Modified percutaneous fixation for displaced intra-articular calcaneal fractures

Baca, Emre; Koluman, Alican

doi:10.5606/ehc.2019.66386

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…The choice of PAAO is based on the patient's own situation. More importantly, PAAO is even applicable in cases where ORIF is contraindicated, and its advantage of less complication can be best demonstrated at the same time [5,6,18]. Early treatment with PAAO is suitable for smokers and diabetic patients to prevent heel skin necrosis caused by severe compression of the displaced fragment.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous and Arthroscopically Assisted Osteosynthesis for Calcaneal Fractures with Displacement of Different Calcaneal Talar Facet: A Retrospective Study

Xia

Liu

Zhang

et al. 2022

Preprint

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Background: Percutaneous and Arthroscopically Assisted Osteosynthesis (PAAO) offers a successful treatment option for displaced intra-articular calcaneal fractures (DIACFs) due to its visibility and minimal invasiveness. However, the fixation method of PAAO is reported as unstable. It can result in postoperative collapse and unsatisfactory reduction. As DIACFs are associated with displacement of the calcaneal talar facet (CTF), the study aimed to investigate whether there is a difference in the efficacy of PAAO in the treatment of DIACFs with different CTF. It can provide guidance and help for the clinic. Methods: A total of 107 cases treated with PAAO were included in this study, and they were classified by CTF. Preoperative radiological parameters were collected, including the Bohler angle and calcaneal height, as well as patient-reported results, including the American Orthopedic Foot and Ankle Society (AOFAS) scores and Visual Analog Scale (VAS) scores. Results after surgery were analyzed and compared between different types of CTF. Results: Based on the CTF, DIACFs were divided into five groups ( 37 Type I, 25 Type II, 18 Type III, 16 Type IV, and 11 Type V). At the last follow-up, the Bohler angle of Type V (32.26 degrees) was larger than that of Type I, II, III, and IV (27.77, 27.99, 25.46 and 27.76 degrees), and calcaneal height of Type III (41.65 mm) was lower than that of Type V (48.22 mm)(all P < 0.05). There was no significant difference in AOFAS scores of five types (all P > 0.05). VAS scores were significantly higher in Type III (3.0) than Type I (2.1) and Type V (1.8)(all P < 0.05). Conclusions: PAAO showed good imaging and clinical results in DIACFs in short-term follow-up and the treatment effect varied from different types of CTF. Therefore, when it comes to DIACFs of CTF V, PAAO can be given priority, but for DIACFs of CTF III, it should be carefully considered whether to use this method.

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Section: Discussionmentioning

confidence: 99%

“…These problems may weaken the advantages of ORIF. In order to reduce these complications, minimally invasive surgery (MIS) was adopted later [3,[5][6][7][8][9][10][11][12]. MIS can avoid large-scale periosteum peeling, prevent skin ap necrosis, and maintain local blood circulation.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous and Arthroscopically Assisted Osteosynthesis for Calcaneal Fractures with Displacement of Different Calcaneal Talar Facet: A Retrospective Study

Xia

Liu

Zhang

et al. 2022

Preprint

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“…A dual-point distractor with or without K-wire fixation has been used in several studies. [ 16 - 18 ] Although many studies have described and investigated the percutaneous fixation approach using a distraction system, no study has compared this technique with the traditional extended lateral approach. In this study, we used dual-point distraction, which was found to be more effective than the extended lateral approach.…”

Section: Discussionmentioning

confidence: 99%

Comparing open reduction and internal fixation versus closed reduction using dual-point distraction and percutaneous fixation for treating calcaneal fractures

