Applied anatomy of the calcaneocuboid articular surface for internal fixation of calcaneal fractures

Wang, Zhijie; Huang, Xian; Chu, Yan-chen; Zou, Yun-wen

doi:10.1016/j.injury.2012.08.023

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Locking plate fixation aims at providing raft support to the condensed areas, mainly, just inferior to the calcaneocuboid joint. 18 Locking plate provides a rigid construct and good pull-out strength. These plates can even negate the use of bone graft, even in osteoporotic bone.…”

Section: Discussionmentioning

confidence: 99%

Radiographic and functional outcome of operated closed intra-articular fractures of calcaneum: a retrospective analysis

Kerketta,

Mittal,

Rahul

et al. 2023

Int J Res Orthop

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Background: The present study aims to analyse the results of surgical outcome of the operated calcaneal fractures using either plates or cannulated cancellous screws. Recently there has been considerable shift of treatment of calcaneal fractures from conservative to operative owing to better understanding of fracture pattern. However, reduction of long-term functional outcome of such patients is always questionable and remains unanswered. Methods: A 25 fractures were operated with locking plates or cannulated screws after proper assessment. Functional assessment was done using AOFAS scoring system. Radiological outcome was assessed using restoration of Bohler and Gissane angle. Results: The results were extrapolated as excellent in 20 patients, good in 3 patient's and poor result in 2 patients. Statistical analysis revealed better outcomes in percutaneous cannulated screw fixation as compared to open plate fixation. 6 patients had to undergo implant exit of which 5 were cannulated screw backout, prominence irritating the soft tissue and 1 plate removal had to be done because of infection. None of the patients had subtalar arthritis, heel pad problems, peroneal tendinitis or implant failure. Conclusions: Surgical management in the treatment of choice for intra articular calcaneal fractures after thorough evaluation. The choice of implant depends upon the communition of fracture, soft tissue compromise, joint surface incongruity and surgical expertise. Radiological maintenance of Bohler and Gissane angle intraoperatively and at follow up is a good indicator for predicting functional outcomes score.

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Section: Discussionmentioning

confidence: 99%

Radiographic and functional outcome of operated closed intra-articular fractures of calcaneum: a retrospective analysis

Kerketta,

Mittal,

Rahul

et al. 2023

Int J Res Orthop

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“…The trabecular bone in the posterior aspect of the calcaneal tuberosity, the immediate posterior region of the calcaneal articular surface, and the vicinity of the calcaneocuboid joint exhibits denser bone trabeculae, making it suitable for screw insertion. [7]. However, below the posterior facet of the subtalar joint lies a region known as the "central triangular area" [8].…”

Section: Applied Anatomy Of the Calcaneusmentioning

confidence: 99%

“…Consequently, when devising screw placement strategies for calcaneal fractures, it is crucial to consider both the anatomical features of the calcaneus and the specific fracture morphology. Over the past three decades, numerous scholars have undertaken comprehensive studies on the anatomical application of internal fixation techniques for calcaneal fractures [6][7][8]. Furthermore, recent advancements in the field, such as the development and implementation of fracture heatmaps, have led to increasingly refined research on fracture morphology in calcaneal fractures [9,10].…”

Section: Introductionmentioning

confidence: 99%

Design and finite element analysis of cross-screw fixation strategy for Sanders IIB calcaneal fractures

