Surgical Treatment of Calcaneal Fracture Malunions and Posttraumatic Deformities

Stapleton, John J.; Belczyk, Ronald; Zgonis, Thomas

doi:10.1016/j.cpm.2008.10.003

Cited by 30 publications

(12 citation statements)

References 12 publications

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“…However, the true position of the calcaneal tuberosity may be masked in the presence of hindfoot oedema or heel widening as it may appear rectus but actually remains in varus when evaluated radiographically. 12 Moreover, care should be taken when dealing with hindfoot varus caused by forefoot deformity, and Coleman block test can distinguish them. 13 Changes in alignment may be more apparent on walking, and gait analysis should also be also performed.…”

Section: Clinical and Radiographic Evaluationmentioning

confidence: 99%

Surgical Management of Calcaneal Malunion

2013

Journal of Orthopaedics, Trauma and Rehabilitation

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Calcaneal malunion is a common complication after conservative treatment or incorrect surgical treatment of calcaneal fracture. The typical pathoanatomies of calcaneal malunion are subtalar joint incongruity, loss of calcaneal height, arch collapse, varus or valgus deformity of the calcaneus, heel widening and so on. Calcaneal malunion often needs to be treated surgically. The classification of calcaneal malunion and the detailed clinical and radiographical assessment play important roles for surgical option. The main surgical methods include in situ subtalar arthrodesis, reconstruction of calcaneal thalamus and subtalar arthrodesis, calcaneal osteotomy with subtalar arthrodesis, corrective calcaneal osteotomy without subtalar arthrodesis. Each option has its different indications, advantages and disadvantages. Thus, the surgical treatment should be individualised.

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Section: Clinical and Radiographic Evaluationmentioning

confidence: 99%

Surgical Management of Calcaneal Malunion

2013

Journal of Orthopaedics, Trauma and Rehabilitation

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“…1,2 The pathoanatomy of calcaneal malunion, although variable, has things in common, including an incongruous posterior calcaneal facet causing arthritis of the subtalar joint, a decreased calcaneal height that flattens the talar inclination angle, a diminished lever arm of the Achilles tendon reducing the push-off power in the gait cycle, and a more dorsiflexed talus that may result in painful anterior impingement of the talar neck on the tibial plafond. 12 Heel widening is due to the lateral wall exostosis resulting from the union of the lateral wall blowout, which can cause calcaneofibular impingement and peroneal tendinosis. Calcaneal varus malalignment is the most commonly encountered deformity, which also alters the foot biomechanics.…”

Section: Introductionmentioning

confidence: 99%

“…Calcaneal varus malalignment is the most commonly encountered deformity, which also alters the foot biomechanics. 1,12…”

Section: Introductionmentioning

confidence: 99%

“…Calcaneal varus malalignment is the most commonly encountered deformity, which also alters the foot biomechanics. 1,12 The aim of this study was to evaluate pain, function, and gait after a salvage procedure consisting of combined subtalar joint fusion, calcaneal osteotomy, and lateral wall exostectomy for patients with neglected or late presented calcaneal fractures with malunion type 3 according to Stephens and Sanders classification type 3 or 4. 11…”

Section: Introductionmentioning

confidence: 99%

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Effect of Subtalar Fusion and Calcaneal Osteotomy on Function, Pain, and Gait Mechanics for Calcaneal Malunion

et al. 2019

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Background: Calcaneal malunion is a common complication of nonoperative management of calcaneal fracture, which leads to a disruption of the biomechanics of the lower extremity, pain, and permanent disability. Our aim was to evaluate pain, function, and gait after combined subtalar joint fusion, calcaneal osteotomy, and lateral wall exostectomy for patients with neglected calcaneal fractures with malunion. Methods: Eighteen patients with malunited calcaneal fractures, varus deformity, and subtalar arthritis were operated upon and then followed up for 18 months. All cases were assessed clinically using the American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS); radiologically by measuring the talar inclination, talocalcaneal and talus-first metatarsal angles, and talocalcaneal height; and biomechanically by measuring the stride duration, step width, comfortable speed, and ground reaction forces in relation to the body weight. Results: A significant improvement in AOFAS (59.8 preoperatively to 80.2 after 18 months) and VAS (61.1 preoperatively to 29.4) was found. Also, our study revealed a significant improvement in the radiographic measurements including the valgus angle, the talocalcaneal angle, the talocalcaneal height, and the talar inclination angle. The gait analysis found that the maximum loading force in the push-off phase and comfortable speed yielded a significant improvement postoperatively. However, no significant differences between the preoperative data and the final follow-up in terms of the step width, stride duration, maximum peak force during loading phase, and minimum peak force during midstance phase were found. Conclusion: The combination of valgus calcaneal osteotomy, lateral wall exostectomy, and subtalar fusion resulted in pain reduction, improved function, and better gait. However, the limited bone stock for the graft used in the subtalar fusion made use of this technique in severely reduced height unadvisable. Level of Evidence: Level IV, case series.

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“…[6][7][8][9] On reviewing the literature for the treatment of symptomatic, malunited calcaneal fractures, the general consensus suggests that resection of impinging bone with isolated subtalar arthrodesis for subtalar joint arthritis yields the best long term results. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Moreover, some surgeons also do endoscopic calcaneal ostectomies for calcaneofibular impingement with good results. 15 We present a case of mismanaged, malunited calcaneal fracture in a young male laborer who had an unusual and rare complication of large exostosis on plantar surface of the middle portion of the calcaneus, which to our knowledge has not been reported.…”

mentioning

confidence: 99%

Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication

Sultan¹,

Dar²,

Wani³

et al. 2010

FAOJ

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On reviewing the literature for the treatment of symptomatic, malunited calcaneal fractures, the general consensus suggests that resection of impinging bone with isolated subtalar arthrodesis for subtalar joint arthritis yields the best long term results. 10-23Moreover, some surgeons also do endoscopic calcaneal ostectomies for calcaneofibular impingement with good results. 15 We present a case of mismanaged, malunited calcaneal fracture in a young male laborer who had an unusual and rare complication of large exostosis on plantar surface of the middle portion of the calcaneus, which to our knowledge has not been reported. The patient presented with bony swelling on the sole of the foot with a painful limp and was managed operatively by excision of the exostosis with subtalar arthrodesis. The patient was symptom free after a 2 year follow-up.

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Surgical Treatment of Calcaneal Fracture Malunions and Posttraumatic Deformities

Cited by 30 publications

References 12 publications

Surgical Management of Calcaneal Malunion

Surgical Management of Calcaneal Malunion

Effect of Subtalar Fusion and Calcaneal Osteotomy on Function, Pain, and Gait Mechanics for Calcaneal Malunion

Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication

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