scholarly journals Innovative Fixation Technique for Avulsion Fractures of the Calcaneal Tuberosity

2021 ◽  
Vol 60 (1) ◽  
pp. 218-220
Author(s):  
Hiroshi Ninomiya ◽  
Makito Watanabe ◽  
Kazunari Kamimura
Keyword(s):  
Fixation Technique ◽  
Avulsion Fractures ◽  
Calcaneal Tuberosity

scholarly journals Mini-Plate and Screw Fixation Technique for Comminuted Flexor Digitorum Profundus Avulsion Fracture

2020 ◽  
Vol 25 (1) ◽  
pp. 33-38
Author(s):  
Hye Yeon Choi ◽  
Jeong Hwan Kim ◽  
Young Ju Noh
Keyword(s):  
Open Reduction ◽  
Avulsion Fracture ◽  
Screw Fixation ◽  
Flexor Digitorum Profundus ◽  
Fixation Technique ◽  
Avulsion Fractures ◽  
Pin Fixation ◽  
Flexor Digitorum ◽  
Mini Plate ◽  
Pull Out Suture

Avulsion fracture of flexor digitorum profundus (FDP) tendon is relatively rare fracture at the distal phalangeal base than avulsion fracture of terminal extensor tendon. Terminal extensor avulsion fracture, known as bony mallet finger, could be successfully treated by closed reduction and pinning, such as extension block technique. However, most of FDP avulsion fracture, known as Jersey’s finger, needed open reduction, because of the proximal migration of fracture fragment and difficulty of pin fixation. Up to date, most of FDP avulsion fractures were treated by open reduction and fixation by pull-out suture or suture anchor technique. We report a case of comminuted FDP avulsion fracture, successfully treated by open reduction and mini-plate and screw fixation technique.

scholarly journals Bone Anchor Suture Tape Fixation Technique for the Treatment of Calcaneal Avulsion Fractures

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0030
Author(s):  
Sandra A. Miskiel ◽  
Andre J. Pagliaro
Keyword(s):  
Weight Bearing ◽  
Case Series ◽  
Fixation Technique ◽  
Bone Anchor ◽  
Fixation Failure ◽  
Superficial Infection ◽  
Avulsion Fractures ◽  
Reliable Technique ◽  
Anchor Suture ◽  
Suture Tape

Category: Hindfoot, Trauma Introduction/Purpose: Surgical treatment of avulsion fractures of the calcaneus has a reported fixation failure rate as high as 23%, and there is much controversy surrounding the best method of treatment for these fractures. We present a technique for fixation of calcaneal avulsion fractures utilizing a bone anchor suture tape fixation technique that can be utilized with or without additional standard internal fixation. Methods: Five patients (2 male, 3 female), with an average age of 73 years old, presenting with a closed extraarticular avulsion fracture of the calcaneus, are included in this case series. Patients underwent bone anchor and suture tape fixation of fracture by a single foot and ankle-fellowship trained orthopaedic surgeon. Patients were additionally assessed pre-operatively, using the contralateral uninjured limb, for gastrocnemius equinus; and if present, patients underwent a gastrocnemius recession. If appropriate, a single compression lag screw and washer inserted perpendicular to fracture line was utilized for additional fixation. Outcomes observed were time to radiographic consolidation, failure of fixation, reoperation rate, presence of post-operative infection, and return to previous function. Results: Of the included patient cohort, all fractures went on to union, and there were no failures of fixation. There was one removal of a compression screw and washer due to hardware pain, and one superficial infection, which resolved with local wound care. All patients went on to weight-bearing as tolerated within 8 weeks post-operatively. Radiographic consolidation was observed at approximately 12 weeks. 4 out of 5 patients returned to previous function, with 1 patient expiring due to unrelated causes prior to determination of final function. Conclusion: Use of a bone anchor suture tape fixation technique appears to hold promise and warrants further investigation for its potential utilization as a reliable technique for fixation for avulsion fractures of the calcaneus. Our technique increases the distribution of surface area forces over the cortical bone while incorporating multiple points of fixation, including through the Achilles tendon insertion, neutralizing the distraction forces of the tendon directly.

