Reduction and functional outcome of open reduction plate fixation versus minimally invasive reduction with percutaneous screw fixation for displaced calcaneus fracture: a retrospective study

Abstract

Background Minimally invasive surgery has become popular because of the lower incidence of wound complications. However, achieving an anatomic reduction that provides a satisfactory outcome is difficult using minimally invasive surgery. Our study aimed to evaluate the reduction and clinical outcomes of closed reduction and percutaneous fixation treatment using a closed reduction traction device for displaced intra-articular calcaneal fractures compared with traditional open reduction plate fixation using an extended lateral approach. Methods A total of 40 patients and 45 feet with calcaneus fractures from 2012 to 2016 were studied. The open reduction plate fixation group (24 feet) was compared to the closed reduction percutaneous fixation group (21 feet) with a traction device. The reduction assessments included length, width, height, Bohler’s angle, Gissane’s angle, and varus or valgus angle before and after surgery. The clinical outcomes included the American Orthopaedic Foot and Ankle Society hindfoot score and the visual analog score for pain, length of stay, and complication rate. Results The patients were followed up for an average of 16.53 ± 3.95 months. No significant differences in reduction were observed between the open and closed groups ( P > 0.05). The American Orthopaedic Foot and Ankle Society scores of the two groups were 80.29 ± 6.15 and 83.62 ± 6.95 (open versus closed) ( P = 0.0957). The visual analog scores of the open and closed groups were 1.50 ± 1.22 and 0.81 ± 0.87 ( P = 0.0364). The lengths of stay in the open and closed groups were 9.63 ± 2.72 days and 6.71 ± 1.85 days ( P = 0.0002). The complication rates of the open and closed groups were 20.8% (5/24) and 4.8% (1/21) ( P < 0.0001). Conclusions The closed reduction percutaneous fixation with traction device method may provide equivalent reduction results and superior outcomes for the length of stay, VAS score, and complication rate for displaced intra-articular calcaneal fractures.

Outcomes of intra-articular calcaneal fractures: surgical treatment of 114 consecutive cases at a maximum care trauma center

“…Complication rates are known to be high ranging from 17.3 to 29% in the literature [ 24 , 27 ]. Recent studies show lower complication rates with minimally invasive techniques compared to open reduction and internal fixation over an extensile lateral approach (4.8% vs. 20.8%) [ 28 ]. In our study, we found an overall complication rate of 29%.…”

Оптимизация Репаративной Регенерации При Переломах Пяточной Кости Обогащенной Тромбоцитами Аутологичной Плазмой

“…Автори [17] зробили аналіз лікування 40 пацієнтів (45 стоп) із переломами п'яткової кістки (2012-2016 рр.). Групу фіксації відкритої репозиції за допомогою пластини (24 стопи) порівнювали з групою закритої репозиції та черезшкірної фіксації (21 стопа) за допомогою тягового пристрою.…”

Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

“…Many doctors prefer to use minimally invasive surgery to treat freshly closed calcaneal fracture [1,2]. In this procedure, the surgeon often performs closed reduction of the fracture or open reduction with a small incision, in conjunction with percutaneous fixation [3]. This has many advantages compared to open reduction internal fixation (ORIF) [4,5] including fewer incision-related complications [6], shorter duration of limb swelling [7], shorter recovery time [8], and lower rate of fixation failure [9].…”