Minimally Invasive Technique Versus an Extensile Lateral Approach for Intra-Articular Calcaneal Fractures

Kline, Alex J.; Anderson, Robert B.; Davis, W. Hodges; Jones, Carroll P.; Cohen, Bruce E.

doi:10.1177/1071100713477607

Cited by 189 publications

(202 citation statements)

References 29 publications

Supporting

Mentioning

194

Contrasting

Unclassified

Order By: Relevance

“…As we recently started performing calcaneal surgery more often by an even more extended lateral approach according to Freeman et al [28] and (in less complex fractures) via the sinus tarsi approach [29,30], the severe wound complication rates appear to have decreased. In the latter type of approach a wound complication rate of 29 % in the ELA versus 6 % in the less invasive sinus tarsi approach was described [31].…”

Section: Discussionmentioning

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)

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

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)

View full text Add to dashboard Cite

show abstract

“…The extensile lateral approach, however, is often associated with soft tissue complications [4,5]. Minimally invasive treatment modalities have been established to avoid these complications, and, when performed by skilled surgeons, the clinical results are comparable and the risk of abnormal wound healing is lower [7,8,13,[22][23][24]. Furthermore, Chen et al concluded that minimally invasive screw osteosynthesis augmented with calcium sulphate cement results in a more rapid return to weight-bearing, diminished joint stiffness and increased patient satisfaction [13].…”

Section: Discussionmentioning

confidence: 99%

A biomechanical comparison of fixed angle locking compression plate osteosynthesis and cement augmented screw osteosynthesis in the management of intra articular calcaneal fractures

Rausch

Klos²,

Wolf

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose The purpose of this study was to investigate whether cement-augmented screw osteosynthesis results in stability comparable to conventional fixed-angle locking plate osteosynthesis using cadaveric bones to model a Sanders type 2B fracture. Methods Seven pairs of fresh frozen human calcanei and the corresponding tali were used. The specimens were assigned pairwise to two study groups in a randomised manner. In order to determine the initial quasi-static stiffness of the boneimplant construct, testing commenced with quasi-static compression ramp loading; subsequently, sinusoidal cyclic compression loading at 2 Hz was performed until construct failure occurred. Initial dynamic stiffness (cycle 1), range of motion (ROM), cycles to failure and load to failure were determined from the machine data during the cyclic test. In addition, at 250-cycle intervals, Böhler's angle and the critical angle of Gissane were determined on mediolateral X-rays shot with a triggered C-arm; 5°angle flattening was arbitrarily defined as a failure criterion. Results Bone mineral density was normally distributed without significant differences between the groups. The augmented screw osteosynthesis resulted in higher stiffness values compared to the fixed-angle locking plate osteosynthesis. The fracture fragment motion in the locking plate group was significantly higher compared to the group with augmented screw osteosynthesis. Conclusions The results of this study indicate that in our selected test set-up augmented screw osteosynthesis was significantly superior to the conventional fixed-angle locking plate osteosynthesis with respect to primary stability and ROM during cyclic testing.

show abstract

“…We believe intervention via locking plates and early weight-bearing does not lead to loss of correction and stabilization as others, even if minimal invasive techniques are performed. [4,18] Similarly, the amount of depression on posterior facet showed a slight loss from early postoperative X-ray to the last visit.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Closed reduction percutaneous fixation, open reduction via extensive or mini incision and internal fixation are the most common procedures. [3,4] The literature agrees that weight-bearing should be avoided roughly three months postoperatively due to the possible risk of collapsed talocalcaneal articular surface. [5,6] The introduction of locking plates in orthopedics has changed the biomechanical durability of bone and fracture.…”

mentioning

confidence: 99%

The effect of early weight-bearing on comminuted calcaneal fractures treated with locking plates

Kayalı¹

2014

Eklem Hastalik Cerrahisi

View full text Add to dashboard Cite

Minimally Invasive Technique Versus an Extensile Lateral Approach for Intra-Articular Calcaneal Fractures

Abstract: Level III, retrospective comparative case series.

Cited by 189 publications

References 29 publications

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

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

A biomechanical comparison of fixed angle locking compression plate osteosynthesis and cement augmented screw osteosynthesis in the management of intra articular calcaneal fractures

The effect of early weight-bearing on comminuted calcaneal fractures treated with locking plates

Contact Info

Product

Resources

About