Evidence-Based Rationale for Percutaneous Fixation Technique of Displaced Intra-Articular Calcaneal Fractures: A Systematic Review of Clinical Outcomes

Wallin, Kelly J.; Cozzetto, Dana; Russell, Lindsay; Hallare, Domingo A.; Lee, Daniel K.

doi:10.1053/j.jfas.2014.03.018

Cited by 45 publications

(49 citation statements)

References 25 publications

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“…The fractures were 39 closed and 6 open. Of the total patients, 6 had Type 2 diabetes and were receiving regular treatment, 20 were cigarette smokers (>10/day), and 5 had an additional injury. The fractures occurred as a result of a fall from 3 metres or higher in 34 patients and from a fall of 2 metres or lower in 9 patients.…”

Section: Resultsmentioning

confidence: 99%

“…In a study by Wang Q et al [19] comparing conservative methods and surgical treatment methods, no statistically significant difference was found in the clinical results but fewer complications were reported in the group where less invasive fixation had been applied . In recent studies evaluating a minimally invasive approach and fixation, satisfactory results and low complication rates have been reported [20,21,22]. Even in Sanders Type 4 fractures, long-term successful results have been reported from conservative treatment [13].…”

Section: Discussionmentioning

confidence: 99%

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Early Stage Results in the Treatment of Intra-Articular Calcaneus Fractures and the Factors Affecting Complication Rates

Tuhanioğlu¹

2017

Ann Clin Anal Med

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Amaç: Eklem içi kalkaneus kırıklarının plak ile osteosentez sonuçlarını değerlendirmek ve komplikasyon oranlarını azaltmaya yönelik izlenecek yöntemleri belirlemek. Gereç ve Yöntem: Merkezimizde 2010-2013 yılları arasında tedavi edilmiş 43 kalkaneus kırıklı hastanın 45 ayağı çalışmaya alındı. Hastaların 36 tanesi erkek, 7 tanesi kadın idi. Hastaların ortalama yaşı 40,6 idi.Tüm hastalara genişletilmiş lateral insizyonla plak osteosentezi uygulandı. Bulgular: Hastalar klinik olarak Maryland ayak skorlamasına göre değerlendirildi. Radyolojik değerlendirme Böhler ve Gissane açılarındaki değişikliklere göre yapıldı. Hastalar ortalama 25 ay (dağılım, 12-38 ay) takip edildi. Beş hasta dışında diğer hastalarda iyi ve çok iyi sonuç elde edildi. Tartışma: Litaratürdeki çalışmalarla karşılaştırıldığında erken ve orta dönemde başarılı sonuçların benzerliği ve plak ile osteosentezde daha yüksek komplikasyon oranlarının bildirilmesi ilk etapta özellikle yüksek komplikasyon riski taşıyan hastalarda minimal invazif yöntemlerin daha kabul edilebilir olduğunu düşündürmektedir.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Stage Results in the Treatment of Intra-Articular Calcaneus Fractures and the Factors Affecting Complication Rates

Tuhanioğlu¹

2017

Ann Clin Anal Med

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“…To overcome problems with wound complications, wound infections, and skin necrosis speci cally, many minimally invasive methods to reduce and x calcaneal fractures have been proposed. (15) At the (xxx institution blinded xxx), this rate was 2.7% using the 2-point distraction method. We believe this is not only a consequence of the operative technique, but also a result of early operative intervention with hematoma evacuation, reduction, and stabilization.…”

Section: Discussionmentioning

confidence: 97%

“…(35,36) Based on these functional results with lower complication rates, two recent sets of authors have argued that minimally invasive techniques are a better option for the treatment of intra-articular fractures. (13,15) Limitations This study has certain limitations and weaknesses that must be considered.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery for Intra-Articular Calcaneus Fractures: A 9-Year, Single-Center, Retrospective Study of A Standardized Technique Using A 2-Point Distractor