Jiang

Lü

Dingxi

et al. 2023

Preprint

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Background Clinicians are increasingly opting for minimally invasive cross screw fixation (CSF) in the treatment of non-severely comminuted calcaneal fractures. However, there is a dearth of design and theoretical guidance regarding the fixation strategy for calcaneal fractures using minimally invasive CSF in clinical practice. The objective of this study is to design a fixation strategy for Sanders type II B calcaneal fractures based on commonly used screw placement methods in clinical practice. Furthermore, we aim to compare the biomechanical stability of different strategies through finite element analysis. The findings of this study will serve as a valuable reference for clinical surgical screw placement. Methods To create a Sanders type II B calcaneal fracture model, we utilized the most up-to-date research on calcaneal fracture heatmaps. By incorporating the anatomical characteristics of the calcaneus and commonly employed minimally invasive screw placement methods in clinical practice, we developed three-dimensional digital designs of CSF strategies on this model. Subsequently, biomechanical experiments were conducted on each strategy within a virtual environment using finite element techniques. The stress distribution, stress magnitude, and displacement of the fracture model were carefully observed and analyzed. Results When subjected to identical loading conditions, Strategy 4 demonstrated smaller maximum displacements of the calcaneus, screw, and fracture gap compared to the other strategies. Among all the strategies, Strategy 5 exhibited the highest maximum stress in the calcaneus, while Strategy 6 had the highest maximum stress in the screw. The three-dimensional digital designs of CSF strategies were developed on this model by integrating the anatomical characteristics of the calcaneus and commonly utilized minimally invasive screw placement methods in clinical practice. Conclusion Our designed Strategy 4 involved the insertion of dual longitudinal screws in a parallel manner from the superior aspect of the calcaneal tuberosity. Additionally, two transverse screws were utilized to fix the articular facet fragment, and one transverse screw was employed to secure the lateral wall of the calcaneus. This fixation method demonstrated superior fixation strength and reduced stress concentration compared to the other strategies. As a result, Strategy 4 serves as a valuable reference for surgeons performing actual clinical screw placement during surgical procedures.

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Section: Introductionmentioning

confidence: 99%

“…1,2 At present, most studies on fracture classification and treatment methods emphasize the importance of anatomical reduction of the subtalar articular surface of the calcaneus, while ignoring the impact of anterior tuberosity fractures of the calcaneus and injury of the CC joint on foot function. [3][4][5][6] The calcaneus anterior process is a saddle-shaped protuberance in front of the calcaneus, varying in length, width and shape. While stabilizing the lateral column of the foot, it articulates with the cuboid and navicular and forms the anterior part of the subtalar joint, the upper posterior part of the calcaneocuboid joint, and serves as the junction of the extensor digitalis brevis, the calcaneocuboid dorsal ligament and the split ligament.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two surgical strategies for fractures of the anterior process of the calcaneus with or without bridging plate fixation

et al. 2023

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Objective To evaluate the therapeutic effects of applying internal fixation with a T-shaped locking plate that was used on the distal radius in fractures of the anterior process of the calcaneus (APC) with calcaneocuboid (CC) joint injury. Methods This retrospective study enrolled adult patients diagnosed with APC with CC joint injury that had received internal fixation with a T-shaped locking plate of the distal radius. Group NA underwent open reduction with ‘not-across’ CC joint plate fixation; and group A underwent open reduction with ‘across’ CC joint locking plate fixation. The outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, a visual analogue scale (VAS) pain score and radiological evaluations. Results A total of 72 patients were enrolled in the study; 36 in each group. At 1 month after surgery, the outcomes of group NA were superior to group A in terms of AOFAS and VAS scores. Compared with group A, group NA showed significantly lower intraoperative blood loss, operation time and length of hospital stay. There were no significant differences in the postoperative improvement of Bolher's and Gissane's angles between the two groups. Conclusion Early functional recovery was faster in group NA than group A.

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Applied anatomy of the calcaneocuboid articular surface for internal fixation of calcaneal fractures

Cited by 6 publications

References 8 publications

Radiographic and functional outcome of operated closed intra-articular fractures of calcaneum: a retrospective analysis

Radiographic and functional outcome of operated closed intra-articular fractures of calcaneum: a retrospective analysis

Design and finite element analysis of cross-screw fixation strategy for Sanders IIB calcaneal fractures

Comparison of two surgical strategies for fractures of the anterior process of the calcaneus with or without bridging plate fixation

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