Open Reduction and Internal Fixation of Displaced Intra-articular Fractures of the Calcaneus

Abstract

On the basis of our result, we recommend that type II and type III fractures be treated with open reduction and internal fixation. Despite the results of type IV fractures being significantly worse than that of type II and type III fractures, we recommend open reduction and internal fixation for type IV fractures to restore the hindfoot architecture and the subtalar joint, if possible. When the disrupted subtalar joint is so comminuted that it is beyond the surgeon's ability to reconstruct, primary subtalar arthrodesis should be performed in addition to open reduction and internal fixation.

Postoperative complications after closed calcaneus fracture treated by open reduction and internal fixation: A review

“…31 We calculated an incidence rate of 1.2%; in the included papers, but the rate rises with longer follow up because of irreversible articular cartilage damage and degenerative changes. 10 When intractable pain cannot be controlled by analgesic drugs, subtalar joint arthrodesis may be the best choice. 10,17 Nonunion is an infrequent postoperative complication: we calculated the incidence rate as only 0.1%.…”

“…Problems generally arose because the plate and screws had irritated the skin, tendons or nerve, or because the screws penetrated the articular facet. 10,11 Irritation of the tendons could result in tendinitis or tendon rupture, leading to peroneal tendinitis, malfunction and secondary pain. Post-traumatic arthritis was considered as a problem in one study because it caused intractable pain.…”

“…2 In such situations, conservative or nonsurgical treatments were often attempted first; if these failed, surgical interventions (including the removal of the implant, and subtalar and calcaneocuboid arthrodesis) were undertaken. 10,17 Nonunion was rarely reported in the included studies of calcaneal ORIF. However, for the few cases of nonunion that were described, surgery may have damaged the blood supply.…”

Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture

“…Stephenson 25) 은 종골의 풍부한 혈액 공 급으로 골결손 부위에 해면골이 8주 이내에 생성된다고 보 고하였으며, Longino와 Buckley 14) , Sanders 등 22) , 그리고 송 등 24) 은 종골 골절에서 관혈적 정복술 및 내고정술 시 골이식 없이도 만족스러운 치료 결과를 보고하였다. 그리 고 최근에는 골이식을 시행한 경우와 시행하지 않은 경우 간에 차이가 없다는 결과들이 보고되고 있다 7,23) . 2) Boack DH, Wichelhaus A, Mittlmeier T, Hoffmann R,…”

Balloon reduction and cement fixation in intra-articular calcaneal fractures: a percutaneous approach to intra-articular calcaneal fractures

“…Calcaneal fractures are a challenging clinical problem due to the complex anatomy of the os calcis, the frequent subtalar joint involvement and frequent articular displacement [1,2]. Open reduction and internal fixation with a lateral plate has been established as a standard therapy [3].…”