Percutaneous arthroscopic calcaneal osteosynthesis for displaced intra-articular calcaneal fractures: Systematic review and surgical technique

Marouby, Stanislas; Cellier, Nicolas; Marès, Olivier; Kouyoumdjïan, Pascal; Coulomb, Rémy

doi:10.1016/j.fas.2019.07.002

Cited by 19 publications

(11 citation statements)

References 27 publications

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“…Calcaneal fractures represent approximately 1-2% of all fractures and 65% of tarsal fractures. Approximately 75% of calcaneal fractures are intra-articular fractures (1). The majority of calcaneal fractures are due to a high-energy injury mechanism and occur in young, active workingage men (26-45 years) (2).…”

Section: Introductionmentioning

confidence: 99%

Fracture mapping of complex intra-articular calcaneal fractures

Ni¹,

Lv²,

Sun³

et al. 2021

Ann Transl Med

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Background: Intra-articular calcaneal fracture remains challenging to manage. Computed tomography and fracture mapping are useful for the diagnosis and treatment of calcaneal fractures. The aim of the present study was to characterize calcaneal fracture patterns using fracture mapping.Methods: Sixty-two calcaneal fractures were retrospectively included in the study. For each case, the fracture was simulated reduction manually. The fracture lines and zones of comminution were graphically superimposed onto an intact calcaneal template to identify fracture patterns. Major fracture lines and comminution were assessed by focusing on the posterior joint facet, medial wall, lateral wall, sustentaculum tali, and anterior process.Results: The fracture lines were mostly concentrated on the area anterior to the posterior joint facet and extended medially. The longitudinal lines ran posteriorly from the angle of Gissane, and separated the sustentaculum tali and medial wall from the calcaneal tuberosity. In the lateral wall, the fracture lines extended posteriorly with some branches to the bottom of the calcaneus. No fracture lines passed through the sustentaculum tali. Fracture lines of the posterior tuberosity and anterior process were rare.Conclusions: Calcaneal fracture lines follow characteristic patterns, which are closely related to the bone structure and fracture mechanism. These fracture patterns will aid clinicians choose surgical approach and fixations in the treatment of calcaneal fractures.

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Section: Introductionmentioning

confidence: 99%

Fracture mapping of complex intra-articular calcaneal fractures

Ni¹,

Lv²,

Sun³

et al. 2021

Ann Transl Med

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“…In recent years, some scholars have proposed the use of arthroscopic targeting devices or preoperative prefabricated templates to improve the accuracy of screw placement into the sustentaculum tail, but the actual clinical situation is limited by many factors and di cult to promote. 8,15,19,30 Theoretically, the sustentaculum tail can be placed through any point on the lateral wall of the calcaneus but where is the exact point of placement of sustentaculum tail screws and the direction of screw placement still cannot reach consensus as it is useful for clinical guidance. 5,13,18,24 In this study, we reviewed and analyzed surgical treatment cases of calcaneal fractures in our hospital, all of which were treated with accurate placement of the sustentaculum tail screws, and de ned the cases in which the sustentaculum tail screws passed through the rst continuous bone trabecula on the lateral side of the central triangle of the calcaneus but not from the range of the sustentaculum tail as the sustentaculum fragment xation group, and compared the clinical e cacy of accurate xation of the sustentaculum tail with that of the displaced intra-articular calcaneal fracture, and speci ed the speci c location of the nail placement in order to guide clinical practice.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Efficacy of Sustentaculum Tali Screws in Calcaneal Fractures

