Management of fracture calcaneum by reconstruction locking plate
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20180440Keywords:
Calcaneum, Fractures, Reconstruction locking plate, ManagementAbstract
Background: There is a considerable amount of literature on calcaneal fractures and their treatment; however the best management approach has yet to be determined. The results of ORIF and conservative treatment have been described and compared in several studies.These studies show improved outcome after operative management.
Methods: This is a study of 30 patients with ages ranged from 18 to 65 years with displaced intraarticular fractures of the calcaneus treated by open reduction and internal fixation. 4 patients had bilateral fractures. Out of 34 fractures in 30 patients, 22 fracture calcaneum were joint depression type and 12 fractures were tongue type.
Results: In 17 cases normal Bohler angle (i. e. 200-400) was achieved. There were 3 cases of post operative delayed wound healing, 2 cases of superficial wound infection and 1 case of sural nerve complication in the form of loss of sensation on lateral aspect of foot. According to American Orthopaedic Foot And Ankle Society (AOFAS) score, 13.33% of the patients had excellent results, 63.33% had good results, 13.33% had fair result and 10% had poor results.
Conclusions: Operative fixation of displaced intra-articular fractures of the calcaneus by reconstruction locking plate, restores the calcaneal height, allows early mobilization and weight-bearing, and maximizes the chances for good joint function.
Metrics
References
Nicklebur S, Dixon TB, Probe R. Calcaneus fractures. EMedicine, 2004.
Sanders R. Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 2000;82:225-50.
Barei DP, Bellabarba C, Sangeorzan BJ, Benirschke SK. Fractures of the calcaneus. Orthop Clin North Am. 2002;33(1):263-85.
Pozo JL, Kirwan EO, Jackson AM. The long-term results of conservative management of severely displaced fractures of the calcaneus. J Bone Joint Surg Br. 1984;66:386-90.
Brauer CA, Manns BJ, Ko M, Donaldson C, Buckley R. An economic evaluation of operative compared with nonoperative management of displaced intra-articular calcaneal fractures. J Bone Joint Surg Am. 2005;87:2741-9.
Essex-Lopresti P: Mechanism, reduction technique and results in fractures of oscalcis. Br J Surg. 1952;39:395- 419.
Assous M, Bhamra MS. Should Os calcis fractures in smokers be fi xed? A review of 40 patients. Injury. 2001;32:631-2.
Murnaghan ML, Buckley RE. Lost but not forgotten: patients lost to follow-up in a trauma database. Can J Surg. 2002;45:191-5.
Hedlund LJ, Maki DD, Griffiths HJ. Calcaneal fractures in diabetic patients. J Diabetes Complications. 1998;12:81-7.
Heier KA, Infante AF, Walling AK, Sanders RW. Open fractures of the calcaneus: soft tissue injury determines outcome. J Bone Joint Surg Am. 2003;85-A:2276-82.
Eastwood DM, Atkins RM. Lateral approaches to the heel. Foot. 1992;2:143-7.
Freeman BJ, Duff S, Allen PE, Nicholson HD, Atkins RM. The extended lateral approach to the hindfoot. Anatomical basis and surgical implications. J Bone Joint Surg Br. 1998;80:139-42.
Hussain T, Al-Mutairi H, Al-Zamel S, Al-Tunaiba W. Modified obtuse-angled lateral exposure of the calcaneum. Foot and Ankle Surg. 2004;10:145-8.
Borrelli J, Jr., Lashgari C: Vascularity of the lateral calcaneal fl ap: a cadaveric injection study. J Orthop Trauma. 1999;13:73-7.
Johnson EE: Intraarticular fractures of the calcaneus: diagnosis and surgical management. Orthopedics. 1990;13:1091-100.
Burdeaux BD, Jr. The medial approach for calcaneal fractures. Clin Orthop. 1993;290:96-107.
Burdeaux BD, Jr. Fractures of the calcaneus: open reduction and internal fi xation from the medial side a 21-year prospective study. Foot Ankle Int 1997;18:685-92.
