Displaced Fractures of the Os Calcis Involving the Subtalar Joint: The Key Role of the Superomedial Fragment

Foot & Ankle ◽  
1983 ◽  
Vol 4 (2) ◽  
pp. 91-101 ◽  
Author(s):  
John R. Stephenson
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Subtalar Joint ◽  
Postoperative Management ◽  
Lateral Approach ◽  
Normal Anatomy ◽  
Os Calcis ◽  
Articular Fractures

Fourteen displaced intra-articular fractures of the os calcis are reviewed following open reduction and internal fixation using a lateral approach with an average follow-up of 22 months (range, 12 to 44 months). Postoperative management consisted of early subtalar motion with delayed weightbearing. Twelve of 14 fractures were considered good results on the basis of no pain, 50% normal subtalar motion, and near-normal anatomy. Pain correlated with incomplete reduction of the superomedial fragment and, thus, incongruent reduction of the posterior facet in two cases. The importance of effecting a reduction of the superomedial border of the os calcis is emphasized.

Fractures of the Calcaneus Part II: Treatment

1996 ◽  
Vol 17 (6) ◽  
pp. 360-366 ◽  
Author(s):  
Robert B.W. Lowery ◽  
Jason H. Calhoun
Keyword(s):  
Internal Fixation ◽  
Classification System ◽  
Open Reduction ◽  
Subtalar Joint ◽  
Calcaneal Fractures ◽  
Articular Fracture ◽  
Articular Fractures ◽  
Anatomic Reduction ◽  
Fracture Management

Extra-articular fracture management of the calcaneus is well accepted. Despite advancements, there is still no consensus on the treatment of intra-articular calcaneal fractures. Although the results of open reduction and internal fixation appear promising, evaluation is difficult because there is no universally accepted classification system. We believe that a consensus is developing for the evaluation, staging, and treatment of the acute calcaneus fracture and its chronic problems. Advancements in the understanding of the anatomy, injury mechanism, and classification of calcaneal fractures were presented in Parti ( Foot & Ankle International, 17(4):230–235, 1996). Treatment of displaced intra-articular fractures gives superior results when anatomic reduction of the subtalar joint is achieved.

scholarly journals Short term outcome of open reduction and internal fixation with plating in displaced intra articular calcaneal fractures

2020 ◽  
Vol 8 (4) ◽  
pp. 1226
Author(s):  
Amit Thakur ◽  
Zubair A. Lone ◽  
John Mohd ◽  
Mohammad Azhar ud din Darokhan ◽  
Tanveer Ali ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Bone Fractures ◽  
Lateral Approach ◽  
Calcaneal Fractures ◽  
Management Options ◽  
Term Outcome ◽  
Articular Fractures ◽  
Effective Treatment Modality ◽  
No Gold Standard

Background: Calcaneum fractures constitute the majority of the tarsal bone fractures worldwide. There is no gold standard consensus as of now for the management of the displaced intra articular calcaneal fractures. Open reduction and internal fixation with plating is one of the management options available.Methods: Authors studied the results of open reduction and internal fixation with plating in 22 calcaneal fractures in a study with a minimum follow up of 6 months. Outcome was studied using Maryland foot score.Results: Authors observed excellent results in 5 patients (22.72%), good results in 12 patients (54.54%), fair results in 4 patients (18.18%) and poor result in 1 patient (04.54%). Authors encountered wound infection in 1 patient (4.54%), heel varus in 1 patient (4.54%), heel broadening in 1 patient (4.54%), reduced range of motion at ankle in 2 patients (9.9%) and persistent heel pain in 1 patient (4.54%).Conclusions: Open Reduction and Internal Fixation (ORIF) with calcaneum plating, through an extensive lateral approach, for displaced intra articular fractures of the calcaneum is an effective treatment modality with very good results in experienced hands.

Open reduction and internal fixation of displaced head-split type humeral fractures and role of the rotator-interval approach

2021 ◽  
pp. 175857322110654
Author(s):  
E. Fleischhacker ◽  
G. Siebenbürger ◽  
J. Gleich ◽  
T. Helfen ◽  
W. Böcker ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Dash Score ◽  
Rotator Interval ◽  
Anatomic Reduction ◽  
Interval Approach ◽  
High Instability

Background Open reduction and internal fixation (ORIF) of humeral head split fractures is challenging because of high instability and limited visibility. The aim of this retrospective study was to investigate the extend of the approach through the rotator interval (RI) on the reduction quality and functional outcome. Methods 37 patients (mean age: 59  ±  16 years,16 female) treated by ORIF through a standard deltopectoral (DP) approach were evaluated. The follow-up period was at least two years. In 17 cases, the approach was extended through the RI. Evaluation was based on radiographs, Constant scores (CS) and DASH scores. Results In group DP, “anatomic” reduction was achieved in 9 cases (45%), “acceptable” in 5 cases (25%), and “malreduced” in 6 cases (30%). In group RI, “anatomic” reduction was seen in 12 cases (71%), “acceptable” in 5 cases (29%), and “malreduced” in none (p  =  0.04). In the DP group, the CS was 60.2  ±  16.2 and the %CS was 63.9  ±  22.3, while in the RI group, the CS was 74.5  ±  17.4 and the %CS was 79.1  ±  24.1 (p  =  0.07, p  =  0.08). DASH score was 22.8  ±  19.5 in DP compared to RI: 25.2  ±  20.6 (p  =  0.53). Conclusions The RI approach improves visualization as it enhances quality of fracture reduction, however functional outcomes may not differ significantly. Type of study and level of proof Retrospective, level III

scholarly journals Intra articular fracture of distal end of radius treated by open reduction and internal fixation with buttress plate-a clinical study

