Arthroscopic Reduction and Percutaneous Fixation of Selected Calcaneus Fractures

Sivakumar, Brahman; Wong, Poo Sing; Dick, Charles G.; Steer, Richard; Tetsworth, Kevin

doi:10.1097/bot.0000000000000157

Cited by 29 publications

(25 citation statements)

References 24 publications

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“…The reported subsidence might be due to suboptimal screw placement and fixation technique, poor patient compliance, and/or a too aggressive rehabilitation protocol. Our patients were permitted full weightbearing 8 weeks after surgery, while Woon et al, 33 Sivakumar et al, 26 and Law et al 18 permitted full weightbearing after 12 weeks. This might contribute to the amount of subsidence of the Böhler angle observed in the present study.…”

Section: Discussionmentioning

confidence: 74%

“…Law et al 18 observed a subsidence from 18.7 degrees postoperatively to 17.6 degrees at long-time follow-up. In their study, Sivakumar et al 26 had a subsidence from 25.0 degrees postoperatively to 23.4 degrees at final follow-up. However, Tantavisut et al 27 reported a postoperative Böhler angle of 18.1 degrees subsiding to 13.1 degrees at 3 months postoperatively after using a percutaneous technique on 182 feet in 153 patients.…”

Section: Discussionmentioning

confidence: 84%

“…We have not found any other comparable studies using the MOxFQ score, but there are a few studies reporting the AOFAS score after treating Sanders II and III fractures using arthroscopically assisted percutaneous techniques. Sivakumar et al 26 reported a mean AOFAS score of 87.8 and a mean CFSS of 83.6 after a mean 14 months of follow-up, while Yeap et al 35 reported an AOFAS score of 86.7 at 17 months of follow-up. The results of the present study correlate with these previous reports confirming good results with the PACO technique.…”

Section: Discussionmentioning

confidence: 99%

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Results After Percutaneous and Arthroscopically Assisted Osteosynthesis of Calcaneal Fractures

et al. 2020

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Background: Operative treatment of calcaneal fractures using the extensile lateral approach is associated with high rates of soft tissue complications. In the past years, there has been a trend toward less invasive surgical approaches. Percutaneous and arthroscopically assisted calcaneal osteosynthesis (PACO) combines the advantages of visualization of the posterior facet of the subtalar joint with a minimally invasive approach. Methods: We conducted a follow-up of 25 patients with 26 calcaneal fractures (Sanders II and III), treated with PACO with a minimum follow-up of 12 months. The median age was 44 years (range, 21-72) and the follow-up period 15 months (12-33). Our clinical outcomes were the Manchester-Oxford Foot Questionnaire (MOxFQ), the Calcaneus Fracture Scoring System (CFSS), the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, the Short-Form-36 (SF-36), the visual analog scale (VAS) for pain, and the number of complications. Radiographs on follow-up were obtained to evaluate the reduction of the fractures as well as osteoarthritis of the subtalar joint. Results: The median MOxFQ score was 26.6 (0-76.6), the CFSS score 85 (26-100), and the AOFAS score 85 (50-100). The VAS pain score was 0 (0-5.7) at rest and 4.1 (0-8.2) during activity. The Böhler angle improved from a mean (SD) of 3.5 (12.3) degrees preoperatively to 27.7 (10.5) degrees postoperatively. The follow-up radiographs showed subsidence of the fractures and a Böhler angle of 20.3 (12.9) degrees. There were no wound-healing complications. Two patients had additional surgery with screw removal due to prominent hardware. Conclusion: Our results suggest that PACO gives good clinical outcomes and a low risk of complications in selected calcaneal fractures. Prospective long-term studies will be necessary to better document the potential advantages and limitations of this operating technique. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Results After Percutaneous and Arthroscopically Assisted Osteosynthesis of Calcaneal Fractures

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confidence: 99%

“…As the study by Sivakumar and colleagues 15 demonstrates, minimally-invasive fixation of calcaneal fractures significantly reduces the risk of soft-tissue complications and is particularly feasible in patients with less severe fracture patterns (Sanders Type II). 15 The authors do not discuss earlier studies using arthroscopically-assisted percutaneous reduction and screw fixation for DIACF's, but the results from these studies involving 13 to 24 patients followed for 1 to 10 years showed that excellent results can also be obtained in the medium term. Consequently, the authors' short-term results with zero infections and good to excellent outcome scores in 9 patients at 14 months follow-up compare favourably with other reported percutaneous reduction techniques, most of them involving traction.…”

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confidence: 99%