scholarly journals Calcaneal fractures: a management dilemma-minimally invasive approach for intra and extra articular calcaneal fractures

2019 ◽  
Vol 7 (3) ◽  
pp. 756
Author(s):  
Kawade M. S. ◽  
Madan H. S. ◽  
Shailesh Khachane ◽  
Manjeet Singh Dhanda
Keyword(s):  
Minimally Invasive ◽  
Open Reduction ◽  
Wound Complications ◽  
Walking Ability ◽  
Complication Rates ◽  
Ct Reconstruction ◽  
Minimally Invasive Approach ◽  
Calcaneal Fractures ◽  
Invasive Approach ◽  
Minimally Invasive Methods

Background: Calcaneal fractures which constitutes 2% of total fractures are frequent and very debilitating if not treated properly. Calcaneal fractures generally affect younger population leading to significant man-days loss(around 2-5 years3) and in-turn leading significant economic burden on the society. The goal of treatment for calcaneal fractures is elimination of pain and restoration of normal foot shape, biomechanics, and walking ability. Wound related complications are common with open surgeries. After open reduction internal fixation with perimeter plates for displaced calcaneal fractures, wound edge necrosis is commonly observed with the extended lateral approach. Because of such high incidence of wound complications in open reduction of calcaneum fractures, minimally invasive approach takes priority over open reduction of these fractures.Methods: The study aimed to evaluate the results of minimally invasive approach for calcaneal fractures. To reduce the operative complications, 30 patients were treated with minimally invasive methods in both extra articular and intra-articular calcaneal fractures and the results were evaluated. All patients were evaluated clinically , functionally and radiologically 3D- CT reconstruction images.Results: All cases were followed up for 2 years at specified intervals. The outcome measures were evaluated by AOFAS scores10 with excellent result in 13 cases and good to fair results in the rest. Operated patients had no wound infection, no skin necrosis, 5 patients had mild subtalar arthrosis and 3 patients complained slight difficulty in wearing shoes. None of them have any gait abnormalities.Conclusions: Our study suggests that the minimally invasive methods will reduce the operative complication rates. The minimally invasive surgical intervention in an expert hand can yield better results with less complication rates.

Minimally Invasive Lateral Retropleural Thoracolumbar Approach: Cadaveric Feasibility Study and Report of 4 Clinical Cases

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons32-ons39 ◽  
Author(s):  
Juan S. Uribe ◽  
Elias Dakwar ◽  
Rafael F. Cardona ◽  
Fernando L. Vale
Keyword(s):  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Early Experience ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Lateral Aspect ◽  
Invasive Approach ◽  
Vertebral Bodies ◽  
Clinical Cases

Abstract BACKGROUND: Traditional anterior and posterior approaches to the thoracolumbar spine are associated with significant morbidity. In an effort to eliminate these drawbacks, minimally invasive retropleural approaches have been developed. OBJECTIVE: To demonstrate the feasibility and clinical experience of a minimally invasive lateral retropleural approach to the thoracolumbar spine. METHODS: Seven cadaveric dissections were performed in 7 fresh specimens to determine the feasibility of the technique. In each specimen, the lateral aspect of the vertebral body was accessed retropleurally, and a corpectomy was performed. Intraprocedural fluoroscopy and postoperative computed tomography were used to assess the extent of decompression. As an adjunct, 3 clinical cases of thoracic fractures and 1 neurofibroma were treated with this minimally invasive approach. Operative results, complications, and early outcomes were assessed. RESULTS: In the cadaveric study, adequate exposure was obtained to perform a lateral corpectomy and to allow interbody grafting between the adjacent vertebral bodies. The procedures were successfully performed in the 4 clinical cases without conversion to conventional approaches. A pleural tear was noted in the first clinical case, and a chest tube was placed without any long-term sequelae. CONCLUSION: Our early experience suggests that the minimally invasive lateral retropleural approach allows adequate vertebrectomy and canal decompression without the tissue disruption associated with posterolateral approaches. This approach may improve the complication rates that accompany open or endoscopic approaches for thoracolumbar corpectomies.

MINIMALLY INVASIVE POSTEROLATERAL THORACIC CORPECTOMY

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. 746-753 ◽  
Author(s):  
Dae-Hyun Kim ◽  
John E. O'Toole ◽  
Alfred T. Ogden ◽  
Kurt M. Eichholz ◽  
John Song ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cancer Metastasis ◽  
Burst Fracture ◽  
Invasive Technique ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Tubular Retractor ◽  
Invasive Approach ◽  
Vertebral Bodies ◽  
Clinical Cases

