Quality of Life and Clinical Evaluation of Calcaneoplasty with a Balloon System for Calcaneal Fracture at 5 Years of Follow-Up

Abstract

Calcaneal fractures are a challenging clinical problem. Management of this type of injury remains controversial, especially in the context of intra-articular fractures. Surgical treatment with open reduction and internal synthesis (ORIF) is considered the standard treatment for CF, but it is associated with many complications. Several minimally invasive techniques such as balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation have been proposed to avoid the frequent and recurrent postoperative problems related to these fractures. We retrospectively examined 20 patients (mean age was 54.5), all undergoing minimally invasive calcaneoplasty surgery at our Department of Orthopaedics and Traumatology between 2012 and 2016. X-ray and CT scan were performed preoperatively and at 5 years of follow-up (57.9 ± 6 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical examination, and the Short-Form (36) Health Survey (SF-36) score and Visual Analogue Scale (VAS) were used to assess the Health-Related Quality of Life (HRQoL). All 20 patients were available at the final follow-up. The mean AOFAS score was 82.25/100. The VAS results attest an overall average of 2.7/10 (0–9). The average of the parameters “Physical Health” and “Mental Health” was, respectively, 81.25 and 83.55. In terms of postoperative complications, we observed no cases of superficial or deep infections. Clinical response after balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation has shown a comparable or better outcome according to the AOFAS and VAS score. Quality-of-life scores, obtained according to the SF-36 questionnaire, are considered high. From both a clinical and quality-of-life point of view, our study highlights that there is not gender distinction. Further comparative studies with a higher number of patients are needed which assess the quality of life in the various techniques used to treat calcaneal fractures.

Predictive Factors of Poor Outcome in Sanders Type III and IV Calcaneal Fractures Treated with an Open Reduction and Internal Fixation with Plate: A Medium-Term Follow-Up

“…The literature shows conflicting results on the outcomes of calcaneus fractures and the potential superiority of one treatment option over another or conservative treatment in those types of fractures [ 7 , 17 , 18 , 19 , 20 ].…”

Patient Reported Outcome Measures (PROMs) in Surgery: Evaluation after Minimally Invasive Reduction and Percutaneous K-Wires Fixation for Intra-Articular Calcaneal Fractures

“…Calcaneoplasty was used in achieving promising outcomes in terms of bone healing and complication rates; however, poor evidence studies exist [ 13 , 14 ].…”

3D simulation of percutaneous sustentaculum tali screw insertion in calcaneal fractures

“…However, the fractures involving intra-articular are challenging injuries to manage because of their complex nature, technical challenges, devastating complications and difficult rehabilitation [ 4 ]. Previous studies have shown that some minimally invasive surgical methods, such as balloon calcaneplasty, arthroscopically assisted reduction and fixation, and percutaneous screw fixation, not only have the same reduction quality and functional outcome as open reduction and internal fixation, but also can reduce the incidence of postoperative complications [ 2 , 5 ]. At the same time, the percutaneous screw fixation (PSF) is a better option, which can not only provide a strong fixation, but also can minimize damage to the surrounding tissues, subsequently result in shorter operative time and hospital stay, and reduced intraoperative blood loss, postoperative pain, and complication rates, specially for Sanders II fractures and a few Sanders III fractures [ 3 , 6 – 8 ].…”