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.

scholarly journals Nascent Malunion of an Isolated Intraarticular Fracture of the Ulnar Head

2019 ◽  
Vol 09 (03) ◽  
pp. 240-243
Author(s):  
Frank Nienstedt ◽  
Markus Mariacher ◽  
Günther Stuflesser ◽  
Wilhelm Berger
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Excellent Result ◽  
Corrective Osteotomy ◽  
Fracture Dislocation ◽  
Intraarticular Fracture ◽  
Ulnar Head ◽  
Ulnar Styloid Fracture ◽  
Palmar Approach

Abstract Background Isolated fractures of the ulnar head are rare. Only few cases have been reported in literature. Case Description We report a case of a 16-year-old student who was treated for an ulnar styloid fracture conservatively. An associated displaced intraarticular fracture of the ulnar head has been overlooked. He presented late in our clinic with a symptomatic nascent malunion of the ulnar head fracture. A corrective osteotomy by a palmar approach was performed. Fixation by screws was used with an excellent result at 7-year follow-up. Literature Review The rare cases of isolated ulnar head fractures reported in literature were treated by open reduction and internal fixation only in case of fracture dislocation. Clinical Relevance The authors highlight the fact that even a nascent malunion of an isolated intraarticular fracture of the ulnar head may be treated successfully by open reduction and internal fixation.

scholarly journals Cost-utility Analysis of Extensile Lateral Approach Versus Sinus Tarsi Approach in Sanders type II/III Calcaneus Fractures

2020 ◽  
Author(s):  
Zihua Li ◽  
Xinbo Wu ◽  
Haichao Zhou ◽  
Shaochen Xu ◽  
Fajiao Xiao ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Internal Fixation ◽  
Incremental Cost ◽  
Lateral Approach ◽  
Type Ii ◽  
Calcaneus Fracture ◽  
Sinus Tarsi Approach ◽  
Significant Difference ◽  
Extensile Lateral Approach ◽  
Calcaneus Fractures

Abstract Background Extensile lateral approach had been recognized as the gold standard technique for displaced intra-articular calcaneus fractures (DIACFs) while sinus tarsi approach had been increasingly valued by surgeons. And comparative clinical outcome was shown in both techniques. Appropriate decisions could be made by the clinicians with the help of CUA about optimal healthcare for type II/III calcaneus fracture. Method A single-center, retrospective study was conducted in which basic characteristics, clinical outcomes and health care costs of 109 patients had been obtained and analyzed. Changes in health-related quality of life (HRQoL) scores, validated by EuroQol five-dimensional-three levels (EQ-5D-3L), were used to enumerate quality-adjusted life-years (QALYs). Cost-effectiveness was determined by the incremental cost per QALY. Results 109 patients were enrolled in our study including 62 in the ELA group and 47 in the STA group. There were no significant differences between these two groups in mean total cost, laboratory and radiographic evaluation expense, surgery, anesthesia and antibiotic expense. The expense of internal fixation materials ($3289.0 ± 543.9) versus ($2630.6 ± 763.7) and analgesia ($145.8 ± 85.6) versus ($102.9 ± 62.7) in ELA group were significantly higher than in the STA group ( P <.001, P =.008, respectively). Visual Analogue Scale (VAS) scores showed significant difference at postoperative 3 and 5 days ( P <.001). American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and the Bohlers’ and Gissane angle showed no significant differences between the two groups before and after the operation. The cost-effectiveness ratios of ELA and STA were $8766.8±2835.2/QALY and $7914.9 ± 1822.0/QALY respectively and incremental cost-effectiveness ratio (ICERs) of ELA over STA was $32110.00/QALY, but both showed no significant difference. Conclusion Both ELA and STA techniques are effective operative procedures for the patients with calcaneus fracture. Moreover, STA seems to be more reasonable for its merits including less postoperative pain, and less expense of analgesia as well as internal fixation materials.