Poigenfurst: The dorsoplantar approach to the calcaneus. Oper Orthop Traumatol. 1991;199:254-64.
Stephenson JR: Surgical treatment of displaced intraarticular fractures of the calcaneus. A combined lateral and medial approach. Clin Orthop. 1993;290:68-75.
Stephenson JR. Treatment of displaced intra-articular fractures of the calcaneus using medial and lateral approaches, internal fi xation, and early motion. J Bone Joint Surg Am. 1987;69:115-130.
Johnson EE, Gebhardt JS. Surgical management of calcaneal fractures using bilateral incisions and minimal internal fi xation. Clin Orthop 1993;290:117-24.
Park IH, Song KW, Shin SI, Lee JY, Kim TG, Park RS. Displaced intra-articular calcaneal fracture treated surgically with limited posterior incision. Foot Ankle Int. 2000;21:195-205.
Ebraheim NA, Elgafy H, Sabry FF, Freih M, Abou-Chakra IS. Sinus tarsi approach with trans-articular fi xation for displaced intraarticular fractures of the calcaneus. Foot Ankle Int. 2000;21:105-13.
Holmes G. Treatment of displaced calcaneal fractures using a small sinus tarsi approach. Techniques in Foot and Ankle Surg. 2005;4:35-41.
Carr JB. Surgical treatment of intra-articular calcaneal fractures: a review of small incision approaches. J Orthop Trauma. 2005;19:109-17.
Abidi NA, Dhawan S, Gruen GS, Vogt MT, Conti SF. Wound-healing risk factors after open reduction and internal fi xation of calcaneal fractures. Foot Ankle Int. 1998;19:856-61.
Lim EV, Leung JP. Complications of intraarticular calcaneal fractures. Clin Orthop. 2001;391:7-16.
Bohler L. Diagnosis, pathology and treatment of fractures of the os calcis. J Bone Joint Surg. 1931;13:75-89.
Thermann H, Tscherne H. Therapy for intraarticular calcaneal fractures. Unfallchirurg 1999;102:151.
Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, et al. Operative compared with nonoperative treatment of displaced intraarticular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84-A:1733-44.
Bridgman SA, Dunn KM, McBride DJ, Richards PJ. Interventions for treating calcaneal fractures. Cochrane Database Syst Rev. 2000:CD001161.
Bajammal S, Tornetta P, 3rd, Sanders D. Displaced intra-articular calcaneal fractures. J Orthop Trauma. 2005;19:360-364.
Pillai A, Basappa P, Ehrendorfer S. Modified Essex-Lopresti / Westheus reduction for displaced intra-articular fractures of the calcaneus; Acta Orthopædica Belgica. 2007;73(1):83-7.
Guzman C, Hospodar P, DiPreta J, Johnson P. Displaced Intra-articular Calcaneal Fractures Comparison of Two Different Surgical Techniques. Albany Medical College Orthopaedic J; 2009.
Singh A, Srivastava RN, Jah M, Kumar A. Ligamentotaxis for complex calcaneal fractures using Joshi’s external stabilization system; IJO. 2008;42(3).
Steven Y. Wei, Enyi Okereke, Adil N. Esmail, Christopher T. Born, And William G. Delong; Operatively Treated Calcaneus Fractures: To mobilize or Not to Mobilize ; The University of Pennsylvania Orthop J. 2001;14:71–3.
Koski A, Kuokkanen H, Tukiainen E. Post-operative wound complication after internal fixation closed calcaneal fracture. Scandinavian J Surg. 2005;94:243–5.
Harvey EJ, Grujic L, Early JS, Benirschke SK, Sangeorzan BJ. Morbidity Associated with ORlF of Intra-Articular Calcaneus Fractures Using a Lateral Approach. Foot Ankle Int. 2001;22(11):868-73.
Rak V, Ira D, Masek M. Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications; IJO. 2009;43(3).
Jiang SD, Jiang LS, Dai LY. Surgical Treatment of Calcaneal Fractures with Use of β-Tricalcium Phosphate Ceramic Grafting. Foot Ankle Int. 2008;29(10):1015-9.