Fractures of the Calcaneus- An Illustrated Review

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Vol 9 | Issue 1 | January-June 2023 | page: 05-17 | Balvinder Rana, Anand Pillai

DOI: https://doi.org/10.13107/ti.2023.v09.i01.032

Authors: Balvinder Rana [1], Anand Pillai [2]

[1] Department of Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University Foundation Trust, Manchester, UK.

[2] Department of Trauma and Orthopaedics, Foot & Ankle Division, Wythenshawe Hospital, Manchester University Foundation Trust, Manchester, UK.

Address of Correspondence

Dr. Balvinder Rana,

Speciality Doctor, Department of Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University Foundation Trust, Manchester, UK.

Email: anklefootsurgery@gmail.com

Abstract

Calcaneal fractures are rare injuries accounting for less than 2% of all fractures. There is considerable published literature on calcaneal fractures, but the optimum management has still not been defined clearly because of different fracture patterns, patient characteristics affecting outcome, soft tissue complications associated with surgical treatment and complex anatomy of the calcaneus making accurate surgical reconstruction difficult. New techniques such as minimally invasive surgery (MIS) have shown promise. In this illustrated pictorial review, we summarise the surgical anatomy, pathophysiology, treatment strategies including tips and tricks on surgical management and discuss the current literature for this complex injury.

Keywords: Calcaneus, fracture, calcaneal anatomy, calcaneal fracture management, outcome of calcaneal fracture, classification

References

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13. Paul M, Peter R, Hoffmeyer P. Fractures of the calcaneum. A review of 70 patients. J Bone Jt Surg – Ser B 2004;86:1142–5. https://doi.org/10.1302/0301-620X.86B8.15219

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15. Griffin D, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, et al. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: Randomised controlled trial. BMJ 2014;349:g4483–g4483. https://doi.org/10.1136/bmj.g4483

16. Luo X, Li Q, He S, He S. Operative Versus Nonoperative Treatment for Displaced Intra-Articular Calcaneal Fractures: A Meta-Analysis of Randomized Controlled Trials. J Foot Ankle Surg 2016;55:821–8. https://doi.org/10.1053/j.jfas.2016.01.035.

17. Chen L, Zhang G, Hong J, Lu X, Yuan W. Comparison of Percutaneous Screw Fixation and Calcium Sulfate Cement Grafting Versus Open Treatment of Displaced Intra-Articular Calcaneal Fractures. Foot & Ankle International. 2011;32(10):979-985. doi:10.3113/FAI.2011.0979

18. Stulík, Jiri & Stulik, Jan & Rysavy, Martin & Wozniak, A. (2007). Minimally-invasive treatment of intra-articular fractures of the calcaneum. The Journal of bone and joint surgery. British volume. 88. 1634-41. 10.1302/0301-620X.88B12.17379

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26. Carr JB. Early wound complications of operative treatment of calcaneus fractures: Analysis of 190 fractures. J Orthop Trauma 1999;13:372. https://doi.org/10.1097/00005131-199906000-00009.

27. Schuberth JM, Cobb MD, Talarico RH. Minimally Invasive Arthroscopic-Assisted Reduction with Percutaneous Fixation in the Management of Intra-Articular Calcaneal Fractures: A Review of 24 Cases. J Foot Ankle Surg 2009;48:315–22. https://doi.org/10.1053/j.jfas.2009.01.002.

28. Hoppenfeld S, DeBoer P, Buckley R. Surgical Exposures in Orthopaedics; The Anatomic Approach. Ch. 12, The ankle and foot. Lippincott Williams & Wilkins. 2009

29. Borrelli J Jr, Lashgari C. Vascularity of the lateral calcaneal flap: a cadaveric injection study. J Orthop Trauma. 1999 Feb; 13(2):73-7.

30. Sirisreetreerux N et al. Location of the vertical limb of Extensile Lateral Calcaneal approach and risk of injury of the calcaneal branch of peroneal artery. Foot Ankle Int. 2019 Feb: 40(2); 224-230.

31. John Y. Kwon, MD et. al. Proximity of the Lateral Calcaneal Artery With a Modified Extensile Lateral Approach Compared to Standard Extensile Approach. Foot & Ankle Int.2016; 38 (3):318-323.