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.

scholarly journals INTERNAL FIXATION OF TYPE I CAPITELLUM FRACTURE WITH HEADLESS SCREWS: A CASE REPORT

2021 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Charlie Sanjaya ◽  
I Ketut Gede Arta Bujangga
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Fracture Site ◽  
Humeral Fractures ◽  
Anatomical Reconstruction ◽  
Type I ◽  
Rigid Fixation ◽  
Distal Humeral Fractures ◽  
Capitellum Fracture

Background: Capitellum fractures are relatively rare. Distal humeral fractures that include capitellum and trochlea constitute approximately 6% of all distal humeral fractures and 1% of all elbow fractures. Despite the rarity of these injuries, an increasing number of clinical series have emerged, enhancing our understanding of these fractures.Case Report: A 26-year-old woman came to the emergency department with complaints of swelling and localized pain on the lateral side of her left elbow 2 hours after she fell off her motorcycle. Routine imaging such as plain radiographs and computed tomography scanning confirmed the fracture. She underwent open reduction and internal fixation surgery, stabilization of articular fragments with headless screws, and was fixated by a back slab and arm sling. The patient was also encouraged to do early elbow mobilization to avoid contractures and joint stiffness, routine follow-up every two weeks for a ROM evaluation. Preoperative Mayo Elbow-Performance Index score (MEPI) was 15, and postoperative 100.Discussion: The aim of capitellum fracture treatment is anatomical reconstruction and fixation to reduce the risk of non-union. In this case, we performed open reduction, secured two headless screws, which allow rigid fixation at the fracture site, provide fracture site compression through variable thread pitch design, and remained not removed later. These screws are suitable for use in anteroposterior and posteroanterior directions.Conclusion: The patient at two months follow-up has shown significant improvement. Accurate reduction, stable fracture fixation, and early postoperative mobilization were reported to provide good results with a MEPI score of 100.

scholarly journals Bilateral Sander IV calcaneus fractures: Primary fusion or fixation?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0006
Author(s):  
Rajiv Shah
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Standard Of Care ◽  
Calcaneus Fracture ◽  
Subtalar Fusion ◽  
Fall From Height ◽  
Long Term Follow Up ◽  
Calcaneus Fractures

Category: Trauma Introduction/Purpose: Primary subtalar fusion for Sander IV calcaneus fractures was considered to be the standard of care till recent past. Presently debate is on whether to manage Sander IV calcaneus fracture cases with primary subtalar fusion or with open reduction and internal fixation. Bilateral Sander IV calcaneus fractures are seen in cases with fall from height. No study has ever been conducted till date to compare the results of primary fusion of a Sander IV calcaneus fracture on one side and open reduction and internal fixation on another side in cases with bilateral Sander IV calcaneus fractures. We present a study comparing the results of primary fusion versus open reduction and internal fixation for bilateral sander IV calcaneus fracture cases. Methods: Twelve cases with bilateral closed Sander IV calcaneus fractures where included in the present study. Cases were operated between four to six weeks by a single surgeon after the appearance of wrinkles. All right sided fractures underwent open reduction and internal fixation with proximal tibia grafting. While all left-sided fractures underwent subtalar fusion with the use of ipsilateral anterior iliac crest grafts. Cases were followed up for 24 months. Results: Though operative time was more in the fusion group wound problems were equal in both the groups. Four months of average time to union was the same in both the groups and so was time to return to work. At two years, the AOFAS score was slightly better in the fusion group but it was not statistically significant. Conclusion: Primary subtalar fusion is with almost similar results as those with open reduction and internal fixation in bilateral Sander IV at 24 months. Long term follow up with more number of cases is required to prove the benefit of one over other.

scholarly journals Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

2013 ◽  
Vol 38 (4) ◽  
pp. 767-773 ◽  
Author(s):  
Manouk Backes ◽  
Tim Schepers ◽  
M. Suzan H. Beerekamp ◽  
Jan S. K. Luitse ◽  
J. Carel Goslings ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Lateral Approach ◽  
Wound Infections ◽  
Calcaneal Fractures ◽  
Extended Lateral Approach

