Comparative study on three surgical techniques for intra-articular calcaneal fractures: open reduction with internal fixation using a plate, external fixation and minimally invasive surgery

Takasaka, Missa; Bittar, Cíntia Kelly; Mennucci, Fernando Saddi; Mattos, Carlos Augusto de; Zabeu, José Luís Amim

doi:10.1016/j.rboe.2016.04.002

Cited by 20 publications

(39 citation statements)

References 21 publications

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“…of patients No. of fractures Takasaka 2016 [ 22 ] Retrospective Not specified 20 vs. 27 23 vs. 27 Kumar 2014 [ 23 ] Prospective 30 vs. 31 21 vs. 21 23 vs. 22 Chen 2011 [ 24 ] Prospective 32 vs. 31 40 vs. 38 40 vs. 38 Wang 2015 [ 25 ] Retrospective 41 vs. 39 53 vs. 54 58 vs. 60 DeWall 2010 [ 26 ] Retrospective 41 vs. 40 41 vs. 79 42 vs. 83 Basile 2016 [ 27 ] Prospective 39 vs. 41 20 vs. 18 20 vs. 18 Kline 2013 [ 28 ] Retrospective 42 vs. 46 79 vs. 33 79 vs. 33 Yeo 2015 [ 29 ] Retrospective 42 vs. 46 60 vs. 40 60 vs. 40 Xia 2014 [ 30 ] Prospective 37 vs. 38 49 vs. 59 53 vs. 64 Wu 2012 [ 31 ] Retrospective 41 vs. 39 148 vs. 181 170 vs. 213 Weber 2008 [ 32 ] Retrospective 40 vs. 42 26 vs. 24 26 vs. 24 …”

Section: Resultsmentioning

confidence: 99%

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Mehta

Phan

et al. 2018

J Orthop Surg Res

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BackgroundOperative management of displaced, intra-articular calcaneal fractures is associated with improved functional outcomes but associated with frequent complications due to poor soft tissue healing. The use of a minimally invasive sinus tarsi approach to the fixation of these fractures may be associated with a lower rate of complications and therefore provide superior outcomes without the associated morbidity of operative intervention.MethodsWe reviewed four prospective and seven retrospective trials that compared the outcomes from the operative fixation of displaced intra-articular calcaneal fractures via either an extensile lateral approach or minimally invasive fixation via a sinus tarsi approach.ResultsPatients managed with a sinus tarsi approach were less likely to suffer complications (OR = 2.98, 95% CI = 1.62–5.49, p = 0.0005) and had a shorter duration of surgery (OR = 44.29, 95% CI = 2.94–85.64, p = 0.04).ConclusionIn displaced intra-articular calcaneal fractures, a minimally invasive sinus tarsi approach is associated with a lower complication rate and quicker operation duration compared to open reduction and internal fixation via an extensile lateral approach.

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Section: Resultsmentioning

confidence: 99%

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Mehta

Phan

et al. 2018

J Orthop Surg Res

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“…For instance, Takasaka et al compared three ORIF methods using plaque, external fixation, and MIS using nuts and wire arriving at the conclusion that there are no differences between these three methods. 37 …”

Section: Resultsmentioning

confidence: 99%

Comparison of calcaneus joint internal and external fractures in open surgery and minimal invasive methods in patients

2018

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Surgical management of calcaneal fractures has various complications. In recent years, minimally invasive surgeries have been utilized for a wide range of surgical procedures on different body parts significantly declining complications. This paper compares surgical outcomes of calcaneal fracture management between the open reduction and internal fixation technique (ORIF) and the MIS technique. In this randomized clinical trial forty patients with calcaneus fractures were randomly assigned to two equal groups; ORIF group and MIS group. Patients were followed for 1 year post-operatively. Gissane and Bohler’s angles, AOFAS questionnaire, pain intensity, ability to conduct previous activities and various complications like wound healing complications and irritation with shoe wear were assessed in the final post-operative visit. Eventually data obtained from the two groups were compared. All patients obtained fracture union. Bohler’s and Gissane angles significantly increased and decreased, respectively, after the operation in both groups (p˂0.05), however, no significant difference was found between the two research groups. AOFAS scores and pain intensity was similar in both groups, however, surgical duration in the MIS group was significantly less than the ORIF group (P=0.021). Only one patient from the ORIF group was not able to resume his previous occupation. 12 patients from the ORIF group and five patients from the MIS group experienced irritation from shoe wear (p=0.025). In the ORIF group, 4 patients suffered from wound healing complications, however, none of the patients of the MIS group had wound complications (p=0.035). In conclusion, based on the results, it can be concluded that the MIS technique demonstrated better functional and radiographic outcomes as well as a more favorable complication profile, thus, it is recommended for the management of calcaneus fractures.

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“…Despite modern surgical techniques and the considerable number of studies in literature, calcaneum fracture and its best treatment method remains an enigma for all orthopaedic surgeons [18,[7][8][9] . Axial loading is by far the most common mechanism of injury causing vast majority of intra-articular fracture calcaneum.…”

Section: Discussionmentioning

confidence: 99%

“…ORIF is associated with potential complications of flap necrosis, neuro-vascular injury, post-traumatic arthritis and potential non-union leading to considerable morbidity in some patients [15][16][17] . In order to circumvent the potential complications of ORIF newer minimally invasive approaches have come up with different implants but all are under close scrutiny and a matter of ongoing debate and research with each having marginal advantages and disadvantages over one another [18][19][20] . The extensile lateral approach has been considered the gold standard approach for treatment of displaced intra-articular fractures.…”

Section: Introductionmentioning

confidence: 99%

Open reduction and internal fixation by extensile lateral approach in displaced intra-articular fracture Calcaneum: A study of 44 cases

Dwivedi¹,

Patel²,

Rathva³

2018

Int. J. Orthop. Sci.

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Introduction: Intra-articular fractures of calcaneum pose a challenge for all orthopaedic surgeons due to different treatment options and their varied eventual functional outcome. The aim of this study is to evaluate the medium term outcome of open reduction and internal fixation by extensile lateral approach using low profile anatomical locking calcaneal plate. Method: 44 cases of intra-articular fracture calcaneum in 40 patients were included in this study. These were classified based on Sanders classification system. Open reduction and internal fixation was done using extensile lateral approach and anatomical locking calcaneal plate. Functional outcome was assessed using the Creighton-Nebraska scoring system at the end of six months. Results: Excellent result was seen in 69% cases, Good result in 13% cases, Fair and Poor results were seen in 9% cases each. Bilateral fractures showed poorer results compared to unilateral fractures. Associated injuries had a direct bearing on the eventual functional rehabilitation. Average union time was 12 weeks. Most of the patients could return to pre-injury work status by the end of six months. Conclusion: Immediate, appropriate post-traumatic soft tissue care can probably decrease the incidence of potential wound problems. Extensile lateral approach provides excellent visualization and reduction of displaced intra-articular fragments. Anatomical calcaneal plate provides stable fixation. Role of bone grafting needs further evaluation in a larger population study.

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Comparative study on three surgical techniques for intra-articular calcaneal fractures: open reduction with internal fixation using a plate, external fixation and minimally invasive surgery

Cited by 20 publications

References 21 publications

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Comparison of calcaneus joint internal and external fractures in open surgery and minimal invasive methods in patients

Open reduction and internal fixation by extensile lateral approach in displaced intra-articular fracture Calcaneum: A study of 44 cases

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