Soft Tissue Complications in the Early Postoperative Period After Osteosynthesis of Calcaneu

Abstract

Introduction. The complex anatomy and biomechanics of the calcaneal bone is an important component in stability of a lower extremity. According to the literature, calcaneus fractures occur in 2% of all skeletal bone fractures. The vast majority of such fractures (almost 75%) are intra-articular injuries resulting from high-energy trauma. The absolute majority of studies show the indisputable advantage of surgical tactics for the treatment of intra-articular fractures of the calcaneal bone in a remote period. Conservative treatment of displaced fractures, in turn, is considered as an alternative in cases where there are absolute contraindications to surgical treatment. An analysis of reliable sources demonstrates better long-term functional results in patients treated by applying minimally invasive techniques. To date, the question of the relationship between the choice of surgical treatment method and early postoperative complications from soft tissues remains not fully resolved. The purpose of this work is to analyze soft tissue complications in the early postoperative period after calcaneus osteosynthesis and to determine the relationship between the frequency of such complications and various methods of surgical treatment. Materials and methods. The treatment outcomes of 42 patients with displaced calcaneal fractures (47 fractures) were analyzed. Patients were divided into 3 groups depending on the surgical techniques used in the treatment: open direct reduction through an extended L-shaped approach followed by fixation with a plate, minimally invasive open reduction through access to the subtalar sinus followed by the fixation with a calcaneal mini-plate, closed reduction with transcutaneous cancellous screw fixation. Results. The main soft-tissue complications in the early postoperative period after calcaneus osteosynthesis among patients of different groups were recorded, and the relationship between the frequency of such complications and various methods of surgical treatment was established. Conclusion. The use of minimally invasive methods of surgical treatment for displaced calcaneus fracture prevents a number of early postoperative complications in soft tissues, promotes wound healing and prevents the development of secondary infectious complications.