Acta Scientific Orthopaedics (ASOR)(ISSN: 2581-8635)

Research Article Volume 4 Issue 8

Clinico-Radiological Outcome of Low Profile Pre-Contoured Anatomical Locking Plates Fixation in Displaced Intraarticular Calcaneum Fracture

Neetin P Mahajan1, Lalkar Laxman Gadod2*, Mrugank Narvekar1, Ishan Gajbe3, Swapnil Bhalerao3 and Kartik Pande1

1Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
2Department of Orthopaedics, Columbia Asia Hospital, Pune, Maharashtra, India
3Department of Orthopaedics, Kamala Nehru Hospital, Pune, Maharashtra, India

*Corresponding Author:Lalkar Laxman Gadod, Department of Orthopaedics, Columbia Asia Hospital, Pune, Maharashtra, India.

Received: June 04, 2021; Published: July 07, 2021

Abstract

Background: Calcaneal fractures are one of the most difficult fractures to be treated by the orthopedic surgeons. Calcaneal fractures (CFs) account for more than 60% of tarsal bone fractures and around 2% of all fractures. This can be a debilitating fracture and is most common in those who are economically active.

Methods: Twenty-four patients with a history of fall from height, and having closed intra-articular joint depression type of calcaneum fractures, included in the study, after obtaining proper valid written informed consent. CT scan of the calcaneum was also done in all patients to further delineate the type and pattern of fractures, and fracture was classified by the Sanders classification system. Functional outcome was measured with the American Orthopaedic Foot and Ankle Society (AOFAS) score 10 and the Maryland Foot Score which includes pain, function and alignment. Radiological outcome was assessed by the angle of Bohler and assessing union of fracture.

Results: The mean AOFAS score at 9 months was 78.87 ± 9.86. According to the AOFAS score, at 9 months, 16 (66.67%) patients had good outcome, 5 (20.83%) patients had fair outcome and 3 (12.5%) patients had poor outcome.

Conclusion: ORIF of closed type II, III and IV sanders calcaneal fractures have superior radiographic and functional outcomes ORIF has to be undertaken only when swelling and fracture blisters are completely resolved. ORIF with bone graft insertion of displaced intra-articular calcaneum fractures is an effective method for treatment as it enables anatomical reduction of fracture and articular surface, restoration of Bohler's angle, and early union by the bone graft. we think that this procedure should be avoided except in the case of severe soft tissue damage or open fractures.