Li,

Xiao,

Huang

et al. 2023

Preprint

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Background To investigate whether accurate placement of sustentaculum tali screws have the impacts on the clinical efficacy of calcaneal fractures. Methods A retrospective analysis of 72 cases (73 feet) of calcaneal fractures from September 2015 to September 2019 treated with open reduction and internal fixation with sustentaculum tali screws was conducted. Patients were divided into the sustentaculum tali fixation group (ST group) and the sustentaculum fragment fixation group (STF group) according to the location of the sustentaculum tali screw placement. The functional outcomes at preoperative, 7 days and 1 year postoperative were collected and analyzed. Results In the ST group (40 feet), the Gissane's angle altered from (109.89 ± 12.13) ° to (121.23 ± 9.34) ° and (119.08 ± 8.31) ° at 7 days and 1 year postoperative, respectively. For Böhler's angles altered from (11.44 ± 5.94) °, to (31.39 ± 7.54) °, and (30.61 ± 7.94) ° at 7 days and 1 year postoperative, respectively. In the STF group (33 feet), Gissane's angle altered from (110.47 ± 14.45) °, to (122.08 ± 8.84) °, and (120.67 ± 9.07) ° and Böhler's angle altered from (11.32 ± 6.77) °, to (28.82 ± 8.52) °, and (28.25 ± 9.13) ° (P < 0.001). However, there was no statistically significant difference in functional outcomes at 1 week after surgery and 1 year after surgery (P > .05). The AOFAS scores at the final follow-up of the two groups: ST group (88.95 ± 6.16) and STF group (89.78 ± 8.76); VAS scores, ST group (0.83 ± 0.98) and STF group (1.03 ± 1.59), all differences were not statistically significant (P > .05). Conclusion The position of sustentaculum tali screws has no significant difference on the short-term clinical outcome in patients with calcaneal fractures, while reliable fixation of screws to sustentaculum tali fragment can achieve similar clinical outcome. Level of Evidence: V

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“…DIACF is the most prevalent mode of calcaneus fracture, accounting for approximately 75% of cases ( Marouby et al, 2020 ). The fracture pattern was classified using the Sanders classification based on the number of fracture lines ( Sanders et al, 1993 ).…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of a Novel Double-Point Fixation Method for Displaced Intra-Articular Calcaneal Fractures

Sun

et al. 2022

Front. Bioeng. Biotechnol.

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The development of minimally invasive procedures and implant materials has improved the fixation strength of implants and is less traumatic in surgery. The purpose of this study was to propose a novel “double-point fixation” for calcaneal fractures and compare its biomechanical stability with the traditional “three-point fixation.” A three-dimensional finite element foot model with a Sanders type IIIAB calcaneal fracture was developed based on clinical images comprising bones, plantar fascia, ligaments, and encapsulated soft tissue. Double-point and three-point fixation resembled the surgical procedure with a volar distal radius plate and calcaneal locking plate, respectively. The stress distribution, fracture displacement, and change of the Böhler angle and Gissane’s angle were estimated by a walking simulation using the model, and the predictions between the double-point and three-point fixation were compared at heel-strike, midstance, and push-off instants. Double-point fixation demonstrated lower bone stress (103.3 vs. 199.4 MPa), but higher implant stress (1,084.0 vs. 577.9 MPa). The model displacement of double-point fixation was higher than that of three-point fixation (3.68 vs. 2.53 mm). The displacement of the posterior joint facet (0.127 vs. 0.150 mm) and the changes of the Böhler angle (0.9° vs. 1.4°) and Gissane’s angle (0.7° vs. 0.9°) in double-point fixation were comparably lower. Double-point fixation by volar distal radius plates demonstrated sufficient and favorable fixation stability and a lower risk of postoperative stress fracture, which may potentially serve as a new fixation modality for the treatment of displaced intra-articular calcaneal fractures.

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Percutaneous arthroscopic calcaneal osteosynthesis for displaced intra-articular calcaneal fractures: Systematic review and surgical technique

Cited by 19 publications

References 27 publications

Fracture mapping of complex intra-articular calcaneal fractures

Fracture mapping of complex intra-articular calcaneal fractures

The Clinical Efficacy of Sustentaculum Tali Screws in Calcaneal Fractures

Biomechanical Analysis of a Novel Double-Point Fixation Method for Displaced Intra-Articular Calcaneal Fractures

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