Operative versus Nonoperative Treatment of Displaced Intra-articular Calcaneal Fractures in Elderly Patients

Basile, Attilio

doi:10.1053/j.jfas.2009.08.001

Cited by 91 publications

(65 citation statements)

References 39 publications

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“…Open reduction of the bone fragments and maintaining the position with plate, screws and bone graft provides better geometrical correction of calcaneus compared to conservative or closed surgical treatment. Similar results were reported before about Bohlers angle [16]. Although open reduction provides better anguler correction of Bohler angle, no difference was observed between groups about Gissane angles before and after treatment.…”

Section: Discussionsupporting

confidence: 87%

The effect of treatment protocol on calcaneus bone mineral densitometry after intra-articular calcaneal fractures

et al. 2016

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Objectives. To identify the effect of treatment protocol on calcaneus bone mineral density of calceneal fractures treated with different methods. Methods. Sixty-three patients with intra-articular calcaneal fractures were observed prospectively. Patients were classified according to their treatment protocols such as; conservative treatment with short leg plaster cast (Group C), closed reduction and fixation with cannulated screws (Group S) and open reduction internal fixation with plate and screws (Group P). All patients' bilateral radiographies, CT scans, the American Orthopaedic Foot and Ankle Society (AOFAS) scores and calcaneus bone mineral density measurements by G&E Archilles Quantitative Ultrasound method were obtained at 15th month of follow up period. Results. Fourteen (22%) patients were female and 49 (88%) were male. The mean age was 43.7±12.1 years. The mean follow-up was 33.7±14.7 months. Bone mineral density measurements were calculated as; t scores; -1.48±1.24 for group C, -1.48±1.31 for group S, -0.27±1.68 for group P and z scores; -0.18±1.41 for group C, -0.17±1.9 for group S, 0.96 ± 1.54 for group P. Group P had the higher t and z scores of injured sides than other groups (p=0.008 and p=0.026, respectively). Average AOFAS scores were 78.13±13.04 in group S, 82.58±10.81 in group P and 79.82±11.75 in group C. No significant differences were detected between groups regarding AOFAS scores. Conclusion. Measurement of calcaneus bone mineral density which we used in our study is a method for evaluation of calcaneal fracture treatments and higher density values were found in open reduction and internal fixation group. This may be owing to better control of defect with the allograft and early mobilization by the evident improvement in angular correction..Eur Res J 2016;2(2):116-120

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Section: Discussionsupporting

confidence: 87%

The effect of treatment protocol on calcaneus bone mineral densitometry after intra-articular calcaneal fractures

et al. 2016

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“…Furthermore, clinical outcomes frequently correlate with particular ranges for preoperative or post-operative BA [7,[14][15][16]. The propagation of reporting BA through the literature has been supported by reports showing its good inter-observer reliability.…”

Section: Introductionmentioning

confidence: 92%

There is poor reliability of Böhler's angle and the crucial angle of Gissane in assessing displaced intra-articular calcaneal fractures

Otero

Westerlind

Tantavisut

et al. 2015

Foot and Ankle Surgery

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“…With the development of locking plate technology along with improved surgical approaches and techniques, the concerns for providing fixation to pathologic bone have been lessened. 39,60,61,78 However, as with the surgical treatment of any osteoporotic/osteopenic bone, should fixation of the foot or ankle injury be tenuous, the use of a nonweight bearing cast or the addition of some method of adjunctive fixation, such as the addition of bone cement or the application of an external fixator or pinning the bones across adjacent joints, can also be used until adequate healing has occurred. 25,26,32,34,35 To complete the treatment of the surgical management of the elderly individuals, a discussion on the management of the soft tissue envelope should also be included.…”

Section: Discussionmentioning

confidence: 99%

“…78,79 Looking specifically at the results of experienced surgeons using internal fixation for the management of calcaneal fractures in the elderly patients has demonstrated rates of healing approaching 97% along with rates of complications and outcomes equivalent to those of younger patients. [22][23][24]39 Whether the elderly patient would be better served with a primary arthrodesis versus primary fixation is unknown, given the fact that none of these 3 articles provides any patients who underwent a primary fusion. However, the indication for a primary fusion would appear to be the same as for a younger patient, that is, fractures that are unable to be reconstructed.…”

Section: Calcaneal Fracturesmentioning

confidence: 99%

Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

Herscovici

Scaduto

2012

Geriatr Orthop Surg Rehabil

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By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 motor vehicle accidents, 30 as a result of high (not ground level) energy falls, 2 from industrial accidents, and 35 classified as other, which included sports, blunt trauma, bicycle, airplane or boating accidents, crush injuries, and injuries resulting from a lawn mower. The injuries produced were 17 metatarsal fractures, 9 Lisfranc injuries, 10 midfoot (navicular, cuneiform, or cuboid) fractures, 23 talus fractures, 63 calcaneal fractures, 73 unimalleolar, bimalleolar, or trimalleolar ankle fractures, 45 pilon fractures, and 3 pure dislocations of the foot or ankle. Overall, 243 (83%) of these injuries underwent surgical fixation and data have shown that when surgery is used to manage high-energy injuries of the foot and ankle in the elderly individuals, the complications and outcomes are similar to those seen in younger patients. Therefore, the decision for surgical intervention for high-energy injuries of the foot and ankle should be based primarily on the injury pattern and not solely on the age of the patient. Keywords elderly, geriatric, high-energy injuries, foot and ankleThe 2010 census demonstrated that of the 308 million people living in the United States, 13% were aged 65 and older 1 and that, except for those in the 45 to 65 years bracket, this group grew at a faster rate than any other segment of the population. 2 Extrapolation data have estimated that by the year 2035, almost 20% of the US population of 389 million people will be 65 years and older. 3

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Operative versus Nonoperative Treatment of Displaced Intra-articular Calcaneal Fractures in Elderly Patients

Cited by 91 publications

References 39 publications

The effect of treatment protocol on calcaneus bone mineral densitometry after intra-articular calcaneal fractures

The effect of treatment protocol on calcaneus bone mineral densitometry after intra-articular calcaneal fractures

There is poor reliability of Böhler's angle and the crucial angle of Gissane in assessing displaced intra-articular calcaneal fractures

Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

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