Percutaneous Fixation of Intraarticular Calcaneus Fractures

Rammelt, Stefan; Heineck, J.; Barthel, Sven; Zwipp, H.

doi:10.1097/btf.0b013e3181a77f71

Cited by 14 publications

(11 citation statements)

References 33 publications

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“…Because of these problems with the ELA, there has been renewed interest to develop alternative techniques to manage intra-articular calcaneal fractures and minimize soft tissue complications [ 17 , 18 , 26 , 27 ]. Many techniques have been described over the last 10 years [ 26 , 28 - 30 ], including percutaneous fixation, arthroscopic assisted, external fixation, trans-articular, and small medial, posterior, lateral or a combined incision technique [ 17 , 26 - 30 ]. The less invasive approach has been described such as the STA [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Yeo

Cho

Lee

2015

BMC Musculoskelet Disord

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BackgroundTwo common surgical approaches included the sinus tarsi and extensile lateral are used for displaced intra-articular calcaneal fractures. However, few studies have compared outcome of treated by the two approaches. The purpose of this study was to compare the outcome between these two approaches for Sanders type-II and type-III fractures.MethodsThis retrospective cohort study was performed from 2004 to 2011. Open reduction and internal fixation using the sinus tarsi and extensile lateral approach was studied in 100 cases (40 sinus tarsi and 60 extensile lateral) with displaced intra-articular calcaneal fractures. All patients were evaluated both clinically and radiologically.ResultsMedian Böhler and Gissane angle were improved to 26.5 degree (4.6 to 45), 115.5 degree (101.2 to 127.4) in the sinus tarsi group and 25.3 degree (3.7 to 44.6), 119.0 degree (73.5 to 145.6) in extensile lateral group at the final follow-up, respectively. Median calcaneal height, length, and width in the sinus tarsi and extensile lateral groups showed improvement to 45.1 mm (23.2 to 54.1), 75.9 mm (64.9 to 90.3), 37.6 mm (29.2 to 53.9) and 46.5 mm (32.7 to 59.5), 76.1 mm (67.3 to 97.9), 39.3 mm (29.2 to 47.8) at the final follow-up, respectively. Median AOFAS score was checked to 90 points (76 to 94) in the sinus tarsi group and 86 points (76 to 94) in the extensile lateral group at the final follow-up. No significant differences in clinical and radiologic outcomes were observed between the two groups. However, wound complication rate (13.3%) in the extensile lateral group was significantly higher compared to the sinus tarsi group (p-value = 0.022).ConclusionsThe final clinical and radiographic outcomes between the two approaches for Sanders type-II and type-III intra-articular calcaneal fractures were comparable and equally successful. The selective sinus tarsi approach appears to be an effective and reliable method for the treatment of Sanders type-II and type-III fractures.

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Section: Discussionmentioning

confidence: 99%

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Yeo

Cho

Lee

2015

BMC Musculoskelet Disord

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“…A 35-month follow-up study by Schepers et al 36 showed that the average score of AOFAS was 83.0 points and the incidence of infection complications was 15%. Rammelt et al 16 reported a study with an average follow-up time of 29 months that showed an average AOFAS score of 92.1 points and no postoperative complications related to surgery were seen. A study by Tomesen et al 37 shows that at a mean follow-up time of 66 months, the mean AOFAS score was 84.0 points and the postoperative infection rate of the wound was 13%.…”

Section: Previous Studies Involving the Two Surgical Approachesmentioning

confidence: 99%

Comparison between Percutaneous Screw Fixation and Plate Fixation via Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Weng

Dai

et al. 2019

Orthopaedic Surgery

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Objective To assess the long‐term outcomes after percutaneous reduction (PR) and screw fixation versus plate fixation via the sinus tarsi approach (STA) for displaced intra‐articular calcaneal fractures (DIACF). Methods This retrospective study included a total of 150 patients (June 2008–August 2011), comprising 85 men and 65 women (mean age, 38.4 years), who were assigned to the PR group or the STA group. The inclusion criteria were DIACF (>2 mm) including Sanders type II and III, closed fracture, unilateral fracture, no history of smoking or no smoking during hospitalization and 3 months after surgery, and follow‐up time not less than 8 years. The exclusion criteria were clear surgical contraindications (severe cardiovascular and cerebrovascular diseases), local or systemic infection symptoms, diagnosis with diabetes or lower extremity vascular disease, and Sanders type IV or open fractures. Outcomes were assessed by means of the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scores, radiographic images, and postoperative complications. Results The mean follow‐up period was 8.7 years (range, 8.0–10.0 years). The AOFAS scores in the PR group during the follow‐up period were 54.2 ± 5.1, 85.8 ± 4.0, 88.1 ± 3.8, 87.9 ± 3.6, 87.8 ± 3.9, 86.9 ± 3.9, respectively, and in the STA group were 55.0 ± 5.6, 84.5 ± 5.2, 87.1 ± 3.8, 86.9 ± 3.8, 87.7 ± 3.3, and 87.6 ± 2.8, respectively. There was no significant difference in AOFAS scores, Bohler's angle, Gissane's angle, calcaneal length, and height between the two groups (P > 0.05). The good to excellent rate of the PR group (80.8%) was less than that of the STA group (91.7%) (P = 0.055). For Sanders III fractures, the good to excellent rate of the PR group (33.3%) was less than that of the STA group (76.9%) (P = 0.029). For calcaneal width recovery, the STA group performed better than the PR group (P < 0.05). The incidence of postoperative complications in the PR group (12.8%) was lower than that in the STA group (27.8%) (P = 0.026), of which the incidence of wound complications was 3.8% in the PR group and 13.9% in the STA group (P = 0.041). In addition, there was no significant difference in other postoperative complications such as sural nerve injury, peroneus longus and brevis muscle injury, calcaneal valgus symptoms, lateral impingement symptoms, and subtalar arthritis (P > 0.05). Conclusion From the 8–10‐year follow‐up results of PR and STA as surgical procedures for the treatment of DIACF, it was found that there was no significant difference in the overall efficacy between them. STA was found to be superior to the PR in terms of the recovery of calcaneal width, providing more stable fixation for Sanders III fractures. PR was found to be more effective in reducing wound complications.

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“…To lower wound complications, the application of minimally invasive technology has been developed. Over the past several years, external fixation, percutaneous fixation, arthroscopically assisted fixation and minimal incision techniques via medial, lateral, posterior or combined approaches were described in the literature . These techniques all attempt to minimize soft tissue trauma to reduce the risk of operative complications, while still allowing good fracture reduction.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis of two surgical approaches for calcaneal fractures: sinus tarsi versus extensile lateral approach

Zhang

Tian

et al. 2017

ANZ Journal of Surgery

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Percutaneous Fixation of Intraarticular Calcaneus Fractures

Cited by 14 publications

References 33 publications

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Comparison between Percutaneous Screw Fixation and Plate Fixation via Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Meta‐analysis of two surgical approaches for calcaneal fractures: sinus tarsi versus extensile lateral approach

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