Comparison and predictive factors analysis for efficacy and safety of Kirschner wire, anatomical plate fixation and cannulated screw in treating patients with open calcaneal fractures

Abstract

This study aimed to compare the efficacy and safety among Kirschner wire, anatomical plate fixation and cannulated screw treatments in patients with open calcaneal fractures, and to explore the predictive factors for treatment response and complication occurrence.The 142 open calcaneal fracture patients were enrolled in this study, who received fixation procedures of Kirschner wire, anatomical plate fixation or cannulated screw on demand. Treatment efficacy was assessed by AOFAS score and occurrence of complications was recorded.No difference of AOFAS score was observed among Kirschner wire, anatomical plate fixation and cannulated screw groups (P = .792), and the numbers of patients with excellent, good, medium, and poor AOFAS score in Kirschner wire group were 16 (16.2%), 42 (42.4%), 32 (32.3%), and 9 (9.1%), which in anatomical plate fixation group were 4 (16.7%), 11 (45.8%), 7 (29.2%), and (8.3%), and in cannulated screw group were 1 (5.3%), 10 (52.6%), 6 (31.6%), and 2 (10.5%), respectively. No difference of total complication occurrence (P = .709) or specific complications including skin graft (P = .419), flap graft (P = .229), deep infection (P = .644) or amputation (P = .428) was discovered among 3 groups. Logistic regression analysis revealed that fixation options did not affect treatment response and complication occurrence (all P > .05), while higher Gustilo type correlates with decreased treatment response (P < .001) and elevated complication occurrence (P < .001) independently.Kirschner wire, anatomical plate fixation, and cannulated screw are equally efficient and tolerated in treating patients with open calcaneal fractures, and higher Gustilo type correlates with decreased treatment response and increased complication occurrence independently.

Comparison of visual and refractive outcomes between femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and photorefractive keratectomy (PRK): a long-term outcomes analysis

“…In our opinion, the main reason for this may be due to the high-order aberrations triggered in patients who received FS-LASIK and structural changes caused by the creation of a corneal flap. Indeed, past studies have demonstrated that higher-order optical aberrations and systematic changes in corneal topography can be associated with uncomplicated lamellar flap creation (19,20).…”

“Open calcaneal fractures with medial exposure: mid term results”

“…Due to its rarity, knowledge about treating open calcaneal fractures is based on small case series (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) . The first studies showed a bleak scenario with complication rates above 60%, including lower limb amputations in 29% and osteomyelitis in 19%-39% of cases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) .…”

Clinical Application Study of Minimally Invasive Double-Reverse Traction in Complex Tibial Plateau Fractures

“…In the current study, we assess the outcomes of 12 patients with complex type VI tibial plateau fractures who were treated with the DRTR. The purpose of this study is to assess the efficacy of the DRTR surgical technique as a minimally invasive treatment of type VI tibial plateau fractures and to demonstrate the safety and efficacy of this technique by roughly comparing it with those associated with common-sense open internal fixation [ 4 ].…”