Fracture of the os calcis

Magnuson, Paul B.; Stinchfield, Frank E.

doi:10.1016/s0002-9610(38)91114-6

“…In 1929, Böhler described the technique of closed reduction with a wooden wedge in the footsole, lateral clamp compression and traction on the calcaneus with countertraction on the tibia [ 4 , 5 ]. Böhler changed this treatment strategy for calcaneal fractures repeatedly, and stopped using the transfixational pin through the tibia because of infectious complications [ 4 , 5 , 23 , 35 , 44 ]. Several authors applied the method used by Böhler completely or with (minor) modifications using specially designed traction devices [ 1 , 9 , 16 , 17 , 23 , 33 , 41 , 47 ] (Fig.…”

Section: Historymentioning

confidence: 99%

“…No universal treatment or surgical approach exists that can be applied to treat all fractures of the calcaneus [ 35 ]. The question remains whether adequate reduction of displaced intra-articular calcaneal fractures is even possible by closed methods [ 1 ].…”

Section: Limitations and Complicationsmentioning

confidence: 99%

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts’ review

Schepers

¹

,

Patka

²

2009

Arch Orthop Trauma Surg

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Introduction A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the diVerent percutaneous distractional approaches for intra-articular calcaneal fractures. The history, technique, anatomical and fracture considerations, limitations and the results of diVerent distractional approaches reported in the literature are reviewed. Method Literature review on diVerent percutaneous distractional approaches for displaced intra-articular calcaneal fractures. Results Eight studies in which application of a distraction technique was used for the treatment of calcaneal fractures were identiWed. Because of the use of diVerent classiWcation, techniques, and outcome scoring systems, a metaanalysis was not possible. A literature review reveals overall fair to poor result in 10-29% of patients. Ten up to 26% of patients are unable to return to work after percutaneous treatment of their fracture. A secondary arthrodesis has to be performed in 2-15% of the cases. Infectious complications occur in 2-15%. Some loss of reduction is reported in 4-67%. Conclusion Percutaneous distractional reduction and Wxation appears to be a safe technique with overall good results and an acceptable complication rate, compared with other treatment modalities for displaced intra-articular calcaneal fractures. A meta-analysis, based on Cochrane Library criteria is not possible, because of a lack of level 1 and 2 trials on this subject.

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“…These methods have also been discussed previously. In 1938, C. W. Goff described and illustrated more than 40 different operative treatment methods for displaced calcaneal fractures, most of which included some form of percutaneous reduction (PR) and skeletal traction. In 1934, the method of closed reduction with percutaneous pin leverage and subsequent plaster immobilization was introduced by the German surgeon Westhues.…”

Section: Introductionmentioning

confidence: 99%

Comparison between Percutaneous Screw Fixation and Plate Fixation via Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Weng

¹

,

Dai

²

,

Tu

³

et al. 2019

Orthopaedic Surgery

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Objective To assess the long‐term outcomes after percutaneous reduction (PR) and screw fixation versus plate fixation via the sinus tarsi approach (STA) for displaced intra‐articular calcaneal fractures (DIACF). Methods This retrospective study included a total of 150 patients (June 2008–August 2011), comprising 85 men and 65 women (mean age, 38.4 years), who were assigned to the PR group or the STA group. The inclusion criteria were DIACF (>2 mm) including Sanders type II and III, closed fracture, unilateral fracture, no history of smoking or no smoking during hospitalization and 3 months after surgery, and follow‐up time not less than 8 years. The exclusion criteria were clear surgical contraindications (severe cardiovascular and cerebrovascular diseases), local or systemic infection symptoms, diagnosis with diabetes or lower extremity vascular disease, and Sanders type IV or open fractures. Outcomes were assessed by means of the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scores, radiographic images, and postoperative complications. Results The mean follow‐up period was 8.7 years (range, 8.0–10.0 years). The AOFAS scores in the PR group during the follow‐up period were 54.2 ± 5.1, 85.8 ± 4.0, 88.1 ± 3.8, 87.9 ± 3.6, 87.8 ± 3.9, 86.9 ± 3.9, respectively, and in the STA group were 55.0 ± 5.6, 84.5 ± 5.2, 87.1 ± 3.8, 86.9 ± 3.8, 87.7 ± 3.3, and 87.6 ± 2.8, respectively. There was no significant difference in AOFAS scores, Bohler's angle, Gissane's angle, calcaneal length, and height between the two groups (P > 0.05). The good to excellent rate of the PR group (80.8%) was less than that of the STA group (91.7%) (P = 0.055). For Sanders III fractures, the good to excellent rate of the PR group (33.3%) was less than that of the STA group (76.9%) (P = 0.029). For calcaneal width recovery, the STA group performed better than the PR group (P < 0.05). The incidence of postoperative complications in the PR group (12.8%) was lower than that in the STA group (27.8%) (P = 0.026), of which the incidence of wound complications was 3.8% in the PR group and 13.9% in the STA group (P = 0.041). In addition, there was no significant difference in other postoperative complications such as sural nerve injury, peroneus longus and brevis muscle injury, calcaneal valgus symptoms, lateral impingement symptoms, and subtalar arthritis (P > 0.05). Conclusion From the 8–10‐year follow‐up results of PR and STA as surgical procedures for the treatment of DIACF, it was found that there was no significant difference in the overall efficacy between them. STA was found to be superior to the PR in terms of the recovery of calcaneal width, providing more stable fixation for Sanders III fractures. PR was found to be more effective in reducing wound complications.

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“…In 1929, Böhler described the technique of closed reduction with a wooden wedge in the footsole, lateral clamp com-pression and traction on the calcaneus with countertraction on the tibia [4,5]. Böhler changed this treatment strategy for calcaneal fractures repeatedly, and stopped using the transWxational pin through the tibia because of infectious complications [4,5,23,35,44]. Several authors applied the method used by Böhler completely or with (minor) modiWcations using specially designed traction devices [1,9,16,17,23,33,41,47] (Fig.…”

Section: Two-point (Linear) Distractionmentioning

confidence: 99%

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts’ review

Schepers¹

2010

TVTR

0

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Introduction A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the diVerent percutaneous distractional approaches for intra-articular calcaneal fractures. The history, technique, anatomical and fracture considerations, limitations and the results of diVerent distractional approaches reported in the literature are reviewed. Method Literature review on diVerent percutaneous distractional approaches for displaced intra-articular calcaneal fractures. Results Eight studies in which application of a distraction technique was used for the treatment of calcaneal fractures were identiWed. Because of the use of diVerent classiWcation, techniques, and outcome scoring systems, a metaanalysis was not possible. A literature review reveals overall fair to poor result in 10-29% of patients. Ten up to 26% of patients are unable to return to work after percutaneous treatment of their fracture. A secondary arthrodesis has to be performed in 2-15% of the cases. Infectious complications occur in 2-15%. Some loss of reduction is reported in 4-67%. Conclusion Percutaneous distractional reduction and Wxation appears to be a safe technique with overall good results and an acceptable complication rate, compared with other treatment modalities for displaced intra-articular calcaneal fractures. A meta-analysis, based on Cochrane Library criteria is not possible, because of a lack of level 1 and 2 trials on this subject.

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Fracture of the os calcis

Cited by 8 publications

References 4 publications

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts’ review

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts’ review

Comparison between Percutaneous Screw Fixation and Plate Fixation via Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts’ review

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