Abstract OBJECTIVE To demonstrate the feasibility of and initial clinical experience with a novel minimally invasive posterolateral thoracic corpectomy technique. METHODS Seven procedures were performed on 6 cadavers to determine the feasibility of thoracic corpectomy using a minimally invasive approach. The posterolateral thoracic corpectomies were performed with expandable 22 mm diameter tubular retractor paramedian incisions. The posterolateral aspects of the vertebral bodies were accessed extrapleurally, and complete corpectomies were performed. Intraprocedural fluoroscopy and postoperative computed tomography were used to assess the degree of decompression. In addition, 2 clinical cases of T6 burst fracture, 1 T4–T5 plasmacytoma, and 1 T12 colon cancer metastasis were treated using this minimally invasive approach. RESULTS In the cadaveric study, an average of 93% of the ventral canal and 80% of the corresponding vertebral body were removed. The pleura and intrathoracic contents were not violated. Adequate exposure was obtained to allow interbody grafting between the adjacent vertebral bodies. The procedures were successfully performed in the 4 clinical cases using a minimally invasive technique, and the patients demonstrated good outcomes. CONCLUSION Based on this study, minimally invasive posterolateral thoracic corpectomy safely and successfully allows complete spinal canal decompression without the tissue disruption associated with open thoracotomy. This approach may improve the complication rates that accompany open or even thoracoscopic approaches for thoracic corpectomy and may even allow surgical intervention in patients with significant comorbidities.

Surgical outcomes of hysterectomy for endometriosis: Benefits of a minimally invasive approach

2021 ◽  
pp. 228402652098571
Author(s):  
Olga Mutter ◽  
Sarah Ackroyd ◽  
George A Taylor ◽  
Juan Diaz
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Surgical Outcomes ◽  
Abdominal Hysterectomy ◽  
Pelvic Surgery ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Improvement Program ◽  
Invasive Approach ◽  
Abdominal Approach

Introduction: We aimed to evaluate surgical outcomes of hysterectomy for endometriosis performed by general obstetricians and gynecologists (OB/GYNs) based on surgical approach. Methods: Using the 2016–2018 National Surgical Quality Improvement Program (NSQIP) database, we examined surgical outcomes including 30-day complication rates based on surgical approach in patients who underwent a hysterectomy for endometriosis by OB/GYNs. Results: From 2016 to 2018, 3641 hysterectomies were performed by OB/GYNs for endometriosis. 86.0% were performed via a minimally invasive (MIS) approach, with 2882 (79.2%) via a laparoscopic and 247 (6.8%) via a vaginal approach. Compared to MIS hysterectomies, those who underwent an abdominal hysterectomy included a higher proportion of African American and a lower proportion of non-Hispanic white patients, had heavier uteri, lower parity, and were more likely obese (all p < 0.05). There were no differences in age, American Society of Anesthesiologists class, comorbidities other than obesity, or a history of prior abdominal or pelvic surgery (all p > 0.05). Women undergoing hysterectomy for endometriosis experienced an overall 9.8% complication rate. Compared to abdominal approaches, MIS had a lower rate of overall complications (8.5% vs 17.8%) including wound (2.7% vs 7.2%) and major (4.4% vs 8.8%) complications (all p < 0.001). MIS had shorter operative time (129.2 ± 60.9 vs 143.8 ± 71.9), shorter length of stay (0.9 ± 1.6 vs 2.4 ± 1.8), and fewer readmissions (2.8% vs 5.5%) (all p < 0.001). Conclusion: While hysterectomy for endometriosis is a challenging procedure to perform, OB/GYNs are performing this procedure predominantly via a minimally invasive approach with fewer complications and more favorable surgical outcomes than an abdominal approach.

scholarly journals Minimally invasive approach with external fixator for intra-articular calcaneal fractures in children

Medicine ◽  
2021 ◽  
Vol 100 (1) ◽  
pp. e22393
Author(s):  
Jin Li ◽  
Rui Jin ◽  
Renhao Ze ◽  
Saroj Rai ◽  
Yudong Liu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
External Fixator ◽  
Minimally Invasive Approach ◽  
Calcaneal Fractures ◽  
Invasive Approach ◽  
Fractures In Children

scholarly journals Minimally invasive surgery for intra-articular calcaneus fractures: A 9-year, single-center, retrospective study of a standardized technique using a 2-point distractor

2020 ◽  
Author(s):  
Christian Rodemund ◽  
Ronny Krenn ◽  
Carl Kihm ◽  
Iris Leister ◽  
Reinhold Ortmaier ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Treatment Modalities ◽  
Wound Complications ◽  
Study Cohort ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Entire Study ◽  
Operation Rate

