Comparison of 5 Treatment Approaches for Displaced Intra-articular Calcaneal Fractures: A Systematic Review and Bayesian Network Meta-Analysis

Shi, Fangling; Wu, Shaoze; Cai, Wei; Zhao, You-Ming

doi:10.1053/j.jfas.2020.03.021

Cited by 8 publications

(11 citation statements)

References 49 publications

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“…Calcaneal fracture is a clinically common lower limb fracture,approximately 60% of all tarsal fractures were calcaneal fractures, and approximately 75% of calcaneal fractures were DIACFs [1,2].Because calcaneal fracture is more common in high fall injury, the high impact of the heel is often easy to involve the articular surface, resulting in intraarticular fracture.Severe trauma or improper treatment may result in peroneal tendon dislocation, subtalar joint arthritis, achilles tendon weakness, etc.For DIACFs, surgical treatment is more effective and satisfactory than conservative treatment [3,4].…”

Section: Introductionmentioning

confidence: 99%

Comparing small locking plate fixation versus small locking plate with screws fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach

Zhao

Yang

Gao

et al. 2023

Preprint

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Background The purpose of this study was to compare the clinical and radiological outcomes of displaced intra-articular calcaneus fractures (DIACFs) treated with small locking plates alone versus small locking plates combined with screws. Methods Retrospective analysis of 120 patients with intra-articular fractures seen from May 2018 to June 2020, all of whom were surgically repositioned using sinus tarsal approach.60 cases received a small locking plate combined with screws fixation (observation group) and 60 cases received a small locking plate fixation alone (control group).Demographic variables were recorded and compared Gissane angle, Bohler's angle, calcaneal varus, and joint line parallel angle at 3 days and 2 years postoperative follow-up.The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score and VAS were applied to assess postoperative foot function, and complications were also compared. Results Compared with the control group, the joint line parallel angle and calcaneal varus in the observation group had lower displacement changes from the postoperative period to the 2-year follow-up,they are 0.07 (0.15) degrees vs 0.47 (0.59) degrees(P < 0.001), 0.19 (0.35) degrees vs 1.18 (0.67) degrees(P < 0.001).There was no significant difference in Gissane angle and Bohler's angle between the observation group and the control group at the preoperative, 3-year and 2-year follow-up (P > 0.05).The final AOFAS score, VAS score and complications were not significantly different between the two groups (P > 0.05). Conclusion When STA is used to treat DIACFs, fixation with a small locking plate combined with screws appears to provide better posterior articular surface stability and better maintenance of calcaneal axial stability than fixation with a small locking plate alone,the two techniques had similar functional outcomes and complications after surgery.

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Section: Introductionmentioning

confidence: 99%

Comparing small locking plate fixation versus small locking plate with screws fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach

Zhao

Yang

Gao

et al. 2023

Preprint

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“…They are intra articular in more than 70% of cases, involving the subtalar joint [ 1 ]. The optimal surgical treatment of IACF is still under debate, since many lifelong debilitating sequelae may occur [ 2 , 3 , 4 ]. CF frequently occur in young patients, who may be unable to return to their previous activities, therefore representing a relevant social and economic concern [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The optimal surgical treatment of IACF is still under debate, since many lifelong debilitating sequelae may occur [ 2 , 3 , 4 ]. CF frequently occur in young patients, who may be unable to return to their previous activities, therefore representing a relevant social and economic concern [ 2 , 3 , 4 ]. In spite of the high incidence of these injuries, their management is still debated [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…CF frequently occur in young patients, who may be unable to return to their previous activities, therefore representing a relevant social and economic concern [ 2 , 3 , 4 ]. In spite of the high incidence of these injuries, their management is still debated [ 2 , 3 ]. Many classifications have been proposed for intra articular CF (IACF).…”

