Tratamento cirúrgico de fraturas intra-articulares de calcâneo sanders II e III: revisão sistemática

Pelliccioni, Adriano Augusto Antoniazzi; Bittar, Cíntia Kelly; Zabeu, José Luís Amim

doi:10.1590/s1413-78522012000100008

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…K-wires have successfully been used for the fixation of calcaneal fractures [ 9 , 20 ]. Pelliccioni et al [ 21 ] made a systematic review on the surgical treatment of intra-articular Sanders’ type II and III calcaneal fractures and found percutaneous fixation using K-wires presented the best results. However, the clinical evidence is insufficient to assert the biomechanical superiority of this treatment in comparison with other surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

The primary stability of different implants for intra-articular calcaneal fractures: an in vitro study

Mei

et al. 2018

BioMed Eng OnLine

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BackgroundCalcaneal fractures account for around 2% of all fractures and most of them are intra-articular fractures. Many implants have been used in the fixation of calcaneal fractures, but their biomechanical stability has not yet been well investigated. The aim of this study was to compare the primary stability of four fixations of calcaneal fracture.MethodsEight cadaveric calcaneus samples were used to simulate the Sanders’ types III fracture pattern and fixed through four different implants, namely, K-wires, cannulated screws (CS), absorbable screws (AS), and plate-screw system (PSS). Each specimen was then placed into a custom-made jig and was loaded through a material testing machine to simulate the physiological condition. The primary stability was measured in the vertical direction as the stiffness and anterior–posterior direction as the calcaneocuboid force. One-way analysis of variance was used for data analysis.ResultsThe results showed the highest stiffness of 634 (383–891; SD 226) N/mm in the intact model. It was significantly higher than the models fixed with K-wires, CS or PSS. There was no significant difference in vertical stiffness between fractures fixed with AS and the intact model or other fixed models. The intact model showed the lowest calcaneocuboid force of 153 (120–218; SD 39) N, while the fractures fixed with AS showed the greatest force of 242 (146–398; SD 84) N. The significance was only detected between these two models.ConclusionsThe global stiffness was similar when the calcaneal fractures were fixed by K-wires, CS and PSS. The stability of the AS fixation differed along both the vertical and anterior–posterior directions, and was greatly influenced by the bone quality. AS for fracture fixation should be designed with greater strength and pull-out resistance.

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Section: Discussionmentioning

confidence: 99%

The primary stability of different implants for intra-articular calcaneal fractures: an in vitro study

Mei

et al. 2018

BioMed Eng OnLine

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“…Em termos de funcionalidade, segundo o questionário American Orthopaedic Foot and Ankle Society (AOFAS), a técnica minimamente invasiva de fixação percutânea com fio de Kirschner apresenta resultado superior e menores complicações, quando comparado a técnicas mais invasivas. 15 Neste trabalho, publicamos o resultado cirúrgico de 49 pacientes (64 lesões) com fraturas articulares de calcâneo que foram tratadas com método cirúrgico minimamente invasivo que teve como premissa a recuperação funcional possível sem a incidência de complicações decorrentes do tratamento, que deve ser considerada como inaceitável.…”

Section: Discussionunclassified

Análise radiográfica de fraturas intra-articulares de calcâneo em pacientes submetidos a tratamento cirúrgico minimamente invasivo em hospital terciário

Félix¹,

Matias²,

Lira³

et al. 2019

Rev Bras Ortop

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Resumo Objetivo Avaliar pacientes com fraturas intra-articulares de calcâneo tratados entre janeiro de 2015 e agosto de 2016 com técnica cirúrgica minimamente invasiva, com ênfase no resultado radiológico. Métodos Estudo retrospectivo de 49 pacientes com 64 fraturas intra-articulares de calcâneo, submetidos a tratamento cirúrgico minimamente invasivo. As lesões foram tratadas com redução aberta por acesso mínimo lateral à articulação subtalar e fixação mínima. Foi realizado estudo radiográfico no pré- e no pós-operatório para aferição dos ângulos de Böhler e de Gissane. Resultados O ângulo de Böhler médio dos casos antes da cirurgia foi de 2,5°, apresentando aumento da média dos ângulos para 25,3° após o tratamento cirúrgico minimamente invasivo. O ângulo de Gissane médio dos casos antes da cirurgia foi de 136,3°, apresentando diminuição da média dos ângulos para 114,3° na análise após a cirurgia. Conclusão A técnica cirúrgica minimamente invasiva permite melhora dos parâmetros radiográficos (ângulos de Böhler e Gissane) nas fraturas intra-articulares de calcâneo, com sua adequada recuperação da forma anatômica.

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“…As fraturas de calcâneo ocorrem usualmente em indivíduos jovens, homens, em uma faixa etária em que são considerados economicamente ativos, o que pode causar grande prejuízo socioeconômico (1)(2)(3)(4)9) . A presente amostra demonstrou-se compatível com a literatura (1) , uma vez que houve predominância de pacientes do sexo masculino, com 88,89% do total.…”

Section: Discussionunclassified

“…O tratamento de fratura de calcâneo, em sua maioria, é cirúrgico, porém ainda não há consenso quanto à melhor técnica cirúrgica para correção da lesão, dependendo de como foi classificada (4) .…”

Section: Introductionunclassified

Pre-operative tomographic evaluation of calcaneum fractures in surgical planning

2018

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Objective: To perform the correlation between the preoperative tomographic evaluation of patients with calcaneal fracture diagnosis and the access routes of choice, as well as the synthesis materials used.Methods: We reviewed 19 medical records of patients between 23 and 56 years old who underwent calcaneal fracture surgery from 01/01/2014 to 12/31/2015. We evaluated the mechanism of trauma, side, Essex-Lopresti classification, Böhler and Gissane angle in the pre- and postoperative period, Sanders tomographic classification and type of osteosynthesis performed. Angular measurements served as a reference for radiological analysis of the quality of the reduction. Results: 90% of the cases were of joint depression, the other 10% considered extra-articular. The preoperative Böhler angle varied between 5 and 40°, and between 10 and 38° in the postoperative period, and 55% of the fractures had an angular reconstruction considered good (between 20° and 40°). Gissane’s angle, on the other hand, varied between 110 and 170° in the preoperative period, and 102 and 132° in the postoperative period. In the tomographic analysis, Sanders IV classification was predominant (65%), followed by type IIIBC fractures (20%), and fractures type I, IIA and IIIAB (5% each). Osteosynthesis with plate and screw was the most used method (89.47%). Conclusion: Correct use of existing diagnostic imaging resources through radiographic and tomographic results provides the possibility of better preoperative planning in the intra-articular fractures of the calcaneus. However, in this study, there was no difference in the access route and synthesis according to the tomographic classification. Level of Evidence III; Diagnostic Studies; Study of Non-Consecutive Patients.

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Tratamento cirúrgico de fraturas intra-articulares de calcâneo sanders II e III: revisão sistemática

Cited by 14 publications

References 22 publications

The primary stability of different implants for intra-articular calcaneal fractures: an in vitro study

The primary stability of different implants for intra-articular calcaneal fractures: an in vitro study

Análise radiográfica de fraturas intra-articulares de calcâneo em pacientes submetidos a tratamento cirúrgico minimamente invasivo em hospital terciário

Pre-operative tomographic evaluation of calcaneum fractures in surgical planning

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