Abstract Background: A fracture of the calcaneus can be a painful and disabling injury. Treatment modalities may be conservative or operative. Surgical treatment strategies include open reduction and internal fixation (ORIF) techniques, as well as a variety of minimally invasive methods. The aim of this study was to evaluate the treatment options and post-treatment complication rates for intra-articular calcaneal fractures at the Traumacenter Linz over a 9-year period.Methods: All patients with calcaneal fractures treated at the Traumacenter Linz between 2007 and 2015 were included in this study. The patients records were retrospectively reviewed, and the data, including demographic parameters, cause of injury, and the time between injury and operative treatment were analyzed. The number of secondary operative interventions due to soft-tissue complications, hardware removal, and the long-term arthrodesis rate were evaluated. Results: A minimally invasive 2-point-distractor method was used in 85.8% (n=182) of all operatively managed calcaneal fractures (n=212) in our department. The majority of the operations (88.7%) were performed within two days after the accident. The secondary operation rate resulting from wound complications was 2.7% in the 2-point distractor group and 16.7% in the ORIF group. A secondary arthrodesis was performed in 4.7% (n=9) of the subtalar joints in the entire study population. Conclusions:Our data supported the assumption that severe wound complications would be less likely to occur after minimally invasive treatment compared to ORIF treatment. The rate of secondary arthrodesis in the study cohort was comparable to that in the literature.Trial Registration: Not applicable, level of evidence IV.

scholarly journals Outcomes of Minimally-Invasive Sinus Tarsi Approach for the Treatment of Intra-articular Calcaneal Fracture

2020 ◽  
Vol 7 (2) ◽  
pp. 47-54
Author(s):  
Hooman Shariatzadeh ◽  
◽  
Bijan Valiollahi ◽  
Mehdi Mohammadpour ◽  
Mohammadamin Haghbin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Wound Complication ◽  
High Rate ◽  
Wound Complications ◽  
Complication Rates ◽  
Invasive Approach ◽  
Calcaneus Fracture ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
The Mean

Background: Open reduction and internal fixation is the standard surgical treatment of calcaneal fractures. However, it is associated with a high rate of wound problems. Objectives: In this study, we evaluated the clinical and radiologic outcomes, as well as the wound complication rates of sinus tarsi minimally-invasive approach in the treatment of intra-articular calcaneus fracture. Methods: In a retrospective study, 62 patients who were referred with an intra-articular calcaneus fracture and treated with a minimally-invasive sinus tarsi approach were included. The radiographic evaluations included the assessment of Bohler and Gissane angles before and after the surgery, as well as the height and length of the calcaneus. The clinical outcome was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire. Results: The Mean±SD age of the patients was 41.8±12.7 years. The Mean±SD follow-up of the patients was 21.3±10 ‎months. After 6 months, in 43 patients (69.3%) both Bohler’s and Gissane’s angles were significantly improved after the surgery (P=0.003 and P<0.001, respectively). The calcaneus height was significantly improved after the surgery (P=0.009), as well. The Mean±SD AOFAS score of the patients was found 79.6±7. Wound infection was seen in only 1 case (1.6%). Delayed wound healing occurred in 4 cases (6.4%). No other wound complication such as dehiscence and skin necrosis was recorded. Conclusion: Minimally-invasive sinus tarsi approach is an efficacious procedure for the treatment of intra-articular calcaneus fracture with a minimized rate of wound complications.

scholarly journals Minimally invasive surgery for intra-articular calcaneus fractures: A 9-year, single-center, retrospective study of a standardized technique using a 2-point distractor

2020 ◽  
Author(s):  
Christian Rodemund ◽  
Ronny Krenn ◽  
Carl Kihm ◽  
Iris Leister ◽  
Reinhold Ortmaier ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Treatment Modalities ◽  
Wound Complications ◽  
Study Cohort ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Entire Study ◽  
Operation Rate

Abstract Background: A fracture of the calcaneus can be a painful and disabling injury. Treatment modalities may be conservative or operative. Surgical treatment strategies include open reduction and internal fixation (ORIF) techniques, as well as a variety of minimally invasive methods. The aim of this study was to evaluate the treatment options and post-treatment complication rates for intra-articular calcaneal fractures at the Traumacenter Linz over a 9-year period.Methods: All patients with calcaneal fractures treated at the Traumacenter Linz between 2007 and 2015 were included in this study. The patients records were retrospectively reviewed, and the data, including demographic parameters, cause of injury, and the time between injury and operative treatment were analyzed. The number of secondary operative interventions due to soft-tissue complications, hardware removal, and the long-term arthrodesis rate were evaluated. Results: A minimally invasive 2-point-distractor method was used in 85.8% (n=182) of all operatively managed calcaneal fractures (n=212) in our department. The majority of the operations (88.7%) were performed within two days after the accident. The secondary operation rate resulting from wound complications was 2.7% in the 2-point distractor group and 16.7% in the ORIF group. A secondary arthrodesis was performed in 4.7% (n=9) of the subtalar joints in the entire study population. Conclusions:Our data supported the assumption that severe wound complications would be less likely to occur after minimally invasive treatment compared to ORIF treatment. The rate of secondary arthrodesis in the study cohort was comparable to that in the literature.Trial Registration: Not applicable, level of evidence IV.

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