32. Pitts CC, Almaguer A, Wilson JT, Quade JH, Johnson MD. Radiographic and Postoperative Outcomes of Plate Versus Screw Constructs in Open Reduction and Internal Fixation of Calcaneus Fractures via the Sinus Tarsi. Foot Ankle Int. 2019 Aug;40(8):929-935. doi: 10.1177/1071100719848063. Epub 2019 May 14. PMID: 31088171.

How to Cite this article: Rana B, Pillai A | Fractures of the Calcaneus- An Illustrated Review | January-June 2023; 9(1): 05-17 | https://doi.org/10.13107/ti.2023.v09.i01.32

 

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Our Experience about Two Cases of Surgical Management of Bilateral Clavicle Fractures

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Vol 9 | Issue 1 | January-June 2023 | page: 23-25 | Magoire Dingamnodji, Valentin Andjeffa, Daniel Adendingue, Kotiyade Ngamai, Fandebnet Siniki, Naobe Emery, Sayouba Tinto

DOI: https://doi.org/10.13107/ti.2023.v09.i01.031

Authors: Magoire Dingamnodji [1], Valentin Andjeffa [2], Daniel Adendingue [2], Kotiyade Ngamai [1], Fandebnet Siniki [1], Naobe Emery [4], Sayouba Tinto [3]

[1] Renaissance University Hospital Centre of N’djamena, Chad.
[2] National Reference General Hospital of N’djamena, Chad.
[3] Yalgado Ouedraogo University Hospital Centre of Ouagadougou, Burkina, Faso.
[4] Military Training Hospital of N’djamena, Chad.

Address of Correspondence

Dr. Magoire Dingamnodji,
Department of Orthopedic and Traumatological Surgery, Renaissance University Hospital Centre of N’djamena, Chad.
E-mail: odialmagloire1989@gmail.com

Abstract

Bilateral clavicle fractures are rare injuries. Their management is a subject of controversery. Some authors advocate surgical intervention, while others recommend orthopedic treatment. Several surgical implants are used, including anatomical screws, reconstruction plates, Kirschner wires and external fixators. We would like to share our experience with osteosynthesis using one-third tubular plate in bilateral clavicle fractures. This about two patients. At the six-month follow-up, excellent anatomical and functional outcomes were achieved.

Keywords: Bilateral clavicle, Targeted plates, Surgical management.

References

1. Canadian Orthopedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures: A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007; 89:1-10.

2. Delvaque JG, Bégué T, Villain B, Mebtouche N, Aurégan JC. Surgical treatment of midshaft clavicle fractures: A preliminary feasibility study of minimally invasive internal fixation facilitated by peroperative external fixation. Hôpital Antoine Béclère, AP-HP, Université Paris Saclay 2019;8:30-103.

3. Bajuri MY, Maidin S, Rauf A, Baharuddin M, Harjeet S. Functional outcomes of conservatively treated clavicle fractures. Clinics (Sao Paulo). 2011; 66(4): 635-9.

4. Marya KM, Yadav V, Kochar H. Case series, bilateral clavicle fractures. Hong Kong J Orthop Surg. 2002; 6(1): 39-41.

5. Van den Bout HET. Bilateral clavicle fractures: A case report and review of the literature. South Afr Orthop J. 2011; 10(2): 55-66.

6. Woltz S, Duijff JW, Hoogendoorn JM, Rhemrev SJ, Breederveld RS, Schipper IB, Beeres FJ. Reconstruction plates for midshaft clavicular fractures: A retrospective cohort study. Orthop Traumatol Surg. Res 2016;102:25-9.

7. Liu W, Xiao J, Ji F, Xie Y, Hao Y. Intrinsic and extrinsic risk factors for nonunion after nonoperative treatment of midshaft clavicle fractures. Orthop Traumatol Surg Res 2015;101:197-200.

8. Grassi FA, Tajana MS, D’Angelo F. Management of midclavicular fractures: Comparison between nonoperative treatment and open intramedullary fixation in 80 patients. J Trauma. 2001;50:1096-100.

9. Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD, Evidence-Based Orthopaedic Trauma Working Group. Treatment of acute midshaft clavicle fractures: Systematic review of 2144 fractures: On behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005;19:504-7.

