Evaluation of the short-term results of closed reduction and percutaneous K-wires fixation of displaced intra-articular calcaneal fractures (DIACF)

The Foot ◽  
2020 ◽  
Vol 45 ◽  
pp. 101740
Author(s):  
Ibrahim Mahmoud Morsi ◽  
Ahmed A. Khalifa ◽  
Mohamed Abdelmoneim Hussien ◽  
Ahmed Abdellatef ◽  
Hesham Refae
2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Mohamed Mesregah

Category: Hindfoot Introduction/Purpose: The operative treatment of calcaneal fractures has been a controversial topic. Open reduction and internal fixation is associated with a high incidence of postoperative soft tissue complications. Closed reduction and percutaneous K-wires fixation was used to preserve soft tissue. The aim of our study is to evaluate the outcome of closed reduction and percutaneous K-wires fixation of displaced intra-articular calcaneal fractures. Methods: Twenty two displaced intra-articular calcaneal fractures were treated by closed reduction and percutaneous K-wires fixation. The clinical evaluation was based on Maryland Foot Score. According to Sander’s Classification, Eleven fractures were type II, nine were type III and two were type IV. Bimanual compression across the calcaneus was applied to reduce the calcaneal width. A Schanz screw was inserted into the calcaneal tuberosity and was forcibly pushed downwards to elevate the depressed fragment. Two parallel 2 mm K-wires were placed from the posterior inferior corner of the calcaneus across the posterior facet and into the talar body. The reduction of the articular surface was maintained by two crossing subchondral 2 mm K-wires. If the reduction was not satisfactory, a 1-2 cm long transverse incision was used just below the tip of the lateral malleolus. A small tipped periosteal elevator was introduced to elevate the depressed fragment before K-wire fixation. Results: The mean follow up period was 7.68 months. The clinical outcome revealed 18 fractures (81.8%) of satisfactory (14 excellent and 4 good), and 4 patients (18.2%) of unsatisfactory results (4 fair and 0 poor). The mean time of radiological union was 11.86 (range 10 – 14) weeks. One patient had pin tract infection. One patient developed heel widening. Conclusion: Closed reduction and percutaneous K-wires fixation of calcaneal fractures minimizes the soft tissue complications and postoperative scar formation. The mini approach for elevation of the depressed posterior facet restores the articular surface and decreases late subtalar arthritis.


2021 ◽  
pp. 193864002098775
Author(s):  
Ahmed Shams ◽  
Osama Gamal ◽  
Mohamed Kamal Mesregah

Background Several minimally invasive techniques were developed for management of intraarticular calcaneal fractures. This study aimed to compare the functional and radiological outcomes of 2 minimally invasive reduction and fixation techniques using cannulated screws or Kirschner wires (K-wires) for fixation. Methods This study was a retrospective comparative review of patients with displaced intraarticular calcaneal fractures, who were treated with cannulated screws or K-wires techniques. Clinical and radiological data were collected and compared between both groups. Functional outcomes and patient satisfaction using the Maryland Foot Score (MFS) and the visual analogue scale (VAS) of pain, in addition to the complications, were compared between both groups. Results In total, 70 patients were included in the study: 34 in the cannulated screws group, with a mean age of 35.2 ± 4 years, and 36 in the K-wires groups, with a mean age of 33.4 ± 3 years. The operative time was shorter in the K-wires group (40.5 ± 5.6 minutes) compared to the cannulated screw group (49.5 ± 4.5 minutes), P < .001. There were no statistically significant differences between both groups regarding the radiological parameters, including Bohler’s angle, angle of Gissane, calcaneal width, height, or length. The mean MFS, mean VAS, and complications were not different between the 2 groups. Conclusion Treatment of displaced intraarticular calcaneal fractures with minimally invasive reduction and fixation using either cannulated screws or K-wires can achieve similar excellent functional and radiological outcomes, with high patient satisfaction. The use of K-wires has the advantage of reduced operative time than cannulated screws. Levels of Evidence: Level III: Retrospective comparative study


2014 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Selene G Parekh ◽  
Todd Bertrand ◽  
Robert Zura ◽  
Samuel Adams ◽  
Alan Yan

ABSTRACT Calcaneal tuberosity fractures comprise only 1 to 2% of all calcaneal fractures. Treatment of these injuries has traditionally included open reduction and internal fixation with various means including lag screws, suture anchors and K-wires. We report on a series of cases treated with excision of the tuberosity fragment with repair of the Achilles tendon supplemented by a flexor hallucis longus tendon transfer. Parekh S, Bertrand T, Zura R, Adams S, Yan A. Novel Techniques in Treating Calcaneal Tuberosity Fractures. The Duke Orthop J 2014;4(1):3-7.


2020 ◽  
Vol 13 (4) ◽  
pp. 335-340
Author(s):  
Danilo Ryuko Cândido Nishikawa ◽  
Bruno Rodrigues de Miranda ◽  
Fernando Aires Duarte ◽  
Guilherme Honda Saito ◽  
Rogério Carneiro Bitar ◽  
...  

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Radwane Faroug ◽  
Paul Stirling ◽  
Farhan Ali

Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF). Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome.


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