Operative Treatment of Displaced Intraarticular Calcaneal Fractures

Sanders, Roy; Vaupel, Zachary M.; Erdoğan, Murat; Downes, Katheryne

doi:10.1097/bot.0000000000000169

Cited by 158 publications

(80 citation statements)

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“…This result agrees with the study published by Tornetta [49] that reported good clinical outcomes with PS only in patients with tongue fractures. The prognostic value of today’s most frequently used Sanders classification [50] has been recently validated by the same author comparing long-term clinical results [48]. That study was confirmed by ours; each considered variable obtained better values in the Sanders II group, and statistical analysis showed significantly lower AOFAS, MFS, PCS, and VAS scores comparing Sanders IV and both of the other two classes ( p < 0.05).…”

Section: Discussionsupporting

confidence: 70%

“…Screw removal was performed in 18 cases (51.4 %) due to the protrusion of their heads from the bone profile and the resulting discomfort when wearing shoes. Secondary arthrodesis was performed in 4 cases (4.6 %), a percentage lower than those reported in other series (Makki et al, 10.6 % [47]; De Boer et al, 20 % after PS and 33 % in ORIF [41]; Sanders et al, 28.7 % [48]). The low percentage is due to patients’ reluctance to undergo joint fusion.…”

Section: Discussionmentioning

confidence: 76%

“…For this reason, this measurement appears to be an inappropriate radiological outcome. Indeed, some authors have recently proposed using a CT examination as radiological outcome, considering good results only cases without irregularities higher than 3 mm on the articular surface [24, 48]. On the contrary, our data confirmed the prognostic value of the Essex-Lopresti classification: better clinical results ( p < 0.05) were obtained in tongue type fractures than in joint depression type (median AOFAS 82.5 and 78; MFS 86 and 81; VAS 8 and 7, respectively).…”

Section: Discussionmentioning

confidence: 99%

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Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: a comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)

et al. 2016

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BackgroundOpen reduction with internal fixation (ORIF) and percutaneous surgery (PS) are the most common surgical procedures for the treatment of displaced intra-articular calcaneal fractures. The purpose of this retrospective study was to compare the clinical and radiological results of these techniques and to verify the prognostic value of the radiographic measurement tools proposed in the literature.MethodsA consecutive series of 104 calcaneal fractures was included in this analysis. Essex-Lopresti and Sanders classifications were used to evaluate the injuries, and their prognostic correlation was tested. Böhler’s angle was measured pre- and postoperatively and evaluated as radiological outcome. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society hindfoot scale (AOFAS), Maryland Foot Scale (MFS), 17-Foot Function Index (FFI), Short Form-36 (PCS), and a 10-point visual analogue scale (VAS).ResultsA total of 87 fractures (5 bilateral), 54 in males and 28 in females, were evaluated with a mean follow-up of 77.0 months. Overall mean age was 51.6 years old. The most frequent cause of trauma was a fall from a height. According to Essex-Lopresti, there were 58 joint depression fractures, 26 tongue, and 3 comminute. According to Sanders: 37 type II, 31 type III, and 19 type IV. Patients were divided into three groups according to surgical treatment: 19 in the ORIF group, 35 in the PS Screw group, and 33 in PS K-wire group. The ORIF group obtained significantly better results (82 AOFAS, 86 MFS, 19.6 FFI, 46.2 PCS, 8 VAS) with respect to the PS K-wire group (74 AOFAS, 76 MSF, 26.4 FFI, 40.8 PCS, 6 VAS). The PS Screw group obtained intermediate results (79 AOFAS, 82 MFS, 22.4 FFI, 41.6 PCS, 7 VAS). The restoration of the Böhler’s angle was achieved most frequently (p = 0.02) in the ORIF group, without better clinical results.ConclusionThe results were best in the ORIF group, despite its risk of complications, inferior in the PS Screw group, however without statistical significance (p > 0.05), and worse in the PS K-wire group. Finally, our data confirmed the prognostic correlation between the two radiographic classifications used and the clinical outcomes.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: a comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)

et al. 2016

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“…9) basiert auf der Anzahl der Gelenkfragmente im breitesten Bereich der posterioren Facette, basierend auf der Darstellung in der koronaren Rekonstruktion in der Computertomografie (CT). Die Klassifikation ist auch prognostisch relevant, zum Beispiel hinsichtlich einer im Langzeitverlauf notwendigen subtalaren Arthrodese [5]. bei Polytrauma, komplexen offenen Frakturen), ▪ primäre subtalare Arthrodese.…”

Section: Sanders-klassifikationunclassified

Rückfußverletzungen – Frakturen von Kalkaneus, Talus und peritalare Luxationen

Weber¹,

Klos²,

Mückley³

et al. 2018

Orthopädie und Unfallchirurgie up2date

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“…Displaced intra-articular calcaneal fractures (DIACF) is usually made by vertical violence delivered to the foot [3]. After many years of studding, management of displaced intra-articular calcaneal fracture has remained unclear for orthopedic surgeons and there is controversy to choose the best methods of treatment such as plates, bone graft and void filler [4]. Wide range of post-operative complications and variety of outcomes cause this complexity.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Displaced Intra-Articular Calcaneal Fracture with Tri-Cortical Iliac Bone Graft

Madadi¹,

Madadi²,

Moghaddam³

et al. 2018

J Bone Res

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Management of displaced intra-articular calcaneal fracture has remained unclear for orthopedic surgeons and there is controversy to choose the best methods of treatment. Wide range of post-operative complications and variety of outcomes cause this complexity. Although, there is no strong evidence, in which support superior benefit of bone grafting in treatment of DIACF, it is still a popular method. The objective of this study was to present outcome and complications of surgical management of DIACF with tri-cortical iliac bone graft. Fifty-three cases containing 47 men (57 feet) and six women (7 feet) with DIACF underwent surgery by mean of tri-cortical auto graft bone from iliac crest. AOFAS hind foot scale (consist of subjective and objective variables including three major categories pain, function and alignment) and VAS questionnaires were used for full assessment of post-operative outcomes and complications. Mann-Whitney U test was used to compare means. The mean ± SD AOFAS hind foot score was 88.18 ± 7.12. AOFAS hind foot and VAS scores showed no significant difference between male and female. Nevertheless, better outcome of surgery among those below 35 year of age based on AOFAS hind foot score. Use of bone graft for treatment of DIACF might yield better results, however, the results probably differ in various conditions and situations. At the end, we recommend comparing results of different methods of treatment of DIACF by one large clinical trial with under the control of confounders.

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Operative Treatment of Displaced Intraarticular Calcaneal Fractures

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 158 publications

References 59 publications

Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: a comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)

Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: a comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)

Rückfußverletzungen – Frakturen von Kalkaneus, Talus und peritalare Luxationen

Surgical Treatment of Displaced Intra-Articular Calcaneal Fracture with Tri-Cortical Iliac Bone Graft

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