10. Robinson CM, Goudie EB, Murray IR, Jenkins PJ, Ahktar MA, Read EO et al. Open reduction and plate fixation versus nonoperative treatment for displaced midshaft clavicular fractures: A multicenter, randomized, controlled trial. J Bone Joint Surg Am. 2013;95:1576-84.

11. Jiang H, Qu W. Operative treatment of clavicle midshaft fractures using a locking compression plate: Comparison between mini-invasive plate osteosynthesis (MIPPO) technique and conventional open reduction. Orthop Traumatol Surg Res. 2012;98:666-71.

How to Cite this article: Dingamnodji M, Andjeffa V, Adendingue D, Ngamai K, Siniki F, Emery N, Tinto S | Our Experience about Two Cases of Surgical Management of Bilateral Clavicle Fractures| January- June 2023; 9(1): 23-25 | https://doi.org/10.13107/ti.2023.v09.i01.34

 

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Fixation of Acromion Fracture by Distal Radius Plate: A Case Report

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Vol 9 | Issue 1 | January-June 2023 | page: 26-28 | Mohd Danish, Hemant Gupta, Ravi Kant, Vikas Singh

DOI: https://doi.org/10.13107/ti.2023.v09.i01.35

Authors: Mohd. Danish [1], Hemant Gupta [1], Ravi Kant [1], Vikas Singh [1]

[1] Department of Orthopaedics, Max Super Specialty Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.

Address of Correspondence

Dr. Mohd Danish,

Department of Orthopaedics, Max Super Specialty Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.

E-mail: danish.shan@gmail.com

Abstract

Acromion process fractures are as rare to happen and even rare to be treated surgically. Acromion acts as a stabilizer of shoulder joint through a number of ligaments and muscles attached to it. Although most of the acromion fractures are treated conservatively which may either be due to surgeon preference or lack of sufficient training in surgically treating these fractures. Our case is of a 54 years old, Male who presented to us after being referred from other hospital with Type II acromion process fracture who was treated surgically after the fracture was fixed by the unconventional distal end radius plate in place of usually used clavicular or recon plates. The patient yielded excellent Oxford shoulder score in the subsequent follow ups. Although the acromion fractures are not fixed by most of the surgeons and if at all they are fixed they usually use the conventional plates as mentioned for its fixation, but our case shows that even the distal radius plates can be used as a fixation device in such fractures with excellent rehabilitation results and almost no complications.

Keywords: Acromion, Fracture, Plate

References

1. Bartonicek J. Rockwood and Green’s Fractures in Adults, 8th Edition. Vol. 1. Netherlands: Wolters Kluwer; 2015. Scapular fractures; p. 1478.

2. Cole PA, Shafiq B. Master Techniques in Orthopaedic Surgery. Vol. 1. Philadelphia: Lippincott Williams & Wilkins; 2006. Scapula fractures: open reduction internal fixation; pp. 15–36.

3. Scapular fractures. Analysis of 113 cases. Ada JR, Miller ME. https://pubmed.ncbi.nlm.nih.gov/1864036/ Clin Orthop Relat Res. 1991;269:174–180.

4. Fracture of the body, neck, or spine of the scapula. A long-term follow-up study. Nordquist A, Peterson C. https://pubmed.ncbi.nlm.nih.gov/1395237/ Clin Orthop Relat Res. 1992;283:139–144.

5. Pre- and postoperative function after scapula malunion reconstruction: a novel kinematic technique. Ganger EM, Ludwig PM, Wijdecks CA, Cole PA. J Orthop Trauma. 2013 Aug;27(8):e186-91.

6. Fractures of the acromion process: a proposed classification system. Kuhn JE, Blasier RB, Carpenter JE. J Orthop Trauma. 1994;8:6–13.

7. Operative treatment of scapular fractures: a systematic review. Lantry JM, Roberts CS, Giannoudis PV. Injury. 2008;39:271–283.

How to Cite this article: Danish M, Gupta H, Kant R,Singh V | Fixation of Acromion Fracture by Distal Radius Plate – A Case Report | January-June 2023; 9(1): 26-28 | https://doi.org/10.13107/ti.2023.v09.i01.35

 

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Long-Term Outcomes Following Synthetic Patch Augmentation to Treat Rotator Cuff Tears

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Vol 9 | Issue 1 | January-June 2023 | page: 01-04 | Florian Hess, JoEllen Welter, Laurenz Jaberg

DOI: https://doi.org/10.13107/ti.2023.v09.i01.031

Authors: Florian Hess [1], JoEllen Welter [1], Laurenz Jaberg [2]

[1] Department of Orthopaedic Surgery and Traumatology, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.

