Functional and radiological outcomes of Essex-Lopresti procedure in intra-articular calcaneal fractures: a prospective study

Authors

  • Varshant Pareek Department of Orthopaedics, S.M.S. Medical College and Hospital, Jaipur, Rajasthan, India
  • Ananya Mishra Department of Orthopaedics, S.M.S. Medical College and Hospital, Jaipur, Rajasthan, India
  • Mohit Yadav Department of Orthopaedics, S.M.S. Medical College and Hospital, Jaipur, Rajasthan, India
  • Kartik Yadav
  • Deepak Khandelwal Department of Orthopaedics, S.M.S. Medical College and Hospital, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252634

Keywords:

Calcaneal fractures, Essex-lopresti procedure, Bohler’s angle, Minimally invasive surgery

Abstract

Background: Calcaneal fractures are among the most common tarsal bone injuries, often leading to significant morbidity. The Essex-Lopresti procedure is a minimally invasive surgical technique used to treat intra-articular fractures of the calcaneum. Objective of the study was to evaluate the functional and radiological outcomes of the Essex-Lopresti procedure in patients with intra-articular calcaneal fractures and assess post-operative pain relief and complication rates.

Methods: A hospital-based prospective study was conducted at tertiary care centre, Jaipur, on 85 patients. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, while radiological outcomes were evaluated using Bohler’s angle.

Results: The mean preoperative Bohler’s angle (15.19°) improved to 29.55° postoperatively and stabilized at 27.38° at the 6-month follow-up. The AOFAS score improved significantly from 47.56 preoperatively to 87.38 at 6 months. The mean Visual Analog Scale (VAS) score decreased from 7.53 preoperatively to 0.54 postoperatively, indicating significant pain relief.

Conclusions: The Essex-Lopresti procedure is an effective treatment for intra-articular calcaneal fractures, achieving favorable functional and radiological outcomes with minimal complications.

Metrics

Metrics Loading ...

References

Sanders R, Gregory P. Calcaneal fractures: an update. Clin Orthop Relat Res. 1995;(290):68-75.

Rammelt S, Zwipp H. Calcaneus fractures: facts, controversies and recent developments. Injury. 2004 May;35(5):443-61.

Eastwood DM, Langkamer VG, Atkins RM. Intra-articular fractures of the calcaneum. Part I: Pathological anatomy and classification. J Bone Joint Surg Br. 1993;75(2):183-18. DOI: https://doi.org/10.1302/0301-620X.75B2.8444934

Griffin D, Parsons N, Shaw E. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial. BMJ. 2014;349:g4483.

Adams MR, Koury KL, Mistry JB, Braaksma W, Hwang JS, Firoozabadi R. Plantar Medial Avulsion Fragment Associated With Tongue-Type Calcaneus Fractures. Foot Ankle Int. 2019;40(6):634-40. DOI: https://doi.org/10.1177/1071100719830948

Buckley R, Tough S, McCormack R. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84(10):1733-44.

Kinner BJ, Best R, Falk K. Management of intra-articular calcaneal fractures: results of a survey in Germany. J Orthop Trauma. 2002;16(3):156-62.

Meek RM, Shah K, Norris SH. Functional outcome following surgical reconstruction of intra-articular calcaneal fractures. Acta Orthop Belg. 2004;70(6):591-8.

Sanders R, Fortin P, DiPasquale T. Operative treatment in 120 displaced intra-articular calcaneal fractures: results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;(290):87-95. DOI: https://doi.org/10.1097/00003086-199305000-00012

Meena S, Barwar N, Sharma V, Kumar V, Sharma P, Gangary SK. Functional outcome of intra-articular calcaneum fractures managed with Essex-Lopresti technique and percutaneous screw fixation. J Clin Orthop Trauma. 2018;9(Suppl 1):S61–S65.

Kharat S, Daveshwar R, Lokhande V. Radiological and functional outcomes of calcaneal fractures using the Essex-Lopresti technique of reduction. Int J Orthop Sci. 2017;3(2):603–8. DOI: https://doi.org/10.13107/ti.2017.v03i02.052

Philip KC, Girishkumar TS. Functional outcome of intra-articular calcaneum fractures managed with closed reduction by Essex-Lopresti technique and percutaneous screw fixation. J Evid Based Med Healthc. 2019;6(10):775-8.

Mantri RK, Mishra R, Chauhan M. Outcome of Essex Lopresti manoeuvre for the management of tongue type intra-articular calcaneal fractures: A prospective study. Int J Orthop Sci. 2021;7(2):13-7.

Shih HN, Hsieh PH, Huang KC. Modified Essex-Lopresti procedure and percutaneous calcaneoplasty for comminuted intra-articular calcaneal fractures. Foot Ankle Surg. 2018;24(4):287–93. DOI: https://doi.org/10.1186/s12891-018-1995-9

Buckley R, Tough S, McCormack R. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: A prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84(10):1733-44. DOI: https://doi.org/10.2106/00004623-200210000-00001

Griffin D, Parsons N, Shaw E. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: Randomised controlled trial. BMJ. 2014;349:g4483. DOI: https://doi.org/10.1136/bmj.g4483

Rammelt S, Zwipp H. Calcaneus fractures: Facts, controversies and recent developments. Injury. 2004;35(5):443-61. DOI: https://doi.org/10.1016/j.injury.2003.10.006

de Vroome SW, van der Linden HJ. The 3-point distraction technique for percutaneous treatment of displaced intra-articular calcaneal fractures: Clinical results. J Foot Ankle Surg. 2013;52(6):710-5.

Downloads

Published

2025-08-25

How to Cite

Pareek, V., Mishra, A., Yadav, M., Yadav, K., & Khandelwal, D. (2025). Functional and radiological outcomes of Essex-Lopresti procedure in intra-articular calcaneal fractures: a prospective study . International Journal of Research in Orthopaedics, 11(5), 1116–1120. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252634

Issue

Section

Original Research Articles