Keywords: Calcaneum; Fracture; Intra-Articular; Locking Plate; Pre-Contoured

References

  1. Wang Q., et al. “Comparison of the outcomes of two operational methods used for the fixation of calcaneal fracture”. Cell Biochemistry and Biophysics 72 (2015): 191-196.
  2. Buckley R., et al. “Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: A prospective, randomized, controlled multicenter trial”. Journal of Bone and Joint Surgery American 84-A (2002): 1733-1744.
  3. Folk JW., et al. “Early wound complications of operative treatment of calcaneus fractures: analysis of 190 fractures”. Journal of Orthopaedic Trauma 13 (1999): 369-372.
  4. Fitzgibbons TC., et al. “Fractures and dislocations of the calcaneus”. In: Bucholz RW, Heckman JD, editros. Rockwood and Green's Factures in Adults. 5th, Philadelphia: Lippincott Williams and Wilkins 3 (2001): 2133-2179.
  5. Murphy GA. “Fractures and dislocations of foot”. In: Canale ST, editror. Campbell's Operative Orthopaedics. 10th, Philadelphia: Mosby Inc 4 (2003): 4231-4283.
  6. Raymakers JT., et al. “Results after operative treatment of intra-articular calcaneal fractures with a minimum follow-up of 2 years”. Injury 29 (1998): 593-599.
  7. Sanders R., et al. “Operative treatment in 120 displaced intra-articular calcaneal fractures resulting used a prognostic computed tomography scan classification”. Clinical Orthopaedics and Related Research 290 (1993): 87-95.
  8. Sanders R. “Current concepts review: displaced intra-articular fractures of the calcaneus”. Journal of Bone and Joint Surgery 82 (2000): 225-250.
  9. Böhler L. “Diagnosis, pathology, and treatment of fractures of the oscalcis”. Journal of Bone and Joint Surgery 13 (1931): 75-89.
  10. Kitaoka HB., et al. “Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes”. Foot and Ankle International 15 (1994): 349-353.
  11. Griffin D., et al. “Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial”. British Medical Journal 349 (2014): g4483.
  12. Mitchell MJ., et al. “The epidemiology of calcaneal fractures”. Foot4 (2009): 197-200.
  13. Biz C., et al. “Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: A comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)”. Journal of Orthopaedic Surgery and Research 11 (2016): 92.
  14. Leung KS., et al. “Operative treatment of displaced intra-articular fractures of the calcaneum. Medium-term results”. The Bone and Joint Journal - Bone 75 (1993): 196-201.
  15. Vaclav Rak., et al. “Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications”. The Indian Journal of Orthopaedics 43 (2009): 271-280.
  16. Frank MA., et al. “Calcaneal fractures: surgical exposure and fixation technique update”. Current Orthopaedic Practice 22 (2011): 4-11.
  17. Gaskill T., et al. “Comparison of surgical outcomes of intra-articular calcaneal fractures by age”. Journal of Bone and Joint Surgery American 92 (2010): 2884-2889.
  18. Cao L., et al. “Surgical treatment of calcaneal fractures of sanders type II and III by a minimally invasive technique using a locking plate”. The Journal of Foot and Ankle Surgery 54 (2015): 76-81.
  19. Daftary A., et al. “Fractures of the calcaneus: a review with emphasis on CT”. Radiographics 25 (2005): 1215-1226.
  20. Besse J-L., et al. “Calcaneal intra-articular fracture osteosynthesis: Clinical and radiological prospective study of 31 cases”. Foot and Ankle Surgery1 (2006): 19-27.
  21. Jain V., et al. “Osteosynthesis for Intra-Articular Calcaneal Fractures”. Journal of Orthopaedic Surgery2 (2007): 144-148.
  22. Stephenson JR. “Treatment of displaced intra-articular fractures of the calcaneus using medial and lateral approaches, internal fixation, and early motion”. Journal of Bone and Joint Surgery American1 (1987): 115-130.
  23. Gould N. “Lateral approach to the os calcis”. Foot Ankle4 (1984): 218-220.
  24. Saurabh Jain., et al. “Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate Chinese”. Journal of Traumatology6 (2013): 355-360.
  25. Longino D and Buckley RE. “Bone graft in operative treatment of displaced intraarticular calcaneus fractures. Is it helpful?” Journal of Orthopaedic Trauma4 (2001): 280-286.
  26. Leung KS., et al. “Operative treatment of intraarticular fractures of the os calcis— the role of rigid internal fixation and primary bone grafting: preliminary results”. Journal of Orthopaedic Trauma3 (1989): 232-240.
  27. Thordarson DB., et al. “Supe- rior compressive strength of a calcaneal fracture construct augmented with remodelable cancellous bone cement”. Journal of Bone and Joint Surgery American2 (1999): 239-246.
  28. Schildhauer TA., et al. “Open reduc- tion and augmentation of internal fixation with an injectable skeletal cement for the treatment of complex calcaneal fractures”. Journal of Orthopaedic Trauma5 (2001): 309-317.
  29. Isaac JD., et al. “The diagnostic accuracy of Böhler’s angle in fractures of the calcaneus”. The Journal of Emergency Medicine 45 (2013): 879-884.
  30. Hyer CF., et al. “Early weight bearing of calcaneal fractures fixated with locked plates: a radiographic review”. Foot and Ankle Specialist 3 (2010): 320-323.

Citation

Citation: Márcio Luís Duarte., et al. “Subcutaneous Calcaneal Bursitis - A Commonly Forgotten Differential Diagnosis". Acta Scientific Orthopaedics 4.8 (2021): 02-08.

Copyright

Copyright: © 2021 Márcio Luís Duarte., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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