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

Calcaneus/surgery* ; Fracture Fixation, Internal ; Fractures, Bone/surgery* ; Humans ; Intra-Articular Fractures/surgery* ; Treatment Outcome

Clinical Protocols ; Fracture Fixation, Internal ; Humans ; Intra-Articular Fractures ; surgery ; Tibial Fractures ; surgery

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

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

Humans ; Fractures, Bone/surgery* ; Calcaneus/surgery* ; Foot ; Fracture Fixation, Internal/methods* ; Intra-Articular Fractures/surgery* ; Treatment Outcome ; Retrospective Studies

PURPOSE: Exposure of the articular surface is the key to the successful treatment of intra-articular fractures of distal humerus. Anterior, posterior olecranon osteotomy as well as medial and lateral approaches are the four main approaches to the elbow. The aim of this study was to compare the exposure of distal articular surfaces of these surgical approaches. METHODS: Twelve cadavers were used in this study. Each approach was performed on six elbows according to previously published procedures. After completion of each approach, the exposed articular surfaces were marked by inserting 0.5 mm K-wires along the margins. The elbow was then disarticulated and the exposed articular surfaces were painted. The distal humeral articular surfaces were then closely wrapped using a piece of fibre-glass screen net with meshes. The exposed articular surfaces and the total articular surfaces were calculated by counting the number of meshes, respectively. RESULTS: The average percentages of the exposed articular surfaces for the anterior, posterior olecranon osteotomy, medial and lateral approaches were 45.7% ± 2.0%, 53.9% ± 7.1%, 20.6% ± 4.9% and 28.5% ± 6.3%, respectively. CONCLUSION The anterior and posterior approaches provide greater exposures of distal humeral articular surface than the medial and lateral ones in the treatment of distal humeral fractures.
Adult ; Aged ; Cadaver ; Elbow ; surgery ; Elbow Joint ; surgery ; Humans ; Humeral Fractures ; surgery ; Humerus ; surgery ; Intra-Articular Fractures ; surgery ; Male ; Middle Aged ; Osteotomy ; methods

OBJECTIVETo introduce and evaluate the clinical effects of percutaneous reduction and Kirschner pin fixation for the treatment of intraarticular fractures of the calcaneus in children.

METHODSFrom March 2001 to February 2009,12 patients with intraarticular calcaneal fractures were treated by percutaneous reduction and Kirschner pin fixation (13 feet). There were 8 males and 4 females,ranging in age from 3 to 14,with an average of 8.7 years. According to Essex-Lopresti classification, among 5 feet were tongue fractures and 8 feet were compressed fractures. According to Sanders classification, 9 feet were type II and 4 feet were type III. The Biihler angle and Gissane angle of the calcaneus were obtained before and after operation. All patients were evaluated according to Maryland Foot Score.

RESULTSAll the patients were followed up for 16-71 months (means 35.9 months),and all the incisions were healed without complications and infection. The preoperative X-ray film showed that Böhler angle was (19.7+/-5.3) degrees, Gissane angle was (137.3+/-7.5) degrees. The postoperative X-ray film demonstrated that Böhler angle was (32.6+/-3.7) degrees, Gissane angle was (125.4+/-2.9) degrees. There was a significant difference between preoperative and postoperative (P<0.01). The average Maryland score was 96.3+/-2.4 (range, 92 to 100 points).

CONCLUSIONPercutaneous reduction and Kirschner pin fixation is an effective minimally invasive way to treat intraarticular fractures of the calcaneus in children, it has many advantages such as minimal invasion, reliable fixation and satisfactory effects.

Adolescent ; Bone Nails ; Calcaneus ; injuries ; surgery ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Intra-Articular Fractures ; surgery ; Male

OBJECTIVETo analyze locking plates with bone graft fusion in treating displaced intraarticular calcaneal fractures and determine whether it is beneficial in maintaining restoration of calcaneal height and anatomic reduction of the articular surface.

METHODSFrom January 2007 to January 2008, 22 patients with displaced intraarticular calcaneal fractures were treated with locking plates with and without bone graft (divided into the bone graft group and non-bone graft group). There were 17 males and 5 females, ranging in age from 18 to 59 years with the mean of 35 years. Sanders III was in 14 cases and Sanders IV in 8 cases. Autologous iliac bone filled defects with locking plates fixation for the bone graft group; just locking plates fixation were performed for non-bone graft group. The Böhler angle and Gissane angle were measured before and after operation. The foot function of two groups were compared according to Maryland standard at the 6th month, 1, 2 years after operation.

RESULTSAll patients were followed up with an average of 25 months. There was no significant difference in the recovery of Böhler angle and Gissane angle between two groups (P > 0.05). After the 6 months,1, 2 years, there was no significant difference in the foot function between two groups (P > 0.05), in bone graft group, excellent result was in 6, 7 ,7 cases respectively; and in non-bone graft group, excellent results in 5, 6, 7 cases respectively.

CONCLUSIONBone graft in the surgical treatment of calcaneal fractures is not an advantage.

Adolescent ; Adult ; Bone Plates ; Bone Transplantation ; Calcaneus ; injuries ; surgery ; Female ; Humans ; Intra-Articular Fractures ; surgery ; Male ; Middle Aged ; Young Adult

Tibial plateau and distal femoral fractures are common injuries presenting a significant operative challenge. Complexity of the fracture often needs multi-planar surgical access. A combined two-staged procedure is frequently suggested both in supine and prone position to address this issue. However, this will significantly increase the operative time and eventually impact the outcome, in addition to the complications associated with prone positioning. In this study we used a standard orthopaedic table to position these patients in order to grant access to the postro-medial and a postro-lateral structures while the patient stays in supine setup, at the same time, giving the flexibility to change the alignment from valgus to varus and vice versa. This facilitates fracture reduction while addressing the anatomical structure of the knee. A further advantage is the unobstructed imaging access throughout the surgical fixation. This facilitates the reduction in operative time hence leading to a better outcome in these difficult fractures. We tested this positioning technique in more than 40 patients over a 4-year period at two different centres in the United Kingdome. We found that this approach is safe, reproducible and relatively easy to set up in the two centres.
Humans ; Tibial Fractures/surgery* ; Orthopedics ; Fracture Fixation, Internal/methods* ; Intra-Articular Fractures/surgery* ; Knee Injuries/surgery* ; Knee Joint/surgery* ; Treatment Outcome