Subtalar Arthroscopy and Flurosocopy in Percutaneous Fixation of Intra-Articular Calcaneal Fractures: The Best of Both Worlds

Woon, Colin Yi-Loong; Chong, K.W.; Yeo, William; Yeo, Nicholas Eng Meng; Wong, Michael

doi:10.1097/ta.0b013e318202f1d0

Cited by 59 publications

(59 citation statements)

References 31 publications

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“…Although the predictive value of Böhler's angle on outcome remains a subject of debate, the initial angle at the time of trauma still guides treatment [5,6]. There is a considerable amount of literature on the change of Böhler's angle following surgically treated displaced intra-articular calcaneal fractures throughout the followup (Table 1) [7][8][9][10][11][12][13][14][15][16][17]. Data on Böhler's angle in conservatively-treated fractures, however, are limited.…”

Section: Introductionmentioning

confidence: 99%

The fate of Böhler’s angle in conservatively-treated displaced intra-articular calcaneal fractures

Bakker

Halm

Lieshout

et al. 2012

International Orthopaedics (SICOT)

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Purpose Although the predictive value of Böhler's angle on outcome remains subject of debate, the initial angle at the time of trauma still guides treatment. Changes in Böhler's angle during follow-up are frequently reported following surgical treatment of displaced intra-articular calcaneal fractures (DIACF). The aim of the present study was to determine the changes in Böhler's angle as a measure of secondary fracture displacement following conservative management of DIACF. Methods Thirty-eight patients with a total of 44 displaced intra-articular calcaneal fractures treated conservatively with a minimum of two lateral radiographs during follow-up were analysed. Böhler's angle at different follow-up times was measured by three observers. The change in angle was compared with the angle at trauma, and influence of trauma mechanism and common calcaneal fracture classifications were determined. Results The results showed a significant decline over time of the Böhler's angle in conservatively-treated patients of more than 11°on average at a mean follow-up of 29.2 weeks. This decrease was not related to gender, the initial angle, or the Essex-Lopresti or Sanders classification. A statistically significantly higher decrease was detected in high energetic trauma compared with low energetic trauma. Conclusion The conservative treatment of displaced intraarticular calcaneal fractures is still a viable option, yet a significant secondary displacement in time should be taken into account, as reflected in a decrease of Böhler's angle of 11°up to one year following trauma.

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Section: Introductionmentioning

confidence: 99%

The fate of Böhler’s angle in conservatively-treated displaced intra-articular calcaneal fractures

Bakker

Halm

Lieshout

et al. 2012

International Orthopaedics (SICOT)

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“…Infection and wound complication rates for MIPO range from 0 to 11% [13,16,27,31,33]. MIPO results in a better subtalar range of motion [26,30].…”

Section: Introductionmentioning

confidence: 98%

“…In some specialized trauma or foot and ankle centers, the current trend is towards surgical management [5,[13][14][15][16]. However, recent publications have shown that conservative management outcomes mirror surgical management [17,18].…”

Section: Introductionmentioning

confidence: 99%

Is arthroscopic assisted percutaneous screw fixation as good as open reduction and internal fixation for the treatment of displaced intra-articular calcaneal fractures?

Yeap¹,

Rao²,

Pan

et al. 2016

Foot and Ankle Surgery

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“…Images and surgical technique described in this section are adapted from our original article by Woon et al 9 Patients are positioned in the lateral decubitus position on the uninjured side. The suggested positioning of the image intensifier, arthroscopy equipment and personnel is shown in Figure 4 to facilitate the use of fluoroscopy and arthroscopy in our technique.…”

Section: Surgical Techniquementioning

confidence: 99%

“…9 The objective of this retrospective study is to evaluate long-term outcomes of the use of dual-modality imaging using similar evaluation parameters.…”

Section: Introductionmentioning

confidence: 99%

Subtalar arthroscopy and fluoroscopy in percutaneous fixation of intra-articular calcaneal fractures

Law

Yeo

et al. 2017

J Orthop Surg (Hong Kong)

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Introduction: Percutaneous fixation of intra-articular calcaneal fractures is traditionally assisted only by intraoperative fluoroscopy. Previous studies have demonstrated that the additional use of subtalar arthroscopy in anatomical reduction of the posterior calcaneal facet of the subtalar joint for less complex calcaneal fractures yielded positive results up to 2-year follow-up. This study aims to investigate long-term outcomes of these patients using similar evaluation parameters. We hypothesized that this novel technique with dual-imaging can provide sustainable, long-term benefits with good functional outcomes and significant restoration of the Bohler's angle. Methods: We performed a retrospective study of 15 Sanders II, AO-OTA 83-C2 intra-articular calcaneal fractures in 14 patients who underwent subtalar arthroscopy and fluoroscopy guided percutaneous fracture fixation with a minimum follow-up of 5 years. Outcome measures were assessed using the ankle and hindfoot NPRS, AOFAS ankle-hindfoot score, and SF-36 Physical Function subscale preoperatively and at 3 months, 6 months, 1 year, 2 years and 5-8 years postoperatively. The Bohler's angle was measured preoperatively, immediately postoperatively and at 5-8 years postoperatively. Results: We report excellent functional outcomes in all scores as well as continued improvements in the majority of patients across all time points with minimal subsidence of the corrected Bohler's angle over our study time frame. Conclusion: Subtalar arthroscopy with intraoperative fluoroscopy in anatomical reduction of the posterior calcaneal facet of the subtalar joint is most useful in Sanders type II, AO-OTA 83-C2 fractures with excellent functional outcomes and good preservation of the corrected Bohler's angle on long-term follow-up.

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Subtalar Arthroscopy and Flurosocopy in Percutaneous Fixation of Intra-Articular Calcaneal Fractures: The Best of Both Worlds

Cited by 59 publications

References 31 publications

The fate of Böhler’s angle in conservatively-treated displaced intra-articular calcaneal fractures

The fate of Böhler’s angle in conservatively-treated displaced intra-articular calcaneal fractures

Is arthroscopic assisted percutaneous screw fixation as good as open reduction and internal fixation for the treatment of displaced intra-articular calcaneal fractures?

Subtalar arthroscopy and fluoroscopy in percutaneous fixation of intra-articular calcaneal fractures

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