DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20194819

Outcome of the patients who underwent minimally invasive screw fixation for calcaneal fracture: an institutional study

Vivek Amritbhai Patel, Pathik Vala

Abstract


Background: Calcaneal fractures account for 2% of all fractures with approximately 65-75% intra-articular. The aim of the present study is to determine the outcome of the patients who underwent minimally invasive screw fixation for calcaneal fracture in our institute.

Methods: The present study was performed in 31 patients who underwent closed reduction and fixations with screw in this institute for the duration of 2 years were included in this study. Present study was conducted to determine the functional outcome of patients with calcaneal fractures treated with minimally invasive fixation of fractures with cancellous screws after indirect reduction with JESS or manual reduction or with Steinmen pin.

Results: The average age of the patients was 44.14 years, ranging from 16 to 74 years, 28 patients were males and 3 were female. The AOFAS score at last follow up was 78.05 this improvement was also significant statistically (p<0.05). The mean Bohler angle at the last radiographic evaluation was 32.87°. The complications noted were proud implant with superficial wound infection in one, deep infection in 2 patients and delay in wound healing in 2 patients, persistent pedal edema in 2 patients.

Conclusions: ORIF of calcaneal fractures is associated with high skin complications and comorbidities. Percutaneous screw fixation has fewer skin complications and can have satisfactory functional outcome. JESS or similar external fixator can be used intraoperatively for achieving reduction through ligamentotaxis.


Keywords


Calcaneal fractures, Edema, Intra-articular, Wound infection

Full Text:

PDF

References


Bajammal S, Tornetta P, Sanders D, Bhandari M. Displaced intra-articular calcaneal fractures. J Orthop Trauma. 2005;19(5):360-4.

Mitchell MJ, McKinley JC, Robinson CM. The epidemiology of calcaneal fractures. Foot. 2009;19(4):197-200.

Ishikava SN. Fractures and dislocations of foot. In: Canale ST, Beaty JH, eds. Campbell’s Operative Orthopaedics. 12th ed. Cananda: Elsevier Mosby; 2013: 4276-4279.

Essex-Lopresti P. The mechanism, reduction technique and results of the os calcis. Br J Surg. 1952;39:395-419.

Badillo K, Pacheco JA, Padua SO, Gomez AA, Colon E, Vidal JA. Multidetector CT evaluation of calcaneal fractures. Radiograph. 2011;31(1):81-92.

Magnuson PB. An operation for relief of disability in old fractures of os calcis. J Am Med Assn 1923;80:1511-3.

Tomesen T, Biert J, Frolke JP. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am. 2011;93:920-8.

Lee D, Yoo JH, Son DW, Kim DH. Is the Bohler angle reliable for operative reduction of calcaneus fracture? J Orthop Sci. 2019; 24(3):521-5.

OoHoo NF, Farng E, Krenek L, Zingmond DS. Complication rates following operative treatment of calcaneus fractures. Foot Ankle Surg. 2011;17(4):233-8.

Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84:1733-44.

Howard JL, Buckley R, McCormack R, Pate G, Leighton R, Petrie D et al. Complications following management of displaced intra-articular calcaneal fractures: a prospective randomized trial comparing open reduction internal fixation with nonoperative management. J Orthop Trauma. 2003;17(4):241-9.

Paley D, Fischgrund J. Open reduction and circular external fixation of intraarticular calcaneal fractures. Clin Orthop Relat Res. 1993;290:123-31.

Talarico LM, Vito GR, Zyryanov S. Management of displaced intraarticular calcaneal fractures by using external ring fixation, minimally invasive open reduction, early weight bearing. J Foot Ankle Surg. 2004;43:43-50.

Yu t, Yang Y. Importance of assistant intra-operative medial distraction technique for intraarticular calcaneus fractures. Acta Orthop Belg. 2018;84(2):235-41.

Rachakonda KR, Nugur A. Minimally invasive fixation for displaced intraarticular fractures of calcaneum: a short-term prospective study on functional and radiological outcome. Musculoskelet Surg. 2019;103(2):181-9.