Bony destructive injuries of the calcaneus: long-term results of a minimally invasive procedure followed by early functional exercise: a retrospective study

Abstract

BackgroundBony destructive injury of the calcaneus (BDIC) represents one of the most severe comminuted fractures of the calcaneus in which soft tissue coverage remains intact. The features of this injury include a collapsed articular surface, significant widening, severe loss of height and an unrecognisable outline of the calcaneus. This study aims to present the long-term outcomes of BDIC treated in a minimally invasive fashion followed by supervised early exercise.MethodsTwelve patients with unilateral BDICs were treated at our institution. The main surgical procedures included percutaneous traction and leverage reduction and internal compression fixation with anatomic plates and compression bolts. Early functional exercise was encouraged to mould the subtalar joint. The height, length and width of the calcaneus; Böhler’s and Gissane’s angles; reduction of the articular surfaces; and functional recovery of the affected feet were assessed.ResultsThe height, length and width of the calcaneus were substantially restored. The mean Böhler’s and Gissane’s angles of the affected calcaneus were 24.5 and 122.8 degrees, respectively. Five patients regained anatomical or nearly anatomical reduction of their posterior facets. Residual articular displacement of more than 3 mm was noted in three patients. Patients were followed for a mean of 93.9 months. The mean American Orthopaedic Foot and Ankle Society score was 83.8. Nine patients showed excellent or good results. Radiographic evidence of post-traumatic subtalar arthritis was observed in four cases. However, no subtalar arthrodesis was required.ConclusionsBDICs can be treated effectively with percutaneous reduction and internal compression fixation followed by early active exercise. This protocol resulted in satisfactory radiological and functional outcomes.

Sinus tarsi approach for displaced, Intra-articular Calcaneal Fractures

“…We don't need extensive dissection to achieve reduction and avoid many complications of lateral extensive approach 19,31 . It takes less time for operating using this technique, less blood loss, no incidence of nonunion, low complication rate, bone graft was never used, And drastically reduced infection rate, no painful and ugly scars 32,33 .…”

Development and Validation of Indicators for Population Injury Surveillance in Hong Kong: Development and Usability Study

“…The long-term outcomes of emotions and behaviors characterized by alteration of feeling tone and by physiological behavioral changes Long-term behavioral and emotional outcomes [67,135,147,155,[158][159][160][161][162] Capacities necessary for the performance of everyday selfcare competence, mobility competence, and social competence Social dependency [163,164] The possibility of having mental illnesses that affect one's mood, thinking, and behavior after experiencing a shocking, scary, or dangerous event Possibility of posttraumatic stress disorder or other mental disorders [55,67,97,131,132,135,148,151,159,162,[164][165][166] The presence of disabilities, which refer to impairments, activity limitations, and participation restrictions Presence or absence of disabilities [32,[48][49][50]56,66,74,82,93,101,103,134,135,167] The number of people taking their own life after injury per 100,000 population in a period Suicide rate [43,121,159] The consequences of the injury on one's work life and study life Effect on employment or studies…”

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