doi:10.1097/ta.0b013e3181ae2d50

Cited by 55 publications

(59 citation statements)

References 56 publications

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“…A study by Johal et al supports the use of an injectable in situ hardening calcium phosphate paste to fill the bone void after a displaced Fig. 2 Böhler's angle (BA) at three time points: median pre-operative, post-operative and at one year follow-up intra-articular calcaneal fracture, as it shows less reduction in BA during follow-up [11].…”

Section: Discussionmentioning

confidence: 99%

“…However, the subtalar joint frequently collapses (calcaneal collapse) post-operatively to some extent, which can be seen at radiological follow-up [11,14,24]. Several authors noted a correlation between initial BA and outcome [3,10,15,18,22,24].…”

Section: Introductionmentioning

confidence: 99%

“…This cutoff value was chosen following an extensive literature search: in patients treated with ORIF, the highest reported decrease in BA ranged from 6 to 10.4°at 1-year follow-up [6,11,14] and in patients treated conservatively an 11°collapse was detected [3].…”

Section: Methodsmentioning

confidence: 99%

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Predicting loss of height in surgically treated displaced intra-articular fractures of the calcaneus

Backes

Dorr

Luitse

et al. 2015

International Orthopaedics (SICOT)

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Purpose The goal of calcaneal fracture surgery is to restore its anatomy and good foot function. However, loss of height of the subtalar joint can occur post-operatively, as expressed by a decrease in Böhler's angle (BA). The aim of this study was to identify potential factors associated with a post-operative decrease in BA. Methods All consecutive adult patients treated with open reduction and internal fixation (ORIF) by an extended lateral approach (ELA) between 2000 and 2013 were retrospectively included. Primary outcome was the occurrence of a calcaneal collapse, defined as a postoperative decrease of ≥10°in BA. The BA was measured pre-operatively, directly following surgery and at one year follow-up. Patient characteristics (body mass index, diabetes mellitus, smoking/alcohol/substance abuse, American Society of Anaesthesiologist classification), fracture classification and treatment characteristics: peroperative increase in BA and occurrence of post-operative wound infection (POWI) were collected. Results A total of 262 patients with 276 calcaneal fractures were included. A calcaneal collapse occurred in 46 cases (17 %). The median preoperative BA, per-operative increase in BA and post-operative decrease in BA were, respectively, 2°, 27°and 4°. A calcaneal collapse was seen more often following a per-operative increase of >25°in BA, but no significant association was found (p=0.056). Uni-and multivariate analysis showed that patients with substance abuse and those with POWI had significantly more calcaneal collapse (p<0.05). No association was found between substance abuse and the occurrence of POWI (p=0.293). Conclusions In nearly one in six patients with an intraarticular calcaneal fracture treated with ORIF by an ELA, a post-operative collapse of ≥10°was found during follow-up. Calcaneal collapse was correlated with the occurrence of a POWI and substance abuse.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predicting loss of height in surgically treated displaced intra-articular fractures of the calcaneus

Backes

Dorr

Luitse

et al. 2015

International Orthopaedics (SICOT)

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“…Although the predictive value of Böhler's angle on outcome remains a subject of debate, the initial angle at the time of trauma still guides treatment [5,6]. There is a considerable amount of literature on the change of Böhler's angle following surgically treated displaced intra-articular calcaneal fractures throughout the followup (Table 1) [7][8][9][10][11][12][13][14][15][16][17]. Data on Böhler's angle in conservatively-treated fractures, however, are limited.…”

Section: Introductionmentioning

confidence: 99%

The fate of Böhler’s angle in conservatively-treated displaced intra-articular calcaneal fractures

Bakker

Halm

Lieshout

et al. 2012

International Orthopaedics (SICOT)

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Purpose Although the predictive value of Böhler's angle on outcome remains subject of debate, the initial angle at the time of trauma still guides treatment. Changes in Böhler's angle during follow-up are frequently reported following surgical treatment of displaced intra-articular calcaneal fractures (DIACF). The aim of the present study was to determine the changes in Böhler's angle as a measure of secondary fracture displacement following conservative management of DIACF. Methods Thirty-eight patients with a total of 44 displaced intra-articular calcaneal fractures treated conservatively with a minimum of two lateral radiographs during follow-up were analysed. Böhler's angle at different follow-up times was measured by three observers. The change in angle was compared with the angle at trauma, and influence of trauma mechanism and common calcaneal fracture classifications were determined. Results The results showed a significant decline over time of the Böhler's angle in conservatively-treated patients of more than 11°on average at a mean follow-up of 29.2 weeks. This decrease was not related to gender, the initial angle, or the Essex-Lopresti or Sanders classification. A statistically significantly higher decrease was detected in high energetic trauma compared with low energetic trauma. Conclusion The conservative treatment of displaced intraarticular calcaneal fractures is still a viable option, yet a significant secondary displacement in time should be taken into account, as reflected in a decrease of Böhler's angle of 11°up to one year following trauma.

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“…Eine Böhler [6] 1931 Palmer [36] 1948 Essex-Lopresti [15] 1952 Warrick u. Brenner [58] 1953 Widen [59] 1954 Rowe et al [43] 1963 Soeur u. Remy [53] 1975 Stephenson [54] 1987 Computertomographiebasierte Klassifikation AO-Klassifikation [35] 1996 Zwipp et al [61] 1989 Crosby u. Fitzgibbons [11] 1990 Brunner et al [9] 1992 Sanders et al [47] 1993 Kuner et al [31] 1995 [26] in Funktion und Schmerz nach 2 Jahren [28].…”

Section: Spongiosaplastik Und Anwendung Von Knochenersatzmaterialienunclassified

Fersenbeinfrakturen

Rixen

Halfmann

Fritzemeier

2013

Trauma Berufskrankh

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A Prospective Randomized Controlled Trial of a Bioresorbable Calcium Phosphate Paste (α-BSM) in Treatment of Displaced Intra-Articular Calcaneal Fractures

Cited by 55 publications

References 56 publications

Predicting loss of height in surgically treated displaced intra-articular fractures of the calcaneus

Predicting loss of height in surgically treated displaced intra-articular fractures of the calcaneus

The fate of Böhler’s angle in conservatively-treated displaced intra-articular calcaneal fractures

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