2017 ◽  
Vol 3 (3) ◽  
pp. 518
Author(s):  
Pavankumar H. Patil ◽  
Srinivas Pamarathi
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Point System ◽  
Unstable Fracture ◽  
Articular Fracture ◽  
Medical College ◽  
Articular Fractures ◽  
Buttress Plate

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Recognition of fracture patterns and fixation of fracture to secure and maintain reduction is the key for successful management of more complex intra articular fractures of distal radius. Devices like buttress plates have been shown to provide excellent stability for an unstable fracture with either dorsal or volar metaphyseal comminution. The objective of the study was to evaluate the functional outcome of intra articular fracture of distal end of radius treated by open reduction and internal fixation by buttress plate using Criteria of Gartland and Werley Point System.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Twenty patients with intra articular fracture of distal end radius were treated by open reduction and internal fixation by buttress plate in Al-Ameen medical college, Bijapur. </span><span lang="EN-IN">Statistical analysis: The data obtained was represented as percentage</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study included 20 patients, 11 males and 9 females aged from 21 to 69 years with mean of 40.2 years. The average duration of follow-up was 7 months ranged from 6-10 months. Using the Demerit scoring system of Gartland and Werley, we had 20% excellent results, 45% good results, 20% fair results and 15% poor result whereas, excellent to good results were found in 65% of patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Open reduction and internal fixation by buttress plate provides better functional outcome in treating the intra articualar fracture of distal end radius. Excellent to good results are produced by using buttress plate for fixation of intra articular fractures of distal end radius. So, this procedure can be used as alternative to other procedures in treating intra articular fractures of distal end radius.</span></p>

scholarly journals Evaluation of functional and clinical outcome of open reduction and internal fixation of Barton’s fracture of the wrist in a central hospital of Kashmir

2021 ◽  
Vol 7 (5) ◽  
pp. 986
Author(s):  
Jawed A. Bhat ◽  
Faesal Khurseed ◽  
Abdul H. Javaid
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Road Traffic ◽  
Excellent Result ◽  
Functional Results ◽  
Functional Evaluation ◽  
College Hospital ◽  
Articular Fractures ◽  
Limited Range Of Motion

<p class="abstract"><strong>Background:</strong> Fractures of the distal end of radius continue to pose a management challenge. Defective alignment of extra articular as well as intra articular fractures result in a variety of complications like post traumatic arthritis, decreased in grip strength and endurance as well as limited range of motion and instability of carpus. The main aim of this study is to assess the functional results of open reduction and internal fixation in the treatment of volar Barton’s fracture.</p><p class="abstract"><strong>Methods:</strong> From December 2006 to December 2019, forty cases of volar Barton’s fracture were operated in Skims Medical College Hospital, Srinagar, Kashmir, however only 32 cases were included in the study group and 8 cases were lost to follow up. In the majority of our cases the injury was sustained as a result of road traffic accident followed by fall. Majority (24) of the cases were operated within one week of trauma, followed by six in two weeks and two in 3 weeks of time since injury.<strong></strong></p><p class="abstract"><strong>Results:</strong> Functional evaluation was done after a mean follow-up of 28.7 months. Fracture union was achieved within 8 to 12 weeks and excellent results were obtained in 18 cases and 10 cases were categorized as good followed by fair result in 4 cases. Median nerve compression was not observed in any case.</p><p class="abstract"><strong>Conclusions:</strong> Good to excellent result can be achieved after open reduction and internal fixation which restores joint congruity.</p>

Intra-Articular Fractures at the Base of the Fifth Metacarpal

1992 ◽  
Vol 17 (2) ◽  
pp. 144-147 ◽  
Author(s):  
K. KJÆR-PETERSEN ◽  
A. G. JURIK ◽  
L. K. PETERSEN
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Plaster Cast ◽  
Percutaneous Pinning ◽  
Articular Fractures ◽  
Grip Power

The treatment of 64 intra-articular fractures at the base of the fifth metacarpal was studied. 11 fractures with minimal displacement had been immobilised in a plaster cast without reduction. The position was improved in five of 25 fractures treated by closed reduction and a plaster cast, six of nine fractures after percutaneous pinning, and 12 of 19 fractures after open reduction and internal fixation. At follow-up after a median of 4.3 years, 19 of 50 patients answering a questionnaire had intermittent pain, especially on firm grip. 43 patients were re-examined clinically and radiographically: 21 (49%) had decreased grip power, and 28 had radiographical signs of osteoarthrosis.

Open Reduction and Internal Fixation of Type II Intra-Articular Calcaneus Fractures

1996 ◽  
Vol 17 (5) ◽  
pp. 253-258 ◽  
Author(s):  
Lynn A. Crosby ◽  
Timothy C. Fitzgibbons
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Excellent Result ◽  
Lateral Approach ◽  
Average Score ◽  
Type I ◽  
Type Ii ◽  
Extended Lateral Approach ◽  
Calcaneus Fractures

Open reduction and internal fixation of 23 type II calcaneus fractures in 21 patients was performed using a standard extended lateral approach. Average follow-up was 26 months (range, 12–47 months). The Creighton-Nebraska Health Foundation Assessment Score for Fractures of the Calcaneus was used to evaluate fractures. The average score was 91.4 (range, 80–100), which represented an excellent result. A series of 10 type II fractures treated with closed methods was also evaluated using the same evaluation methods. The average score was 70 (range, 60–84), which represented a fair result. There was a clear statistically significant superiority with type II calcaneus fractures treated with open reduction and internal fixation ( P < 0.0001). We recommend type I calcaneus fractures (nondisplaced) be treated with closed methods, and type II calcaneus fractures (displaced) be treated with open reduction and internal fixation.

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