The objective of this study was to evaluate the outcome of semi-open reduction and minimal internal fixation through a single small lateral approach as a minimally invasive technique for treatment of displaced intra-articular calcaneal fractures. This prospective study was conducted on eighteen patients (16 men and 2 women). The average age was 37.7 (22–55). The most common cause of injury was a fall from height in fourteen patients. Patients were operated on within a mean time of 4.8 days of admission (1–11 days) and were followed up for an average period of 24.1 months (6–39 months). Patients were evaluated clinically using the Creighton-Nebraska Heath Foundation Assessment score of Crosby and Fitzgibbons (J Bone Joint Surg (Am) 72-A:852–859, 1990). The scoring system proposed by Knirk and Jupiter was used for radiological assessment of the posterior subtalar joint (Knirk and Jupiter in J Bone Joint Surg (Am) 68-A: 647–659, 1986). The skin incision healed in all cases without necrosis, infection, or sural nerve injury. All fractures healed after an average of 8 weeks (7–10 weeks), and patients returned to the routine daily activities after an average time of 4.3 months (3–7 months). In conclusion, semi-open reduction and minimal internal fixation through a small lateral approach is an effective treatment for carefully selected cases of displaced intra-articular calcaneal fractures.
The aim of this study was to evaluate the results of extracapsular base of neck osteotomy and Southwick osteotomy from clinical and radiologic points of view. This retrospective study included 35 hips in 33 patients who presented with moderate to severe slipped capital femoral epiphysis (SCFE) between 1995 and 2001. These patients were divided into two groups according to the type of osteotomy: group A patients (n = 15) were treated by extracapsular base of neck osteotomy and group B patients (n = 18) were treated by modified Southwick osteotomy. Follow-up averaged 3.5 years (range 1-6 years). Clinical and radiologic evaluations were done before and after surgery. All patients were finally evaluated according to the modified Southwick criteria. Group A had 86.7% satisfactory results; group B had 90% satisfactory results. There was no statistically significant difference between the type of osteotomy and the final outcome. The authors believe that both types of osteotomy are equally safe and effective procedures, with minimal risks of avascular necrosis and chondrolysis, in the treatment of moderate to severe chronic SCFE.
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