Comparison of the Outcomes of Two Operational Methods Used for the Fixation of Calcaneal Fracture

Abstract

This study was aimed to compare the outcomes of two operational methods used for the fixation of calcaneal fracture, the open reduction using a plate and the minimally invasive cannulated screw fixations. Thus, we attempted to find out as to which of these fixation regimens was therapeutically superior by assessing improvement in the restoration of foot functioning and estimating the biochemical indices that reflect bone recovery. A total of 492 calcaneal fracture patients admitted in our hospital from February, 2008 to February, 2012 were selected for the study and randomly divided into two groups of 246 cases each. They were treated with either open reduction using a plate or minimally invasive cannulated screw fixation procedures. After the operations, patients were followed up for 2 years and the outcomes including functional restoration of calcaneus, the post-operational complications, and measure of the biochemical indicators of bone recovery were compared. The patients who underwent plate fixation procedure showed the excellent and good rate of 76.8 %. The minimally invasive cannulated screw fixation led to the excellent and good rate of 82.5 %. The angle, width, and height of calcaneus observed in the last follow-up were also improved significantly in the two groups (p < 0.05); however, these outcomes of the two techniques were not significantly different from each other (p > 0.05). The post-operative complications occurred with the rates of 14.2 and 4.9 % in the patients treated with the plate and the minimally invasive cannulated screw fixations, respectively. The length of stay and hospitalization costs in the plate fixation group were 9.16 ± 0.83 days and 12,639.74 ± 2,573.82 Chinese Yuan, respectively. In comparison, in cannulated screw fixation group, the length of hospital stay (7.03 ± 0.52 days) and its cost (6,795.01 ± 996.53 Chinese Yuan) were significantly lower. Serum bone alkaline phosphatase and tartrate-resistant acid phosphatase-5b levels measured at the last follow-up examination were significantly altered (p < 0.05) in the two groups. However, the difference between the outcomes of the two methods was not statistically significant (p > 0.05). Plate screw and the cannulated screw fixations showed equally good therapeutic effect and significantly improved patients' mobility. However, the cannulated screw fixation was superior in terms of post-operative infection-free recovery and economical burden to the patients.

Analysis of the Interaction between Tropomyosin Allergens and Antibodies Using a Biosensor Based on Imaging Ellipsometry

“…14−17 Imaging ellipsometry records the light reflection intensity (I) and represents layer thickness (d) of the ultrathin films within protein chips. 16 Supposing that the refractive index is invariant, the relationship between light intensity (I) and layer thickness (d) in the range of 0−30 nm can be expressed as I = k × d. 18 Under the same conditions for protein and ellipsometry, "k" is constant and can be determined from a protein layer with known light intensity and thickness. 19 On the other hand, there is a relation between the surface concentration and film thickness: surface concentration (μg cm −2 ) ≈ K × d, where K = 0.12.…”

“…Three monoclonal antibodies (Mc Abs) were screened against the TM allergen and then immobilized covalently as ligands or bioprobes on the surface of silicon wafers. 16,29 The specificity of Mc Abs and the sensitivity of BIE in detecting the TM allergen were then determined. The standard curve representing different concentration gradients was computed to assess the quantitative detection of the TM allergen.…”

Management of Displaced Intra-Articular Calcaneal Fractures: A Comparative Study of Open and Minimally Invasive Surgery

“…Wang et al included 492 CFs and looked into the functional outcome of open and MIS procedure [ 1 ]. They did not find significant difference in outcome, which is supported by our radiological findings in both groups.…”

“…Calcaneal fractures (CFs) account for more than 60% of tarsal bone fractures and around 2% of all fractures [1]. This can be a debilitating fracture and is most common in those who are economically active [2].…”

A Novel Minimally Invasive Reduction Technique by Balloon and Distractor for Intra-Articular Calcaneal Fractures: A Report of 2 Cases

“…Many authors recommend minimally invasive procedure with good results, supported by studies comparing open fixation and minimally invasive treatment [ 6 ] with excellent American Orthopaedic Foot and Ankle Society (AOFAS) scale results [ 7 , 8 ]. Using Schanz pins and Kirschner wires, cannulated screws, arthroscopically guided percutaneous fixation, and application of bone substitute, with lower complication rates found, the procedures were considered as promising [ 9 ].…”