Batıbay¹,

Bayram

2020

Jt Dis Relat Surg

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This study aims to compare the early clinical, functional and radiographic outcomes of a small cohort of patients with calcaneal fractures treated with closed reduction using a dualpoint distraction system and the traditional lateral approach. Patients and methods: We prospectively treated 40 patients with calcaneus fractures who presented to our emergency department between January 2017 and February 2018. In total, 35 patients (22 males, 13 females; median age 39.8 years; range, 19 to 57 years) were included in this study since five patients were not followed up. Fractures were classified according to the Sanders classification system using computer tomography images. Clinical outcomes including postoperative two-week visual analog scale (VAS) score, sickness absence period, operating time and complication rate were recorded. Results: The mean follow-up period was 24 months. Closed reduction using dual-point distraction and percutaneous fixation (group 1) was performed in 17 patients, whereas the extended lateral approach (group 2) was used in 18 patients. There were no significant differences between both groups in age, follow-up outcomes and Sanders classification. Operating time was significantly shorter in group 1 than in group 2. At postoperative two weeks, VAS scores were significantly lower in group 1 than in group 2. The complication rate and sickness absence period were significantly lower in group 1 than in group 2. Conclusion: Closed reduction using dual-point distraction can be preferred owing to many advantages including considerably decreased risk of wound complications, sickness absence period and length of hospital stay as well as superior postoperative rehabilitation with a low pain score.

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“…

Calcaneus fractures are the most common fractures of the hindfoot, accounting for 1 to 2% of all fractures of the human skeleton. [1,2] The majority of injuries involve the subtalar joint (about 75%) and the calcaneocuboid joint (about 68%). [2][3][4] The subtalar joint, the determinative joint of the hindfoot, is often disrupted by fractures of the calcaneus.

…”

mentioning

confidence: 99%

“…[1,2] The majority of injuries involve the subtalar joint (about 75%) and the calcaneocuboid joint (about 68%). [2][3][4] The subtalar joint, the determinative joint of the hindfoot, is often disrupted by fractures of the calcaneus. The main goal of treatment for calcaneal fractures must be restoration of the joint and, particularly, calcaneal height, length, and heel width restitution.…”

mentioning

confidence: 99%

The importance of Böhler’s angle in calcaneus geometry: A finite element model study

et al. 2021

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Objectives: Calcaneal fractures are the most common tarsal fractures following a foot-ankle trauma. The Böhler’s angle is an important measurable angle before, during, and after surgery. In this study, we aimed to investigate correlation between Böhler’s angle, calcaneal strength, and subtalar joint stress using a finite element analysis (FEA). Patients and methods: Between January 2016 and December 2016, computed tomography (CT) scans were used with MIMICS® software for FEA. The ankle and foot of a 23-year-old male person with a height of 180 cm and weighing 80 kg was modeled as reference. Raw coronal CT images were obtained in Digital Imaging and Communications in Medicine format with the resolution of 512X512 pixels and 0.3-mm slice intervals in 135 kV. The structures including tibia, fibula and 26 other bones (talus, calcaneus, cuboid, navicular, three cuneiforms, five metatarsals, and 14 components of phalanges), cartilage and ligamentous tissues were modeled to form ankle joint. After determining Böhler’s angle as 35 degrees for the reference model, a fracture line was created on calcaneus. Calcaneus was remodeled with the Böhler’s angle of 45, 40, 30, 25, 20, 10, and 0 degrees respectively. All models were transferred to ANSYS software for FEA and the loads on the lower extremities with normal posture were applied on models. Results: Analysis of all models based in the reference model revealed that maximum tension values on calcaneus increased, while the Böhler’s angle decreased, indicating a statistically significant difference. The decreased Böhler’s angle indicated statistically significantly higher maximum tension values (p=0.04). Action force in subtalar joint was evaluated by comparing with the forces in reference model. The increased Böhler’s angle was found to be associated with statistically significantly decreased amount of load on subtalar joint. The decreased Böhler’s angle was related to the statistically significantly increased amount of load on subtalar joint. Conclusion: Our study results suggest that decreased Böhler’s angle increases the possibility of subtalar arthrosis, although overcorrection of the Böhler’s angle seems not to increase the risk of subtalar arthrosis.

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Modified percutaneous fixation for displaced intra-articular calcaneal fractures

Cited by 11 publications

References 25 publications

Percutaneous and Arthroscopically Assisted Osteosynthesis for Calcaneal Fractures with Displacement of Different Calcaneal Talar Facet: A Retrospective Study

Percutaneous and Arthroscopically Assisted Osteosynthesis for Calcaneal Fractures with Displacement of Different Calcaneal Talar Facet: A Retrospective Study

Comparing open reduction and internal fixation versus closed reduction using dual-point distraction and percutaneous fixation for treating calcaneal fractures

The importance of Böhler’s angle in calcaneus geometry: A finite element model study

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