Severity of Injury Predicts Subsequent Function in Surgically Treated Displaced Intraarticular Calcaneal Fractures

Rammelt, Stefan; Zwipp, H.; Schneiders, Wolfgang; Dürr, C.

doi:10.1007/s11999-013-3062-z

Cited by 74 publications

(47 citation statements)

References 51 publications

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“…1,11,12,24,26,[27][28][29][30] When performing open reduction and internal fixation of DIACFs, anatomic reduction of overall shape of the calcaneus and meticulous restoration of subtalar joint congruity is prerequisites for reliable long-term results. [3][4][5][6][7]11,26 The most widely used extended lateral approach allows adequate exposure for anatomic reduction of the posterior, medial, and cuboidal facet, restoration of the lateral wall, and application of a locking or nonlocking plate. 9,12,24,31 A major concern when using extensile approaches is the development of soft tissue complications including hematoma, skin necrosis, soft tissue infection, and even osteitis of the calcaneus.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, published studies on open reduction and internal fixation of DIACFs with a plate using an extensile lateral approach showed reproducibly good long-term results, provided proper reduction of the calcaneal shape and joint congruity. [3][4][5][6][7] However, soft tissue complications including hematoma, skin necrosis, soft tissue infection, and even osteitis of the calcaneus have been reported in up to 25% using extensile approaches. 1,6,[8][9][10][11][12] Therefore, alternative procedures including arthroscopically or fluoroscopically assisted percutaneous reduction and fixation, external fixation, and limited lateral or sinus tarsi approaches have been recommended.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7] However, soft tissue complications including hematoma, skin necrosis, soft tissue infection, and even osteitis of the calcaneus have been reported in up to 25% using extensile approaches. 1,6,[8][9][10][11][12] Therefore, alternative procedures including arthroscopically or fluoroscopically assisted percutaneous reduction and fixation, external fixation, and limited lateral or sinus tarsi approaches have been recommended. [13][14][15][16][17][18][19][20] Internal fixation of DIACFs with an interlocking nail may offer the advantage of stable fixation without the need for an extensile lateral approach.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures

Zwipp

Paša

Žilka

et al. 2016

Journal of Orthopaedic Trauma

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures

Zwipp

Paša

Žilka

et al. 2016

Journal of Orthopaedic Trauma

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“…Rammelt et al [23] reported that fracture severity has a predictive value for functional outcome. Csizy et al [24] showed that initial injury severity is the most predictive factor for late subtalar fusion.…”

Section: Primary Subtalar Fusionmentioning

confidence: 99%

Reduction and internal fixation of displaced intra-articular calcaneal fractures with a locking nail: a prospective study of sixty nine cases

Simon

Goldzak

Eschler

et al. 2015

International Orthopaedics (SICOT)

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Purpose The best treatment for intra-articular fractures of the calcaneus is still debated. The aims of this study were to determine whether intrafocal reduction of thalamic fractures is effective, to evaluate whether a locking nail is able to maintain reduction of the articular surface and to analyse the functional results of this original method. Methods This prospective study assessed 69 fractures treated with a locking fracture nail in 63 cases and with primary subtalar fusion in six (Calcanail ®, FH). Articular congruity and global reduction of the calcaneus was assessed in all patients by computed tomography (CT) scan three months postoperatively. Functional results were evaluated according to the American Orthopaedic Foot and Ankle Society AnkleHindfoot Score (AOFAS-AHS) and all complications recorded. Results For the 63 fracture nails, the average AOFAS score was 85.9 at a mean final follow-up of 12 months. Only three secondary fusions were performed. For the six comminuted fractures requiring primary fusion, the average AOFAS score was 75.9 at the last follow-up. Conclusions The posterior intrafocal approach for both reduction and locked nailing of intra-articular calcaneal fractures has been proven as an effective and reliable procedure.

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“…The incidence of a wound infection following operative treatment of closed calcaneal fractures varies between 2 % and 25 % and rates of complications requiring surgery are up to 21 % [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Backes

Schepers

Beerekamp

et al. 2013

International Orthopaedics (SICOT)

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Purpose Post-operative wound infections (PWI) following calcaneal fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF). Methods This study is a retrospective case series. All consecutive patients from 2000 to 2010 with a closed unilateral calcaneal fracture treated with open reduction and internal fixation (ORIF) by an extended lateral approach were included. Patient, fracture, trauma and peri-operative characteristics were collected, including RF such as smoking, diabetes mellitus, time to operation, pre-operative in-or outpatient management and wound closure technique. The primary end point was a PWI as defined by the US Centers for Disease Control and Prevention. Results A total of 191 patients were included of which 47 patients (24.6 %) had a PWI; 21 (11.0 %) and 26 (13.6 %) patients had a superficial and deep wound infection, respectively. American Society of Anesthesiologists (ASA) classification higher than ASA 1 was associated with an increased risk. Placement of a closed suction drain at the end of surgery was associated with less PWI (35 % vs 15 %, p =0.002). In this study, none of the previously reported RF were associated with an increased risk for PWI. Conclusions ORIF of displaced calcaneal fractures is associated with a high rate of PWI of 25 %. Factors that were associated with an increased risk were ASA classification other than 1 and absence of a closed suction drain placement.A closed suction drain may be a protective measure to avoid wound complications.

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Severity of Injury Predicts Subsequent Function in Surgically Treated Displaced Intraarticular Calcaneal Fractures

Abstract: We found the severity of a DIACF related to subsequent foot function and quality of life. Both fracture severity classifications predicted function. Anatomic reconstruction of the shape and articular surfaces of the calcaneus leads to predictable function in the medium to long term.

Cited by 74 publications

References 51 publications

Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures

Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures

Reduction and internal fixation of displaced intra-articular calcaneal fractures with a locking nail: a prospective study of sixty nine cases

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

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