Arthroscopic Resection of an Anterior Calcaneal Fracture: A Case Report

Frey, Carol; Wallis, David; Feder, Keith S.; Hohl, William M.

doi:10.1177/107110070502600513

Cited by 7 publications

(2 citation statements)

References 22 publications

(9 reference statements)

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“…There is one case report on arthroscopic removal of a malunited loose anterior process fragment at the superior rim of the calcaneocuboid joint. 39 However, the joint itself appears rather small for arthroscopy, and reduction can be achieved in most cases by using the articular surface of the cuboid as a template. After percutaneous screw fixation, the stab incisions are closed, and an elastic bandage is applied.…”

Section: Surgical Techniquementioning

confidence: 99%

Percutaneous Fixation of Intraarticular Calcaneus Fractures

Rammelt

Heineck

Barthel

et al. 2009

Techniques in Foot &Amp; Ankle Surgery

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The method of arthroscopically assisted percutaneous reduction and screw fixation is an alternative treatment of selected intraarticular calcaneus fractures (Sanders type II) to reduce the risk of wound complications and improve patient comfort while ensuring anatomical reduction of the posterior calcaneal facet. The results compare favorably to those after open reduction and internal fixation in patients with similar fracture patterns. Surgery should be performed within 1 week after the injury. If anatomical reduction by means of percutaneous manipulation is impossible because of deep impaction of the posterior facet fragment or soft tissue interposition, open reduction via a lateral approach becomes necessary. Unless open reduction is contraindicated, the uniform and indifferent application of percutaneous reduction methods to all calcaneal fractures is not encouraged to avoid malreduction of the articular surface or damage to the soft tissues during repeated reduction attempts.

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Section: Surgical Techniquementioning

confidence: 99%

Percutaneous Fixation of Intraarticular Calcaneus Fractures

Rammelt

Heineck

Barthel

et al. 2009

Techniques in Foot &Amp; Ankle Surgery

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“…Since the increasing use of computed tomography (CT) and magnetic resonance imaging (MRI), APC injuries have accounted for up to 38% of all extraarticular calcaneus fractures and are often associated with other injuries at the Chopart joint Open Access line [5][6][7]. In the few studies to date, which are predominantly case reports, various surgical and conservative treatment options have been described, but mostly with low case numbers and often without a uniform classification or consensus on therapy [1,2,5,[8][9][10][11][12][13][14][15][16][17]. In addition, APC fractures can only poorly be classified using the current fracture classifications of the calcaneus [2,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Introduction of a modified Degan classification to specify treatment algorithms in fractures of the anterior process of the calcaneus

Cibura

Lülsdorff

Ramczykowski

et al. 2022

BMC Musculoskelet Disord

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Background Fractures of the anterior process of the calcaneus are often missed, and their treatments and results receive little attention in the current literature. The aim of this study was to specify treatment algorithms through a modification of the Degan classification. Methods Between 2009 and 2019, patients with APC fractures were retrospectively analyzed. The Degan classification was used and modified. Type III fractures were further divided into subgroups A (not displaced) and B (displaced). The type of treatment and complications were recorded. Return to work and posttraumatic osteoarthritis were determined as primary and secondary outcome parameters, respectively. Results Forty-one patients with 43 fractures were included. Follow-up averaged 35,5 months (range 1,5–152 months). Fractures were eight type I, six type II, 15 type IIIA and 14 type IIIB. The fracture was initially recognized in 29 (70,7%) patients, and missed in 12 (29,3%) patients, respectively. Overall, the delayed diagnosed fractures had a significantly higher complication rate (p < 0,000) than the initially diagnosed fractures and received surgical treatment significantly (p < 0,009) more often. After surgical treatment of 13 type IIIB, one nonunion occurred. Six missed type IIIA fractures were treated surgically after delayed diagnosis because of persistent symptoms. Two type I fractures required arthrodesis of the Chopart joint. Four patients did not return to work during the follow-up (3 missed type IIIA fractures, 1 type II fracture). Conclusion Missed APC type IIIA fractures are at risk to develop complications, which is why computed tomography diagnostics should be performed if there is any clinical suspicion.

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Frakturen des Processus anterior calcanei – häufig übersehene Verletzungen nach Sprunggelenkdistorsion

et al. 2018

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Fractures to the anterior process of the calcaneus (PAC) have long been considered rare injuries and have received little attention in clinical research. On the contrary, recent studies have reported a distinct higher incidence, especially following ankle sprains. Decisive reasons are that fractures of the PAC are regularly missed on plain radiographs and that a clinical differentiation from injuries to the lateral ankle ligaments is difficult. With the broad availability of cross-sectional imaging modalities fractures of the PAC are diagnosed more frequently and more reliably. The purpose of this review is to give an overview on the diagnostics, classification and treatment recommendations to this topic and discuss the studies available. To date no evidence-based recommendations are available for the treatment of fractures of the PAC. The few case reports and case series published, predominantly recommend conservative treatment; however, the treatment regimens vary considerably, ranging from immobilization in a lower leg cast (2-10 weeks) to early functional treatment with full weight-bearing. The surgical treatment by open reduction and internal fixation has been described primarily for large dislocated fractures. Surgical excision is considered mainly in cases of persistent pain or symptomatic non-union following non-operative treatment. For both, non-operative and operative treatment, the case reports and case series report satisfactory outcomes for the majority of patients. Nevertheless, comparative studies and patient-rated outcome measures are missing. Therefore, evidence-based recommendations cannot be given.

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Arthroscopic Resection of an Anterior Calcaneal Fracture: A Case Report

Cited by 7 publications

References 22 publications

Percutaneous Fixation of Intraarticular Calcaneus Fractures

Percutaneous Fixation of Intraarticular Calcaneus Fractures

Introduction of a modified Degan classification to specify treatment algorithms in fractures of the anterior process of the calcaneus

Frakturen des Processus anterior calcanei – häufig übersehene Verletzungen nach Sprunggelenkdistorsion

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