Section: Introductionmentioning

confidence: 99%

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Patient Reported Outcome Measures (PROMs) in Surgery: Evaluation after Minimally Invasive Reduction and Percutaneous K-Wires Fixation for Intra-Articular Calcaneal Fractures

et al. 2023

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Background: The optimal surgical treatment of intra-articular calcaneal fractures (IACF) is still under debate. In the literature, results are based on clinical or radiographical findings. Few studies have evaluated the effect of patient expectations on patient-reported outcomes after surgery and little is known about outcomes directly reported by the patient who experienced it. Patient reported outcome measures (PROMs) may represent a viable and useful tool for evaluating the efficacy of the procedure and can be considered as an indicators of health-care quality. The aim of this study is to evaluate PROMs after minimally invasive reduction and percutaneous Kirschner-wires fixation for IACF, and to compare PROMs to pre-operative and last follow-up radiographic findings. Methods: 33 consecutive patients with IACF treated with minimally invasive reduction and percutaneous K-wires fixation were included. Data collection included demographics, pre-operative and last available Böhler and Gissane angle X-rays, foot function index (FFI), and foot and ankle outcome score (FAOS). Results: At a mean follow up of 36.7 months, the mean FFI score was 24.3 ± 19.9 and the mean FAOS score was 68 ± 24.8. Patients with better Gissane angle showed better activity limitations FFI subscores. Moreover, worse pre-operative Gissane and Böhler angle were significantly associated with a worse total FAOS score and subscores. Conclusions: Minimally invasive reduction and percutaneous K-wires fixation provided satisfactory PROMs. Despite these results, prospective randomized studies are required to confirm the validity and reliability of PROMs in evaluating different treatments.

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“…The sustentaculum tali is rich in cortical bone; in addition, the dense trabecular bone continues with the trabecular bone in the anterior part of the calcaneus and the colliculus, which also provides a stable mechanical basis for the maintenance of screw fixation [7]. A number of studies have confirmed the reliability and effectiveness of sustentacular screw fixation in operations to treat calcaneal fractures [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Axial and frontal X-ray fluoroscopy technique of the sustentaculum tali can improve the accuracy of sustentacular screw placement

et al. 2022

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Introduction Calcaneal fractures, especially those involving the articular surface, should be anatomically reduced as much as possible. Fixing the fracture by placing a screw into the sustentaculum tali from the lateral side of the calcaneus is generally considered to be the key to successful surgery. However, due to the limited visibility during surgery, it is not easy to place screws into the sustentaculum tali accurately. The purpose of this study was to explore a new fluoroscopy method for the sustentaculum tali and verify the value of this method in improving screw placement accuracy. Methods In this study, a total of 42 human foot and ankle specimens were dissected and measured. The shape and position of the sustentaculum tali were observed, and the influence of adjacent bones on imaging findings was analysed. The axial and frontal X-ray fluoroscopy method to view the sustentaculum tali was formulated, and the appropriate projection angle through anatomical and image measurements was explored. Thirty specimens were randomly selected for screw placement, and the direction of the screw was dynamically adjusted under the new imaging method. The success rate of sustentacular screw placement was evaluated. Results The anteversion angles of the sustentaculum tali were 30.81 ± 2.21° and 30.68 ± 2.86° by anatomical and imaging measurements, respectively. There was no statistically significant difference in the anteversion angle between the two measurement methods. Harris heel views should be obtained at 30° to identify the sustentaculum tali on axial X-ray images. Frontal X-ray imaging was performed perpendicular to this projection angle. Through frontal and axial X-ray imaging, the position and shape of the sustentaculum tali can be clearly observed, and these factors are seldom affected by adjacent bones. Under the new fluoroscopy method, the screws were placed from the anterior region of the lateral wall of the calcaneus to the sustentaculum tali. A total of 60 screws were placed in the 30 specimens; of these, 54 screws were in good position, 2 screws penetrated the cortical bone, and 4 screws did not enter the sustentaculum tali. The success rate of sustentacular screw placement was 90% (54/60). Conclusions Axial and frontal X-ray images of the sustentaculum tali can clearly show the shape of the structure, which improves sustentacular screw placement accuracy.

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Comparison of 5 Treatment Approaches for Displaced Intra-articular Calcaneal Fractures: A Systematic Review and Bayesian Network Meta-Analysis

Cited by 8 publications

References 49 publications

Comparing small locking plate fixation versus small locking plate with screws fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach

Comparing small locking plate fixation versus small locking plate with screws fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach

Patient Reported Outcome Measures (PROMs) in Surgery: Evaluation after Minimally Invasive Reduction and Percutaneous K-Wires Fixation for Intra-Articular Calcaneal Fractures

Axial and frontal X-ray fluoroscopy technique of the sustentaculum tali can improve the accuracy of sustentacular screw placement

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