The use of U-shaped external fixator combined with close manipulative reduction for calcaneal fractures
- VernacularTitle:“U”形外固定架结合闭合手法复位治疗跟骨骨折
- Author:
Zhigang GAO
;
Hao ZHANG
;
Jing XUE
- Publication Type:Journal Article
- Keywords:
Calcaneus;
Fractures;
Manipulation, orthopedic;
External fixators
- From:
Chinese Journal of Orthopaedics
2001;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To manage calcaneal fractures with an U-shaped external fixator combined with close manipulative reduction. Methods From February 1997 to November 2002, 31 patients with 34 calcaneal fractures were treated with self-designed U-shaped external fixator combined with close manipulative reduction. All patients were males aging from 7 to 50 years with an average of 32 years. The external fixation device consisted of two partial rings, three modular connecting rods and several pins. According to Essex-Lopresti classification, there were 10 extra-articular fractures without involving the subtalar joint, and 24 intra-articular fractures involving the subtalar joint. Two upper pins were inserted in cross through the distal tibia, and one of two lower pins was inserted laterally through the anterior part of calcaneus, the other was posterior into the calcaneous tuberosity or larger fragment connecting with Achilles tendon. After the manipulative reduction, the frames were applied. Results 31 calcaneal fractures were found with satisfactory reductions after manipulation. The widths of the heels were restored in certain extent; the heights of foot arch and calcaneus were resumed to normal; the B hler angle increased from 15? to 40? (mean, 25?). The duration of hospitalization was on an average of 7 days. The duration of external fixation was averagely 8 weeks. All patients were followed up with a mean period of 8 months (range, 6 to 12 months). All of the fractures healed well. No nonunion, delayed healing of bone or other complications was found. All patients resumed to walk on foot after 2 to 4.5 months. According to Fernandez scoring system, results were graded as excellent and good in 31(91%). Conclusion Using U-shaped external fixator combined with close manipulative reduction is a satisfying technique to treat calcaneal fractures. By ankle joint spanned traction and fixation, this technique overcomes displacement of fragments caused by contracture of tendo calcaneus, maintains width of heel and biodynamic anatomy of foot, avoids complications of wound caused by open reduction and internal fixation.
