Complications Following Management of Displaced Intra-Articular Calcaneal Fractures: A Prospective Randomized Trial Comparing Open Reduction Internal Fixation With Nonoperative Management

Howard, J; Buckley, Richard; McCormack, Robert G.; Pate, Graham; Leighton, Ross; Petrie, David; Galpin, Robert

doi:10.1097/00005131-200304000-00001

Cited by 240 publications

(153 citation statements)

References 47 publications

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“…Although the 4 RCTs [10][11][12][13] deriving from the large multicenter study gave important data on the operative treatment of displaced intra-articular calcaneal fractures, they provide no definitive evidence on the best management of displaced intra-articular calcaneal fractures, in particular for the varying severity of the fractures. These studies considered all types of fractures in the same group.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of calcaneal fractures: the available evidence

Bondì

Padua

Bondì

et al. 2007

J Orthopaed Traumatol

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Calcaneal fracture is the most common of the tarsal fractures and represents 1%-2% of all fractures. The fractures may be divided into extra-articular (not affecting the joint) and intra-articular (involving the talo-calcaneal and calcaneal cuboid joints) types. The management of heel fractures includes nonoperative and operative treatments, but no clear consensus has been reached. The choice of operative treatment is still controversial with many factors influencing the final clinical outcome. Many studies have assessed the outcome of treatment of calcaneal fractures, but there is a general disagreement on their management. The objective of this study was to collect and evaluate the scientific evidence reported in the literature supporting the different treatments for calcaneal fractures.

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Section: Discussionmentioning

confidence: 99%

“…Howard et al [11] assessed complications following management of displaced intra-articular calcaneal fractures, which are a significant cause of morbidity. The population consisted of 424 patients (459 fractures).…”

Section: Rctsmentioning

confidence: 99%

Treatment of calcaneal fractures: the available evidence

Bondì

Padua

Bondì

et al. 2007

J Orthopaed Traumatol

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“…Patients treated with open reduction and internal fixation (ORIF) are more likely to develop wound complications. However, surgery correlates with better patient-related outcome [3,4].…”

Section: Introductionmentioning

confidence: 99%

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Backes

Schepers

Beerekamp

et al. 2013

International Orthopaedics (SICOT)

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Purpose Post-operative wound infections (PWI) following calcaneal fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF). Methods This study is a retrospective case series. All consecutive patients from 2000 to 2010 with a closed unilateral calcaneal fracture treated with open reduction and internal fixation (ORIF) by an extended lateral approach were included. Patient, fracture, trauma and peri-operative characteristics were collected, including RF such as smoking, diabetes mellitus, time to operation, pre-operative in-or outpatient management and wound closure technique. The primary end point was a PWI as defined by the US Centers for Disease Control and Prevention. Results A total of 191 patients were included of which 47 patients (24.6 %) had a PWI; 21 (11.0 %) and 26 (13.6 %) patients had a superficial and deep wound infection, respectively. American Society of Anesthesiologists (ASA) classification higher than ASA 1 was associated with an increased risk. Placement of a closed suction drain at the end of surgery was associated with less PWI (35 % vs 15 %, p =0.002). In this study, none of the previously reported RF were associated with an increased risk for PWI. Conclusions ORIF of displaced calcaneal fractures is associated with a high rate of PWI of 25 %. Factors that were associated with an increased risk were ASA classification other than 1 and absence of a closed suction drain placement.A closed suction drain may be a protective measure to avoid wound complications.

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“…Foram obtidos dados clínicos pré-operatórios considerados como fatores de risco na evolução, tais como: diabetes, tabagismo, alcoolismo e hipertensão (7) .…”

Section: Métodosunclassified