Displaced Intra-Articular Calcaneal Fractures Treated in a Minimally Invasive Fashion

Zhang, Tao; Su, Yanling; Chen, Wei; Zhang, Qi; Wu, Zhiyong; Zhang, Yingze

doi:10.2106/jbjs.l.01215

Cited by 91 publications

(70 citation statements)

References 32 publications

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“…In current literature, a lower POWI rate of 6-14 % is reported following the sinus tarsi approach [12,30,31,33]. This could be accompanied by a lower incidence of post-operative calcaneal collapse.…”

Section: Discussionmentioning

confidence: 99%

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%

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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“…28 The sural nerve and the peroneal tendons are retracted plantar and the anatomical plate can be applied through the horizontal incision. 29 The wound complications that have been reported in this approach range from 0% to 15.4%. 28 A small longitudinal lateral incision on the hindfoot and the use of a plate and compression bolts have recently been proposed in an effort to further develop the minimally invasive techniques.…”

Section: Wound Infectionmentioning

confidence: 98%

“…30 It seems that the utilization of this approach additionally reduces wound complications and the operating time, especially when it is used for Sanders type II and type III displaced intra-articular fractures. 29 …”

Section: Wound Infectionmentioning

confidence: 99%

Complications of Intra-articular Calcaneal Fractures in Adults

Koutserimpas

Magarakis

Kastanis

et al. 2016

Foot & Ankle Specialist

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“…[4][5][6][7] In an attempt to lower the complication rate, various minimally invasive techniques have recently been introduced, including external fixation, percutaneous fixation, arthroscopically assisted fixation, and minimal incision techniques via medial, modified lateral (such as the sinus tarsi approach), longitudinal, or combined approaches. [8][9][10][11][12][13][14] Minimally invasive techniques have been reported as effective in minimizing soft tissue trauma, thereby reducing the incidence of wound-related complications. The soft tissues remain major challenge in treating these injuries.…”

Section: Introductionmentioning

confidence: 99%

A study of intra articular calcaneal fractures treated with minimally invasive cannulated screw fixation

et al. 2018

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Background: The management of displaced intra-articular calcaneal fractures (DIACFs) remains challenging and controversial. A prospective study to assess the functional outcome of patients with displaced intra-articular calcaneal fractures treated with percutaneous reduction, cannulated screw fixation.Methods: Ultimately, 14 patients with a DIACFs, underwent. percutaneous reduction, cannulated screw fixation. Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores. Radiological results were assessed using plain radiographs and computed tomography (CT) scans, and postoperative wound-related complications were also recorded.Results: A total of 46 adult patients were assessed in our study. Twenty patients did not meet the inclusion criteria and were excluded. Twelve patients were excluded due to severe medical ailments (2 patients) and non-adherence to the treatment plan (10 patients). Therefore, 14 patients with an average age of 42.5 years old (range, 20 to 72 years) including 10 men and 4 women participated in the study. All patients were followed-up for 12 months averagely (range, 11 to 18 months). Complete articular reduction is achieved in 8 patients, 6 patients had articular depression of posterior facet, 3 patients had heel widening and lateral impingement. There was no wound complications in any of the patients, 2 patients developed sub talar arthritis at 2 years of follow up. Conclusions: Surgical treatment of intra articular calcaneal fractures remains challenging task. Minimally invasive reductions remain good option to minimize wound complications. Cannulated cancellous screw fixation is good option for intra articular calcaneal fracture.

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Displaced Intra-Articular Calcaneal Fractures Treated in a Minimally Invasive Fashion

Cited by 91 publications

References 32 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

Complications of Intra-articular Calcaneal Fractures in Adults

A study of intra articular calcaneal fractures treated with minimally invasive cannulated screw fixation

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