Treatment of Fractures of the Humeral Capitellum Using Herbert Screws

2006 ◽  
Vol 31 (3) ◽  
pp. 320-325 ◽  
Author(s):  
M. MAHIROGULLARI ◽  
A. KIRAL ◽  
C. SOLAKOGLU ◽  
O. PEHLIVAN ◽  
I. AKMAZ ◽  
...  
Keyword(s):  
Open Reduction ◽  
Excellent Result ◽  
Early Mobilization ◽  
Type I ◽  
Posterior Surface ◽  
Lateral Epicondyle ◽  
Postoperative Assessment ◽  
Elbow Injuries ◽  
The Mean

Isolated fractures of the capitellum are rare injuries and account for 1% of all elbow injuries. The purpose of this study is to evaluate the clinical outcomes of 11 Type I capitellum fractures treated by open reduction and internal fixation using at least two standard Herbert screws between 1998 and 2003. The average age of the patients was 27.5 years. The mean follow-up time was 23.4 months. The final postoperative assessment was made at the 12th month. The results were evaluated according to the Mayo Elbow Performance Index. We obtained excellent result in eight patients and good result in three patients. We recommend open reduction and fixation with Herbert screws inserted from the posterior surface of the lateral epicondyle and early mobilization in Type I fractures of the capitellum.

scholarly journals Closed reduction and percutaneous pinning vs open reduction and internal fixation in pediatric lateral condylar humerus fractures displaced by > 4 mm: an observational cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Li-wei Xie ◽  
Zhi-qiang Deng ◽  
Ren-huan Zhao ◽  
Juan Wang ◽  
Xin Liu ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Postoperative Treatment ◽  
Therapeutic Effects ◽  
Type I ◽  
Percutaneous Pinning ◽  
Cubitus Varus ◽  
Humerus Fractures

Abstract Background Although open reduction and internal fixation (ORIF) is recommended for lateral condylar humerus fractures (LCHFs) displaced by > 4 mm, several studies have reported the use of closed reduction and percutaneous pinning (CRPP) to treat LCHFs with significant displacement. However, little is known about the clinical differences between these two surgical techniques. This study aimed to compare the therapeutic effects of CRPP and ORIF in treating LCHFs displaced by > 4 mm. Methods We retrospectively reviewed pediatric LCHFs displaced by > 4 mm treated with either CRPP or ORIF at our center from June 2019 to October 2020. Song and Milch fracture classifications were used. Variables such as age at injury, sex, side injured, fracture displacement, fracture type, operating time, postoperative treatment, and complications were compared between the two techniques. Results One hundred twenty LCHFs met inclusion criteria. There were 36 Milch type I and 84 type II LCHFs, and 69 Song stage 4 and 51 stage 5 LCHFs. CRPP was performed in 45 cases and ORIF in 75 cases. No differences were found in age, sex, side injured, preoperative displacement, postoperative displacement, and length of immobilization between the CRPP and ORIF groups. There was a difference between operation time and pin duration. The CRPP group had shorter operation times and pin duration, and required no additional operations to remove internal pins. The average follow-up duration was 13.9 months. All patients achieved fracture union, and no complications such as infection, nonunion, delayed union, osteonecrosis, fishtail deformity, cubitus varus or valgus, or pain were recorded during follow-up. Bone spurs, lateral prominences, and decreased carrying angle were common complications in all groups. No obvious cubitus varus was observed. Unaesthetic scars were only observed in the ORIF groups. No differences in range of motion or elbow function was found among the different therapies. Conclusions Both CRPP and ORIF can achieve satisfactory clinical outcomes in treating LCHFs displaced by > 4 mm. No differences were found in complications or prognoses between the two groups. However, CRPP shows some advantages over ORIF, like less invasive surgery, no obvious scarring, and no need for secondary surgery with anesthesia for pin removal.

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