Calcaneus ; injuries ; surgery ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans

Calcaneus ; injuries ; surgery ; Humans ; Intra-Articular Fractures ; surgery ; therapy

Calcaneus ; injuries ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans

OBJECTIVE: To compare the clinical efficacy of staged surgery on Sanders Ⅳ calcaneal fractures with soft tissue Ⅲ swelling. METHODS: The clinical data of 76 patients with Sanders type Ⅳ closed calcaneal fracture with soft tissue three-degree swelling treated from June 2017 to May 2020 was retrospectively analyzed, including 54 males and 22 females, aged from 25 to 50 (38.16±10.24) years. The patients were divided into observation group and control group according to different treatment methods. Twenty-four patients in the observation group were treated by staged surgery stageⅠclosed prying traction reduction and Kirschner wire fixation, stageⅡopen reduction and internal fixation with titanium plate, including 17 males and 7 females, aged from 25 to 50 (36.12±9.56) years. There were 52 patients in the control group, including 37 males and 15 females, aged from 25 to 50 (38.32±10.67) years, these patients were treated with open reduction and internal fixation with titanium plate after the dermatoglyphic signs appeared. The swelling subsidence time, the length of hospitalization days, and the incidence of postoperative incision complications were compared between two groups. The Bhler angle, Gissane angle, and calcaneal varus angle were measured by X-ray before and 6 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) about the ankle hindfoot score was used to evaluate the clinical efficacy. RESULTS: All 76 patients were followed up for 8 to 12 (9.52±2.01) months. The swelling subsidence time and hospitalization days in observation group were (12.12± 3.24) d and (24.53±6.44) d, respectively, which in control group were (15.16±4.16) d and (29.46±9.61) d, with statistical difference between two groups ( CONCLUSION Compared with open reduction and internal fixation with titanium plate after the appearance of dermatoglyphic signs, staged surgery for Sanders type Ⅳ calcaneal fractures with soft tissue three-swelling does not increase the risk of soft tissue complications, and can significantly shorten the patient's swelling subsidence time and hospitalization days, improve the quality of fracture reduction and short term function, and relieve pain.
Ankle Injuries ; Calcaneus/surgery* ; Female ; Foot Injuries ; Fractures, Bone/surgery* ; Humans ; Male ; Retrospective Studies

Adolescent ; Adult ; Calcaneus ; injuries ; Female ; Humans ; Male ; Middle Aged ; Rupture ; Suture Techniques ; Tendon Injuries ; surgery

Adolescent ; Adult ; Calcaneus ; injuries ; surgery ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome

Calcaneus ; injuries ; surgery ; Fracture Fixation, Internal ; Humans ; Intra-Articular Fractures ; surgery

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; Female ; Humans ; Intra-Articular Fractures ; physiopathology ; surgery ; Male ; Middle Aged

OBJECTIVEDebate continues regarding the management of calcaneal fractures, between open reduction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.

METHODSIn this series, 28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury. Patients were evaluated in terms of associated injuries and X-rays of anteroposterior, lateral and axial views of the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement of calcaneal height and width. Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society (AOFAS) scale.

RESULTSAt average follow-up of 14.5 months, average AOFAS score was 86.3 (range 66 to 97), with 86% having excellent to good results and 2 (7.7%) and 1 (3.7%) having fair and poor results respectively. All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30 degrees. Average subtalar range of motion was 17 degrees The mean Bohler's angle, mean Gissane's angle, calcaneal height and width were 25.47 degrees 121.3 degrees 4.32 cm and 3.81 cm respectively at final follow-up. Three patients had flap necrosis at incision site and one had superficial and deep infection. Subtalar arthritis was seen in 5 patients, whereas sural nerve hypoaesthesia in 1 patient. None of the patients had compartment syndrome, heel pad problems, peroneal tendinitis, reflex sympathetic dystropy or implant failure.

CONCLUSIONOpen reduction and internal fixation with locking calcaneal plate gives sound functional outcome, i.e. restoring anatomically reconstruction of height, width, Bohler's and Gissiane's angles of the calcaneum, and allowing early mobilization.

Calcaneal fracture is a kind of common injury of foot. Calcaneal fracture could be treated with conservative therapy, open reduction and internal fixation (ORIF), minimal invasive poking reduction and Kirschner wire fixation, arthrodesis or external fixation and other treatment methods. Open reduction and internal fixation as the main treatment method of calcaneus fracture, especially for intra-articular calcaneal fractures, as Sanders type II and III fractures, could gain satisfactory effect. But whether bone grafting should be taken is controversial in Sanders type IV fractures, because soft tissue complications are disadvantages of ORIF. The treatment of minimally invasive percutaneous poking reduction and internal fixation for calcaneal fractures has been paid more and more attention. Because of the differ of the classification of calcaneal fractures, indications of poking reduction and fixation methods, efficacy evaluation standard of choose, the clinical efficacy is different. Because of the complex treatment process, various treatment methods have their own advantages and disadvantages. Through consulting relevant literatures of domestic and abroad in recent years, comprehensive analysis is made and new progress of the calcaneal fractures treatment is summarized.
Calcaneus ; injuries ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Minimally Invasive Surgical Procedures