Neuropathic Calcaneal Tuberosity Avulsion Fractures

1993 ◽  
Vol &NA; (296) ◽  
pp. 8???13 ◽  
Author(s):  
WILLIAM C. BIEHL ◽  
JAMES M. MORGAN ◽  
F. WILLIAM WAGNER ◽  
RODNEY GABRIEL
Keyword(s):  
Avulsion Fractures ◽  
Calcaneal Tuberosity

Outcomes of operatively treated calcaneal tuberosity avulsion fractures

Injury ◽  
2021 ◽  
Author(s):  
Choon Chiet Hong ◽  
Joel Xue Yi Lim ◽  
Jun Hao Tan ◽  
Christopher Jon Pearce
Keyword(s):  
Avulsion Fractures ◽  
Calcaneal Tuberosity

Arthroscopic Two-Point Suture Bridge Fixation Technique for the Treatment of Anterior Cruciate Ligament Tibial Avulsion Fractures

2021 ◽  
Vol 11 (10) ◽  
pp. 1977-1982
Author(s):  
Dong Zheng ◽  
Jianjian Yin ◽  
Long Han ◽  
Jianchao Gui
Keyword(s):  
Anterior Cruciate Ligament ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Suture Fixation ◽  
Fixation Technique ◽  
Avulsion Fractures ◽  
Anterior Drawer ◽  
Kt 1000 ◽  
Anterior Cruciate

This study aimed to present and evaluate a new arthroscopic technique that uses two-point suture fixation for anterior cruciate ligament (ACL) tibial avulsion fractures. A total of 15 patients diagnosed with ACL tibial avulsion fracture underwent arthroscopic suture fixation from November 2018 to October 2019 and were treated using two-point suture fixation. The patients were followed up and evaluated according to Lysholm scores, International Knee Documentation Committee (IKDC) subjective scores, Tegner activity level scales, anterior drawer testing, and KT-1000 arthrometer testing. The mean follow-up period was 18 months (12 to 24). All patients had a negative Lachman test and anterior drawer test at final follow-up and showed the radiological union of avulsion fracture at 12-week postoperative radiograph. The Lysholm score improved significantly postoperatively with a mean score of 94.26±3.63 (87 to 98; p < 0.001). The Tegner score improved significantly postoperatively from 3.61 ±1.37 to 7.14±1.51 (P < 0.001). The KT-1000 measured value decreased significantly postoperatively from 7.3±1.5 to 1.4 ±1.2 (P < 0.001). The IKDC category was abnormal or severely abnormal preoperatively, and all patients improved to normal or nearly normal at final follow-up. Arthroscopic treatment using the two-point suture fixation technique is effective for ACL avulsion fracture and can restore the function and stability of the knee joint.

Calcaneal Tuberosity Fracture (Beak Fracture) Fixation Using a Pre-contoured “L-form” Hook Plate: A Retrospective Study

2021 ◽  
Author(s):  
Qiang Zhang ◽  
Chan Zhu ◽  
Zongde Wu
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Plate Fixation ◽  
Hook Plate ◽  
Fixation Technique ◽  
Fixation Failure ◽  
Clinical Healing ◽  
Ankle Function ◽  
Calcaneal Tuberosity

Abstract Background: The treatment of calcaneal tuberosity fracture (beak fracture) is very tricky. Patients’ ankle function may be badly affected by skin flap necrosis and internal fixation failure. This study presented a simple, and safe internal fixation technique which is to fix the fracture fragment with a pre-contoured “L-form” hook plate.Methods: A retrospective study was done to analyze patients with calcaneal tuberosity fracture who were treated with pre-contoured “L-form” hook plate fixation from January 2015 to February 2020. When the patients could complete single-legged heel raise tests, and when they achieved clinical healing criteria were reviewed. Functional assessment was performed according to the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS-AH) scores and the Visual Analogue Scale (VAS) was recommended for assessment of pain intensity (PI).Results: There were a total of 15 patients of calcaneal tuberosity fracture (beak fracture) treated with the pre-contoured “L-form” hook plate fixation technique, among which eight patients were female and the others were male, with the age ranging from 35 to 69 years (average of 55.3±9.0 years). And the mean duration of follow-up was 22.53±5.78 months (range: 12 to 36 months). 11 cases underwent emergency surgery. After the operation, there were no complications such as wound dehiscence, poor wound healing, infections, or plate exposure, no sural nerve injuries or venous thromboembolic events. Also, there was no loss of reduction or fixation failure in the follow-up. All 15 cases achieved clinical healing at 8-13 weeks (average 10.5±1.4 weeks) postoperatively. They were able to perform the test on their affected leg after 3.7±0.7 months (3-5 months) on average. The preoperative VAS and AOFAS-AH scores were 5.7±0.6 and 24.0±9.9 respectively, while the postoperative VAS and AOFAS-AH scores at the last follow-up were 1.3±0.5 and 93.8±5.2 (p<0.001).Conclusion: Emergency open reduction and internal fixation should be provided as soon as possible. For patients with Beavis type II beak fractures, the pre-contoured “L-form” hook plate fixation technique helps them restore normal ankle function. This simple, safe, and strong internal fixation technique can be one of the treatment options for avulsion fractures of the calcaneal tuberosity.

scholarly journals Combined Lag Screw and Cerclage Wire Fixation for Calcaneal Tuberosity Avulsion Fractures

