Short-Term Outcomes of Open Reduction and Internal Fixation for Sanders Type III Calcaneal Fractures With and Without Bone Grafts

Abstract

Calcaneal fractures, often caused by a fall from a height, are the most common injuries encountered by orthopedic surgeons. Currently, open anatomic reduction and internal fixation (ORIF) is considered a valuable treatment of displaced intraarticular fractures of the calcaneus; however, the need for bone grafting in the treatment is still controversial. Therefore, in the present study, we investigated the outcomes of 2 methods (with and without bone grafting) used for the surgical treatment of Sanders type III calcaneal fractures. From January 2013 to September 2015, 57 cases (55 patients) with displaced Sanders type III calcaneal fractures (53 unilateral and 2 bilateral) were enrolled. The patients were divided into 2 groups: group I was treated by ORIF with bone grafting (n = 28) and group II was treated by ORIF without bone grafting (n = 29). The radiologic evaluation included Böhler's angle, Gissane's angle, and the height and width of the calcaneum. In addition, the American Orthopaedic Foot and Ankle Society questionnaires and visual analog scale were completed by the patients. During the follow-up period, no differences were found in the outcome measures (Böhler's angle, p = .447; Gissane's angle, p = .599; calcaneal height, p = .065; calcaneal width p = .077; and American Orthopaedic Foot and Ankle Society questionnaires, p = .282) with or without bone grafting. The only difference between the 2 groups was the occurrence of postoperative pain (p = .024 and p = ≤ .05), which was greater in the patients who had undergone bone grafting. We have provided evidence that bone grafting with internal fixation in the treatment of intraarticular calcaneal fractures failed to improve the restoration of Böhler's angle or Gissane's angle. No statistically significant difference was found in the short-term outcomes between the 2 methods used for the surgical treatment of Sanders type III calcaneal fractures.

Lateral bone flap approach for displaced intra‐articular calcaneus fractures

“…Rate of complications for the ELA ranged from 3.5% to 31.2% and from 5% to 8.49% for the STA . Complication rate of 3.5% in 57 Sanders type III calcaneal fractures treated with ELA was reported by Cao et al George et al even reported that they had never encountered any wound dehiscence, or wound infection during an 18‐year period using a minimally invasive approach for ORIF for DIACFs . This study showed that smoking (39.7%) had no adverse effect on wound healing, which may contribute to forbidden smoking during perioperative time until wound completely healed up.…”

“…Reported complications rate related to calcaneus varied quite widely according to literature. Rate of complications for the ELA ranged from 3.5% to 31.2% and from 5% to 8.49% for the STA . Complication rate of 3.5% in 57 Sanders type III calcaneal fractures treated with ELA was reported by Cao et al George et al even reported that they had never encountered any wound dehiscence, or wound infection during an 18‐year period using a minimally invasive approach for ORIF for DIACFs .…”

“…The ELA is the gold standard of operative approach for calcaneus fractures and is applied for any type of Sanders fracture. However, the rate of complications, including infection, dehiscence and skin necrosis was high and was reported to range from 13.3% to 31.2% …”

Rückfußverletzungen – Frakturen von Kalkaneus, Talus und peritalare Luxationen

“…Der therapeutische Nutzen wird jedoch in der aktuellen Literatur kontrovers beurteilt. Während einige Autoren keine Vorteile nachweisen konnten [10,11], werden in anderen Studien ein überlegenes radiologisches Ergebnis [12] oder eine frühere Belastbarkeit beschrieben [13]. [19].…”

Comminuted calcaneal fracture with avulsion of Achilles insertion treated with the use of intramedullary nailing in the modified original method

“…The use of allogeneic bone grafts during the open reposition of fracture and internal fixation is controversial [18], while the use of preventively increased oxygen pressure to improve wound healing after operative treatment of the calcaneal fracture also produces promising outcomes [19].…”