Rodemund

Krenn

Kihm

et al. 2020

Preprint

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Background: A fracture of the calcaneus can be a painful and disabling injury. Treatment modalities may be conservative or operative, as in open reduction and internal fixation (ORIF) via different approaches, including a number of minimally invasive methods. The aim of this study was to evaluate the treatment options and post-treatment complication rates for intra-articular calcaneal fractures at the (xxx institution blinded xxx) over a 9-year period. Methods: All patients with calcaneal fractures treated at the (xxx institution blinded xxx) between 2007 and 2016 were included in this study. The patients’ protocols were retrospectively reviewed, and the data, including demographic parameters, cause of injury, and the time between the accident and the first operative treatment were analyzed. Secondary operative interventions due to soft-tissue complications, hardware removal, and the long-term arthrodesis rate were evaluated. Results: A minimally invasive 2-point-distractor method was used in 85.8% (n=182) of all operatively managed calcaneal fractures (n=236) in our department. The majority of the operations (88.7%) were performed within two days after the accident. The secondary operation rate resulting from wound complications was 2.7% in the 2-point distractor group and 16.7% in the ORIF group. A secondary arthrodesis was performed in 4.7% (n=9) of the subtalar joints in the entire study population. Conclusions: Our data supported the assumption that severe wound complications would be less likely to occur after minimally invasive treatment compared to ORIF treatment. Additionally, our arthrodesis rate was comparable to that in the literature.

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“…апологеты метода открытой репозиции констатировали в своих наблюдениях хорошие исходы и низкую частоту инфекционных осложнений (до 10%) [12,13]. Другие исследователи констатировали частоту инфекционных осложнений при открытой репозиции и фиксации до 30% и более, а также сделали вывод о преимуществах минимально инвазивной фиксации, как в аспекте инфекционных осложнений, так и в функциональных исходах [14,15,16]. Техника чрескожной репозиции позволяет выполнять операции без существенного риска даже у пациентов с компрометированным местным и общим статусом [17], однако качество репозиции без непосредственного визуального контроля вызывают сомнения у многих хирургов.…”

Section: Sklilfosovsky Clinical and Research Institute For Emergencyunclassified

Comparison of Three Options for Treatment of Calcaneal Fracture

Kalensky

Каленский²,

Иванов

et al. 2018

Traumatology and Orthopedics of Russia

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Until now the problem of selecting a conservative or operative treatment option for calcaneal fractures and moreover the choice of the most optimal surgical procedure for such lesions have not been solved. Thus, comparative studies in this area is one of the most important tasks of the modern traumatology. Purpose of the study — to compare treatment outcomes, pattern and complications rate following the use of three treatment options for calcaneal fractures. Material and Methods. The authors analyzed treatment outcomes of 95 patients from 2013 till 2016. Mean age of patients was 39.04±12.51 years. Patients were divided into three groups: group 1 consisted of 41 patients with 54 fractures who underwent functional conservative treatment; group 2 consisted of 18 patients with 22 fractures treated by open reduction and plate fixation; group 3 consisted of 36 patients with 40 fractures treated by minimally invasive reduction and intramedullary fixation. Groups did not differ in respect of risk factors rate and rate of surgical risks under ABCDEF scale. Outcomes were evaluated basing on roentgenological criteria of reduction, complications rate and the functional scales FFI (Foot Function Index) and LEFS (Lower Extremity Functional Score). Results. Mean follow up was 20.8±9.0 months. Catamnesis was controlled in 68 out of 95 patients (71.6%). Variances were observed for all criteria of reduction quality between group 1 (no reduction) and groups 2 and 3. Groups 2 and 3 demonstrated similar criteria in respect of reduction quality of posterior articular surface, restoration of height and axis of calcaneus (р>0.05). FFI and LEFS scores in group 1 were inferior to results in groups 2 and 3 (р<0.05) at 6 and 12 months follow up. At 24 months follow up the variances persisted for mean values but were not statistically significant (р>0.05). No differences between groups 2 and 3 were observed during all follow up terms (р>0.05). Sum rate of complications in wound healing in group 2 was significantly higher than in groups 1 and 3 (р = 0.033). Conclusion. Any of the described options of surgical treatment resulted in an earlier functional restoration after calcaneal fractures as compared to conservative treatment. Reduction quality and late functional outcomes did not vary between the study groups, however, the rate of complications for wound healing in the group with open internal fixation was higher.

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Evidence-Based Rationale for Percutaneous Fixation Technique of Displaced Intra-Articular Calcaneal Fractures: A Systematic Review of Clinical Outcomes

Cited by 45 publications

References 25 publications

Early Stage Results in the Treatment of Intra-Articular Calcaneus Fractures and the Factors Affecting Complication Rates

Early Stage Results in the Treatment of Intra-Articular Calcaneus Fractures and the Factors Affecting Complication Rates

Minimally Invasive Surgery for Intra-Articular Calcaneus Fractures: A 9-Year, Single-Center, Retrospective Study of A Standardized Technique Using A 2-Point Distractor

Comparison of Three Options for Treatment of Calcaneal Fracture

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