[2] Department of Orthopaedic Surgery, Clinica Ars Medica, Gravesano, Switzerland.

Address of Correspondence

Dr. Florian Hess,

Department of Orthopaedic Surgery and Traumatology Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.

E-mail: florian.hess@stgag.ch

Abstract

Background: Treatment of massive rotator cuff (RC) tears can result in re-rupture rates up to 94%, and some studies have detected re-ruptures occurring 3.5 years postoperatively. This study aimed to compare long-term clinical outcomes, measured at two time points, after massive RC tears with patch augmentation.

Methods: We performed 58 arthroscopic RC reconstructions augmented with a synthetic polyester patch between 2012 and 2014. 50 patients were available for long-term follow-up one and five years after surgery. We compared clinical outcomes (Constant-Murley score (CS) and subjective shoulder value (SSV)) to assess if the results were sustained over time.

Results: 86% (50/58) of the patients were assessed at the one- and five-year follow-up visits. The median CS one year postoperative reached 84 (interquartile range 76.5-90), and SSV was 95 (IQR 82.5-100). The median CS five years after surgery was 85 (IQR 81.5-91.5) and SSV was 95 (IQR 85-100). The clinical improvement between postoperative years one and five was statistically significant for CS (p=0.0013) and SSV (p<0.0001).

Conclusions: Rotator cuff repair with polyester patch augmentation achieved good clinical outcomes over the long term. Clinical improvement continued over time, with slightly more favorable results measured at the five-year follow-up visits.

Keywords: Massive rotator cuff tears, Augmentation, Patch, Shoulder, Arthroscopy

References

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2. Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL (2012) National trends in rotator cuff repair. J Bone Joint Surg [Am] 94 (3):227-233.

3. Jain NB, Higgins LD, Losina E, Collins J, Blazar PE, Katz JN (2014) Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. BMC Musculoskelet Disord 15:4.

4. Paloneva J, Lepola V, Aarimaa V, Joukainen A, Ylinen J, Mattila VM (2015) Increasing incidence of rotator cuff repairs–A nationwide registry study in Finland. BMC Musculoskelet Disord 16:189.

5. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res (304):78-83.

6. Davey MS, Hurley ET, Carroll PJ, Galbraith JG, Shannon F, Kaar K, Mullett H (2023) Arthroscopic Rotator Cuff Repair Results in Improved Clinical Outcomes and Low Revision Rates at 10-Year Follow-Up: A Systematic Review. Arthrosc – J Arthrosc Relat Surg 39 (2):452-458.

7. Meyer DC, Wieser K, Farshad M, Gerber C (2012) Retraction of supraspinatus muscle and tendon as predictors of success of rotator cuff repair. Am J Sports Med. 40 (10):2242-2247.

8. Shah NS, Suriel Peguero E, Umeda Y, Crawford ZT, Grawe BM (2022) Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review. HSS J 18 (1):130-137.

9. Smolen D, Haffner N, Mittermayr R, Hess F, Sternberg C, Leuzinger J (2020) Application of a new polyester patch in arthroscopic massive rotator cuff repair-a prospective cohort study. J Shoulder Elbow Surg 29 (1):e11-e21.

10. Proctor CS (2014) Long-term successful arthroscopic repair of large and massive rotator cuff tears with a functional and degradable reinforcement device. J Shoulder Elbow Surg 23 (10):1508-1513.

11. Gerber C, Fuchs B, Hodler J (2000) The results of repair of massive tears of the rotator cuff. J Bone Joint Surg [Am] 82 (4):505-515.

12. Davidson J, Burkhart SS (2010) The geometric classification of rotator cuff tears: a system linking tear pattern to treatment and prognosis. Arthrosc – J Arthrosc Relat Surg 26 (3):417-424.

13. Bailey JR, Kim C, Alentorn-Geli E, Kirkendall DT, Ledbetter L, Taylor DC, Toth AP, Garrigues GE (2019) Rotator Cuff Matrix Augmentation and Interposition: A Systematic Review and Meta-analysis. Am J Sports Med 47 (6):1496-1506.

