Early Clinical and Radiographic Outcomes after Treatment of Displaced Intra-articular Calcaneal Fractures Using Delta-Frame External Fixator Construct

Kissel, Charles G.; Husain, Zeeshan S.; Cottom, James M.; Scott, Ryan T.; Vest, Joshua R.

doi:10.1053/j.jfas.2010.12.026

Cited by 22 publications

(10 citation statements)

References 41 publications

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“…Studies assessing outcomes of calcaneus fractures are difficult to compare because of the multiple outcome instruments used in previous studies. 1,8,9,[12][13][14][15] The Maryland Foot Score and the Creighton-Nebraska Health Assessment both have been used to measure outcomes in previous studies assessing CT classification systems. 3,22 Howard and colleagues used the SF-36 as an outcome instrument in their recent prospective randomized study.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Computed Tomography Classification Systems for Intra-articular Calcaneus Fractures

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Computed Tomography Classification Systems for Intra-articular Calcaneus Fractures

et al. 2014

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“…Many scholars have reported the use of an external fixator in treating calcaneal fractures, 13 - 18 with the advantage of reduced soft-tissue injury and without the limitation of surgical timing and fracture types, thereby facilitating the treatment of open wounds and avoiding incision complications effectively. 19 However, if the fractures were treated solely with the external fixator, the subtalar joint could not be restored anatomically.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures

Pan

Chai

Xue

et al. 2017

Bone & Joint Research

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ObjectivesThe aim of this study was to compare the biomechanical stability and clinical outcome of external fixator combined with limited internal fixation (EFLIF) and open reduction and internal fixation (ORIF) in treating Sanders type 2 calcaneal fractures.MethodsTwo types of fixation systems were selected for finite element analysis and a dual cohort study. Two fixation systems were simulated to fix the fracture in a finite element model. The relative displacement and stress distribution were analysed and compared. A total of 71 consecutive patients with closed Sanders type 2 calcaneal fractures were enrolled and divided into two groups according to the treatment to which they chose: the EFLIF group and the ORIF group. The radiological and clinical outcomes were evaluated and compared.ResultsThe relative displacement of the EFLIF was less than that of the plate (0.1363 mm to 0.1808 mm). The highest von Mises stress value on the plate was 33% higher than that on the EFLIF. A normal restoration of the Böhler angle was achieved in both groups. No significant difference was found in the clinical outcome on the American Orthopedic Foot and Ankle Society Ankle Hindfoot Scale, or on the Visual Analogue Scale between the two groups (p > 0.05). Wound complications were more common in those who were treated with ORIF (p = 0.028).ConclusionsBoth EFLIF and ORIF systems were tested to 160 N without failure, showing the new construct to be mechanically safe to use. Both EFLIF and ORIF could be effective in treating Sanders type 2 calcaneal fractures. The EFLIF may be superior to ORIF in achieving biomechanical stability and less blood loss, shorter surgical time and hospital stay, and fewer wound complications.Cite this article: M. Pan, L. Chai, F. Xue, L. Ding, G. Tang, B. Lv. Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome. Bone Joint Res 2017;6:433–438. DOI: 10.1302/2046-3758.67.2000640.

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“…The use of additional Steinman pins to obtain reduction and better "frame" the fracture site is one approach. Adding temporary external fixation may be an answer to better reduce the elevation of the greater tuberosity as found in some cases [22]. However, the balloon reduction tamp and cement fixation concept have provided us excellent tools to achieve reduction without performing an extensive approach damaging to the soft tissues, and we believe the tools and concept are here to stay in the arsenal available to the surgeon in regular clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Balloon reduction and cement fixation in calcaneal articular fractures: a five-year experience

Jacquot

Letellier

Atchabahian³

et al. 2013

International Orthopaedics (SICOT)

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Purpose Balloon reduction and cement fixation of displaced articular fractures of the calcaneus have been described elsewhere but support for it lacks clinical evidence. We have been performing the technique since October 2006 and describe here our clinical experience including three to five-year follow up of our first ten cases with no patient lost to follow up. Methods From September 2006 to September 2009, ten patients were admitted with a calcaneus fracture, six were female and four male, one case was bilateral (11 fractures). Patients were operated upon in the prone position according to the technique we have described. Reduction was obtained in all cases. Patients were discharged after an average of four days postoperatively and were allowed weight bearing after two to three months. All patients were followed up regularly and were examined by an independent observer at the latest follow up. The clinical results were assessed using the AOFAS ankle score, the Babin score and the RAND-36 physical components score. A CT scan was obtained in all patients before, after the operation and at the latest follow up.Results After a minimal follow up of 36 months (three to five years), no patient was lost to follow up and none required further surgery. The AOFAS clinical results were rated good or excellent in 81.8 % of cases (nine fractures, eight patients), and the physical component of the RAND-36 was 74.6. One patient only (one fracture) had a bad clinical result and evidence of subtalar arthritis on the CT scan and was offered a subtalar fusion; she refused. All patients had returned to their former professional activities at the same level as before the fracture except one who had retired but had resumed leisure walking. Conclusion Balloon reduction and cement fixation of fresh calcaneal fractures ("balloon calcaneoplasty") appears a safe and effective procedure in a variety of calcaneal fractures with lasting and excellent clinical results. More studies are needed to further refine the indications and the limits of the procedure.

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Early Clinical and Radiographic Outcomes after Treatment of Displaced Intra-articular Calcaneal Fractures Using Delta-Frame External Fixator Construct

Cited by 22 publications

References 41 publications

Prognostic Value of Computed Tomography Classification Systems for Intra-articular Calcaneus Fractures

Prognostic Value of Computed Tomography Classification Systems for Intra-articular Calcaneus Fractures

Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures

Balloon reduction and cement fixation in calcaneal articular fractures: a five-year experience

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