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Vincenzo Giordano ◽  
Alexandre Leme Godoy-Santos ◽  
Felipe Serrão de Souza ◽  
Hilton Augusto Koch ◽  
Cesar de Cesar Netto ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Large Diameter ◽  
Minor Trauma ◽  
Cannulated Screws ◽  
Avulsion Fractures ◽  
Cerclage Wire ◽  
Plantar Aspect ◽  
Calcaneal Tuberosity

Avulsion fractures of the calcaneal tuberosity represent a rare injury pattern that is caused by a powerful tension force from the Achilles tendon and is usually seen following minor trauma, especially in elderly patients. The objective of this study is to describe a surgical technique using cerclage wiring through cannulated screws in the treatment of extra- and intra-articular avulsion fractures of the calcaneal tuberosity and to present our results in a small patient’s cohort. Through a 5.0 cm longitudinal skin incision over the posterolateral aspect of the calcaneus, after adequate debridement of the fracture fragments and while keeping the ankle in plantarflexion, the calcaneal tuberosity is anatomically reduced with the help of a periarticular reduction clamp and an accessory plantar longitudinal approach. Provisionally fixation is performed with K-wires. Definitive fixation is achieved with two parallel partially threaded 7.0 cannulated screws, which are positioned from the superior and posterior aspect of the tuberosity to the inferior and anterior aspect of the plantar surface of the calcaneus, and 1.5 mm cerclage wires that are pulled epiperiosteally to the plantar aspect of the calcaneus to avoid damage to local soft tissues. Alternatively, for smaller fracture fragments, two 3.5 mm partially threaded cannulated screws and 1.25 mm cerclage wires can be used. We also report the results of the procedure in a small cohort of four patients. All fractures healed in an anatomic position. There was no failure of fixation, loss of reduction, or need for secondary surgery, including hardware removal. At final follow-up, all patients had regained full plantar flexion range of motion and strength, with no gait or weight-bearing restrictions. In conclusion, the combination of cerclage wire and large diameter cannulated screws represents a promising option in the treatment of avulsion fractures of the calcaneal tuberosity, demonstrating good functional and radiographic results in our cohort of patients.

Efficacy of Arthroscopic suture fixation technique in comminuted avulsion fractures of Anterior Cruciate Ligament

2016 ◽  
Vol 2 (3) ◽  
pp. 231
Author(s):  
Prashant Vilas Bhandari ◽  
Punarvasu Rajeev Jagtap ◽  
Suyog Prakash Burgute ◽  
Vijay Vasant Nemade
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Suture Fixation ◽  
Fixation Technique ◽  
Avulsion Fractures ◽  
Anterior Cruciate

The Heel of Achilles: Calcaneal Avulsion Fracture from a Gunshot Wound

Foot & Ankle ◽  
1989 ◽  
Vol 9 (4) ◽  
pp. 204-206 ◽  
Author(s):  
Daniel E. Cooper ◽  
James D. Heckman
Keyword(s):  
Achilles Tendon ◽  
Gunshot Wound ◽  
Achilles Tendon Rupture ◽  
Penetrating Trauma ◽  
Triceps Surae ◽  
Greek Mythology ◽  
Calcaneal Fractures ◽  
Avulsion Fractures ◽  
Simultaneous Extension ◽  
Calcaneal Tuberosity

Greek mythology relates that the legendary warrior Achilles was made invincible by his mother Thetis, who dipped him in the River Styx while holding him by his heel. Because his heel was never immersed, it remained his one area of vulnerability. After the fall of Troy, Achilles met his demise when he was shot in the heel by Paris, whose arrow was guided by the Greek god Apollo. This is the derivation of the term “Achilles tendon.” Avulsion fractures of the tuberosity of the calcaneus are rare injuries. 1 , 2 , 3 , 6 , 7 , 12 Schonbauer 14 reviewed a series of 870,000 accident cases treated at the Vienna Trauma Hospital and found only four such cases in addition to 151 cases of subcutaneous Achilles tendon rupture. In Bohler's 4 series of 182 calcaneal fractures, avulsion of the calcaneal tuberosity accounted for less than 1% of these injuries. Rowe 13 reported four Achilles avulsion fractures in his series of 154 calcaneal fractures. Three basic mechanisms of injury have been described: (1) dorsiflexion violence against the maximally plantarflexed foot, typically occurring in a fall from a height; (2) powerful contraction of the triceps surae muscle with simultaneous extension of the knee such as when a person is about to sprint in a race; (3) a direct blunt blow to the hindfoot. 1 , 2 , 8 We are describing a case of avulsion of the calcaneal tuberosity due to direct penetrating trauma from a gunshot wound, a mechanism not previously reported.

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