14. Ferguson DP, Lewington MR, Smith TD, Wong IH (2016) Graft Utilization in the Augmentation of Large-to-Massive Rotator Cuff Repairs: A Systematic Review. Am J Sports Med 44 (11):2984-2992.

15. Steinhaus ME, Makhni EC, Cole BJ, Romeo AA, Verma NN (2016) Outcomes After Patch Use in Rotator Cuff Repair. Arthroscopy 32 (8):1676-1690.

16. Smolen D, Haffner N, Mittermayr R, Hess F, Sternberg C, Leuzinger J (2019) Application of a new polyester patch in arthroscopic massive rotator cuff repair-a prospective cohort study. J Shoulder Elbow Surg.

17. Barber FA, Burns JP, Deutsch A, Labbe MR, Litchfield RB (2012) A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthrosc – J Arthrosc Relat Surg 28 (1):8-15.

18. Gilot GJ, Alvarez-Pinzon AM, Barcksdale L, Westerdahl D, Krill M, Peck E (2015) Outcome of Large to Massive Rotator Cuff Tears Repaired With and Without Extracellular Matrix Augmentation: A Prospective Comparative Study. Arthroscopy 31 (8):1459-1465.

19. Mori D, Funakoshi N, Yamashita F (2013) Arthroscopic surgery of irreparable large or massive rotator cuff tears with low-grade fatty degeneration of the infraspinatus: patch autograft procedure versus partial repair procedure. Arthroscopy 29 (12):1911-1921.

20. Audenaert E, Van Nuffel J, Schepens A, Verhelst M, Verdonk R (2006) Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc 14 (4):360-364.

21. Badhe SP, Lawrence TM, Smith FD, Lunn PG (2008) An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears. J Shoulder Elbow Surg 17 (1 Suppl):35S-39S.

22. Giannotti S, Ghilardi M, Dell’osso G, Magistrelli L, Bugelli G, Di Rollo F, Ricci G, Calabrese R, Siciliano G, Guido G (2014) Study of the porcine dermal collagen repair patch in morpho-functional recovery of the rotator cuff after minimum follow-up of 2.5 years. Surg Technol Int 24:348-352.

23. Nada AN, Debnath UK, Robinson DA, Jordan C (2010) Treatment of massive rotator-cuff tears with a polyester ligament (Dacron) augmentation: clinical outcome. J Bone Joint Surg Br 92 (10):1397-1402.

24. Rotini R, Marinelli A, Guerra E, Bettelli G, Castagna A, Fini M, Bondioli E, Busacca M (2011) Human dermal matrix scaffold augmentation for large and massive rotator cuff repairs: preliminary clinical and MRI results at 1-year follow-up. Musculoskelet Surg 95 Suppl 1:S13-23.

25. Ciampi P, Scotti C, Nonis A, Vitali M, Di Serio C, Peretti GM, Fraschini G (2014) The benefit of synthetic versus biological patch augmentation in the repair of posterosuperior massive rotator cuff tears: a 3-year follow-up study. Am J Sports Med 42 (5):1169-1175.

26. Longo UG, Lamberti A, Maffulli N, Denaro V (2010) Tendon augmentation grafts: a systematic review. Br Med Bull 94:165-188.

27. Iannotti JP, Codsi MJ, Kwon YW, Derwin K, Ciccone J, Brems JJ (2006) Porcine small intestine submucosa augmentation of surgical repair of chronic two-tendon rotator cuff tears. A randomized, controlled trial. J Bone Joint Surg [Am] 88 (6):1238-1244.

28. Papalia R, Franceschi F, Zampogna B, D’Adamio S, Maffulli N, Denaro V (2013) Augmentation techniques for rotator cuff repair. Br Med Bull 105:107-138.

29. Phipatanakul WP, Petersen SA (2009) Porcine small intestine submucosa xenograft augmentation in repair of massive rotator cuff tears. Am J Orthop 38 (11):572-575.

30. Sclamberg SG, Tibone JE, Itamura JM, Kasraeian S (2004) Six-month magnetic resonance imaging follow-up of large and massive rotator cuff repairs reinforced with porcine small intestinal submucosa. J Shoulder Elbow Surg 13 (5):538-541.

31. Walton JR, Bowman NK, Khatib Y, Linklater J, Murrell GA (2007) Restore orthobiologic implant: not recommended for augmentation of rotator cuff repairs. J Bone Joint Surg [Am] 89 (4):786-791.

32. Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, Schemitsch E (2015) Arthroscopic Repair for Chronic Massive Rotator Cuff Tears: A Systematic Review. Arthroscopy 31 (12):2472-2480.

33. Shimokobe H, Gotoh M, Honda H, Nakamura H, Mitsui Y, Kakuma T, Okawa T, Shiba N (2017) Risk factors for retear of large/massive rotator cuff tears after arthroscopic surgery: an analysis of tearing patterns. J Orthop Surg Res 12 (1):140.

34. Miller BS, Downie BK, Kohen RB, Kijek T, Lesniak B, Jacobson JA, Hughes RE, Carpenter JE (2011) When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med 39 (10):2064-2070.

How to Cite this article: Hess F, Welter J, Jaberg L | Long-term Outcomes Following Synthetic Patch Augmentation to Treat Rotator Cuff Tears | January-June 2023; 9(1): 01-04 | https://doi.org/10.13107/ti.2023.v09.i01.031

 

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A Simple Surgical Technique of Trans Articular K Wires Fixation Through Sinus Tarsi Approach for Treating Intra Articular Calcaneal Fractures : A Large Case Series

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Vol 9 | Issue 1 | January-June 2023 | page: 18-22 | Sampat Dumbre Patil, Gurunath Wachche, Harsh R. Vyas, Rohil Singh Kakkar, Vaishali Dumbre PatilAddress of Correspondence

DOI: https://doi.org/10.13107/ti.2023.v09.i01.033

Authors: Sampat Dumbre Patil [1], Gurunath Wachche [2], Harsh R. Vyas [1], Rohil Singh Kakkar [1], Vaishali Dumbre Patil [3]

[1] Department of Orthopaedics, Sahyadri Super Speciality Hospital, Hadapsar, Pune, Maharashtra, India.

[2]Department of Orthopaedics, Dr. V M Government Medical College, Solapur, Maharashtra, India.

[3] Department of Radiology, Oasis Orthopaedic and Sonography Clinic, Hadapsar, Pune, Maharashtra.

Address of Correspondence

Dr. Harsh R. Vyas

Department of Orthopaedics, Sahyadri Super Speciality Hospital, Hadapsar, Pune, Maharashtra.

E-mail: drharshvyas333@gmail.com

Abstract

Introduction: Calcaneum fractures are the most common tarsal bone fractures accounting for 2% of all bone fractures and approximately 60 % of tarsal bone fractures. Management of intra-articular calcaneal fractures have evolved from conservative to open and minimally invasive surgeries till date. There are still some controversies in treating intra articular displaced calcaneum fractures and treatment modalities continue to evolve with different surgical techniques and implants. We present a large retrospective study series of a safe and simple technique of managing intra-articular calcaneum fractures through sinus tarsi approach and fixation with transarticular Kirschner wires with or without sustentacular screw.

Methods: This retrospective study was done from January 2016 to March 2019 and aimed to evaluate the radiological and functional outcomes in a series of 226 patients with displaced intra-articular fractures of calcaneum managed with a simple surgical technique treated with trans articular K wires with or without sustentacular screw through sinus tarsi approach. Statistical analysis was performed utilizing independent t-test using the p-value ≤0.5

Results: All 226 cases achieved union of fracture within 4 months of follow up and as per American Orthopaedic Foot and Ankle Society (AOFAS) scoring, 57.96% cases had excellent results, 23.45% cases had good and 18.58% cases had fair results respectively. Conclusion Fixation of displaced intra-articular calcaneum fractures with trans articular K wires with or without sustentacular screw through sinus tarsi approach is a soft tissue preserving surgical technique which restores the near normal biomechanics of the calcaneum.

Keywords: Calcaneum fractures, Heel injuries, Sinus tarsi approach, Minimally invasive surgery, Calcaneum fixation, K wire fixation

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How to Cite this article: Patil SD, Wachche G, Vyas HR, Kakkar RS, Patil VD | A Simple Surgical Technique of Trans Articular K Wires Fixation Through Sinus Tarsi Approach for Treating Intra Articular Calcaneal Fractures : A Large Case Series | January-June 2023; 9(1): 18-22 | https://doi.org/10.13107/ti.2023.v09.i01.33

 

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