Anatomic Alignment and Integrity of the Sustentaculum Tali in Intra-Articular Calcaneal Fractures

Gitajn, Ida Leah; Abousayed, Mostafa M.; Toussaint, Rull James; Ting, Beverlie L.; Jin, Jennifer; Kwon, John Y.

doi:10.2106/jbjs.m.00330

Cited by 27 publications

(32 citation statements)

References 23 publications

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“…We defined the sustentaculum tali as the portion of the calcaneus extending 13 mm from the most medial prominence and evaluated it on axial, sagittal, and coronal CT images ( Figure 2). 16,20 Sustentacular displacement was defined as fragment translation more than 2 mm in any plane. 16 All operations were performed after swelling diminished, which was confirmed by positive wrinkle sign.…”

Section: Preoperative Managementmentioning

confidence: 99%

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Extended Sinus Tarsi Approach for Treatment of Displaced Intraarticular Calcaneal Fractures Compared to Extended Lateral Approach

et al. 2018

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Background: We compared the radiographic results and clinical outcomes of patients operated on via the extended sinus tarsi approach (ESTA) and the extended lateral approach (ELA) for treatment of displaced intraarticular calcaneal fractures. Methods: We retrospectively studied the utility of the ELA (46 patients, 52 feet) and the ESTA (56 patients, 64 feet) in patients operated on between January 2009 and March 2015. We evaluated pre- and postoperative x-rays and computed tomography (CT) data. Pain, patient-reported functional outcomes, satisfaction, and postoperative complications were investigated at the 3-year follow-up. Results: Neither the postoperative nor 3-year follow-up Böhler angles, nor the calcaneal width, differed significantly between the 2 groups (both P > .05). However, the maximum step-off of the posterior facet on the 3-month CT follow-up of the ESTA group was significantly less than that of the ELA group ( P < .05). We found no significant between-group differences in terms of postoperative translation ( P = .232) or angulation ( P = .132) of the sustentacular fragment on the 3-month CT follow-up. At the 3-year follow-up, we found no significant between-group difference in the mean visual analog scale pain score at rest ( P = .641) or during weightbearing ( P = .525). We found no significant between-group difference in the Foot Function Index (FFI) ( P = .712) or self-reported satisfaction ( P = .823). The ELA group experienced significantly more wound complications ( P = .041) and nonunions ( P = .041) than the ESTA group. Four instances of superficial peroneal nerve injury were reported in the ESTA group ( P = .127). Conclusion: Compared with the ELA, the ESTA afforded comparable, favorable radiological results and clinical outcomes, associated with fewer wound complications and nonunions. We suggest that the ESTA is an effective operative option when treating displaced, intraarticular calcaneal fractures. Level of Evidence: Level III, comparative study.

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Section: Preoperative Managementmentioning

confidence: 99%

“…16,20 Sustentacular displacement was defined as fragment translation more than 2 mm in any plane. 16 All operations were performed after swelling diminished, which was confirmed by positive wrinkle sign.…”

Section: Preoperative Managementmentioning

confidence: 99%

Extended Sinus Tarsi Approach for Treatment of Displaced Intraarticular Calcaneal Fractures Compared to Extended Lateral Approach

et al. 2018

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“…Berberian et al in 2013 [ 46 ] retrospectively reviewed the computed tomography (CT) scans of 88 patients with 100 DIACFs for evidence of sustentacular displacement and found that the fragment was displaced in 40% of fractures. Gitajin et al in 2014 [ 47 ] reported similar results in 20 % of DIACFs. However currently, there is no data to evaluate a combined medial and lateral approach and its effect on the functional outcome.…”

Section: The Myth Of the “Constant Fragment”mentioning

confidence: 77%

Treatment of displaced intra-articular calcaneus fractures: a current concepts review

Dhillon¹,

Prabhakar²

2017

SICOT-J

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Displaced Intra-Articular Calcaneus fractures (DIACFs) represent a source of tremendous disability to the patient, economic burden to the society and a treatment challenge to the average orthopaedic surgeon. To date, no single approach is universally applicable to all calcaneus fractures. Despite a plethora of published meta-analyses and recent randomized controlled trials, the literature is still unclear and offers conflicting recommendations. The aim of this current concepts review is to assess the latest available data and offer pragmatic and practical recommendations to address some of the issues surrounding DIACFs.

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“…Therefore, special attention should be paid to the integrity and alignment of the sustentacular fragment prior to surgical fixation. 102…”

Section: Displaced Sustentacular Fragmentmentioning

confidence: 99%

Displaced Intra-articular Calcaneal Fractures: Classification and Treatment

Wei¹,

Zhou²,

Chang³

et al. 2017

Orthopedics

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The calcaneus is the most commonly fractured tarsal bone. Displaced intraarticular calcaneal fractures are usually caused by a fall from height with one or both heels directly hitting the ground. Displaced intra-articular calcaneal fractures are complex and highly disabling injuries. There is ongoing debate regarding the optimal treatment for each type of displaced intra-articular calcaneal fracture. This review aims to summarize the classification of, various treatment options for, prevention of perioperative complications in, and management algorithms for displaced intra-articular calcaneal fractures. [Orthopedics. 2017; 40(6):e921-e929.].

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Anatomic Alignment and Integrity of the Sustentaculum Tali in Intra-Articular Calcaneal Fractures

Abstract: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 27 publications

References 23 publications

Extended Sinus Tarsi Approach for Treatment of Displaced Intraarticular Calcaneal Fractures Compared to Extended Lateral Approach

Extended Sinus Tarsi Approach for Treatment of Displaced Intraarticular Calcaneal Fractures Compared to Extended Lateral Approach

Treatment of displaced intra-articular calcaneus fractures: a current concepts review

Displaced Intra-articular Calcaneal Fractures: Classification and Treatment

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