scholarly journals Complications in surgical management of calcaneal fractures with anatomical plates

2021 ◽  
Vol 8 (1) ◽  
pp. 94
Author(s):  
Asfia Quadri ◽  
M. Zeeshan Vasif
Keyword(s):  
Surgical Management ◽  
Articular Surface ◽  
Deep Infection ◽  
Calcaneal Fractures ◽  
Anatomical Reduction ◽  
Superficial Skin ◽  
Subtalar Arthritis ◽  
A Prospective Study ◽  
Essex Lopresti

<p class="abstract"><span lang="EN-US">Calcaneal fractures, irrespective of their types, are treated non-operatively, one of the reasons being fear of complications. But conservatively managed fractures can result in equally problematic complications. Incidence of subtalar arthritis in such cases is reported to be 16.9% compared 3.3% in cases treated surgically. With surgical treatment aimed at achieving anatomical joint reduction, regaining calcaneal height, its length and width, successful attempts at curtailing the long-term complications can be made. This was a prospective study of 20 cases of calcaneal fractures, admitted to MNR Medical College and Hospital, Sangareddy from August 2020 to September 2021 were treated with ORIF with non-locking anatomical calcaneal plates using Fernandez’s approach, without use of bone graft. Essex Lopresti and Sander’s classification were used. Intra-operative assessment of reduction and articular surface reconstruction was done under fluoroscopic guidance. Regular follow up was done for assessment of fracture union and complications, assessment of late collapse. Among the 20 cases, 73% were men and 27% women. On typing the fractures based on Essex-Lopresti classification, intra-articular tongue type constituted 13% and 87% were of joint depression. Near normal anatomical reduction was obtained in all cases except in one where it was difficult due to comminution noted during surgery. 2 cases developed superficial skin necrosis at the surgical site, 1 case of deep infection and abscess formation and 3 cases of subtalar arthritis. This study showed that the incidence of long-term complications can probably be minimized by restoring the altered anatomy through surgical means; hence we advocate surgical management and accurate anatomical reduction in cases of displaced and comminuted calcaneal fractures with proper surgical principles. </span></p>

scholarly journals Subtalar arthroscopy and fluoroscopy in percutaneous fixation of intra-articular calcaneal fractures

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668499 ◽  
Author(s):  
Gin Way Law ◽  
Nicholas Eng Meng Yeo ◽  
William Yeo ◽  
Kevin Koo ◽  
Keen Wai Chong
Keyword(s):  
Functional Outcomes ◽  
Subtalar Joint ◽  
Time Frame ◽  
Percutaneous Fixation ◽  
Calcaneal Fractures ◽  
Anatomical Reduction ◽  
Intraoperative Fluoroscopy ◽  
Böhler’S Angle

Introduction: Percutaneous fixation of intra-articular calcaneal fractures is traditionally assisted only by intraoperative fluoroscopy. Previous studies have demonstrated that the additional use of subtalar arthroscopy in anatomical reduction of the posterior calcaneal facet of the subtalar joint for less complex calcaneal fractures yielded positive results up to 2-year follow-up. This study aims to investigate long-term outcomes of these patients using similar evaluation parameters. We hypothesized that this novel technique with dual-imaging can provide sustainable, long-term benefits with good functional outcomes and significant restoration of the Bohler’s angle. Methods: We performed a retrospective study of 15 Sanders II, AO-OTA 83-C2 intra-articular calcaneal fractures in 14 patients who underwent subtalar arthroscopy and fluoroscopy guided percutaneous fracture fixation with a minimum follow-up of 5 years. Outcome measures were assessed using the ankle and hindfoot NPRS, AOFAS ankle–hindfoot score, and SF-36 Physical Function subscale preoperatively and at 3 months, 6 months, 1 year, 2 years and 5–8 years postoperatively. The Bohler’s angle was measured preoperatively, immediately postoperatively and at 5–8 years postoperatively. Results: We report excellent functional outcomes in all scores as well as continued improvements in the majority of patients across all time points with minimal subsidence of the corrected Bohler’s angle over our study time frame. Conclusion: Subtalar arthroscopy with intraoperative fluoroscopy in anatomical reduction of the posterior calcaneal facet of the subtalar joint is most useful in Sanders type II, AO-OTA 83-C2 fractures with excellent functional outcomes and good preservation of the corrected Bohler’s angle on long-term follow-up.

scholarly journals Percutaneous K-Wires Fixation of Displaced Intra-articular Calcaneal Fractures (A Novel Technique)

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Mohamed Mesregah
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Articular Surface ◽  
Calcaneal Fractures ◽  
Type Iv ◽  
Subtalar Arthritis ◽  
The Mean ◽  
K Wires ◽  
Pin Tract Infection ◽  
Periosteal Elevator

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.

1026 SURGICAL MANAGEMENT OF PENILE FRACTURE AND LONG-TERM OUTCOME – RESULTS OF A PROSPECTIVE STUDY

2011 ◽  
Vol 10 (2) ◽  
pp. 318
Author(s):  
G. Hatzichristodoulou ◽  
A. Dorstewitz ◽  
J.E. Gschwend ◽  
K. Herkommer ◽  
N. Zantl
Keyword(s):  
Prospective Study ◽  
Surgical Management ◽  
Penile Fracture ◽  
Term Outcome ◽  
Long Term Outcome ◽  
A Prospective Study

Surgical management of extracranial carotid artery aneurysms

VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Jan Paweł Skóra ◽  
Jacek Kurcz ◽  
Krzysztof Korta ◽  
Przemysław Szyber ◽  
Tadeusz Andrzej Dorobisz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Surgical Management ◽  
Minor Stroke ◽  
Stroke Rate ◽  
Extracranial Carotid Artery ◽  
Long Term Follow Up ◽  
End To End ◽  
Dacron Patch ◽  
Major Stroke

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

Short- and Long-Term Results of the Surgical Management of Frontobasal Fractures

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Boštjan Lanišnik ◽  
Vojko Didanovič ◽  
Bogdan Čizmarevič
Keyword(s):  
Surgical Management ◽  
Long Term Results ◽  
Short And Long Term

Long-term outcomes of surgical management in subtypes of Chiari malformation

2021 ◽  
pp. 1-7
Author(s):  
Recep Basaran ◽  
Caglar Bozdogan ◽  
Mehmet Senol ◽  
Dogan Gundogan ◽  
Nejat Isik
Keyword(s):  
Surgical Management ◽  
Chiari Malformation ◽  
Long Term Outcomes

scholarly journals Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001440
Author(s):  
Shameer Khubber ◽  
Rajdeep Chana ◽  
Chandramohan Meenakshisundaram ◽  
Kamal Dhaliwal ◽  
Mohomed Gad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Management ◽  
Medical Management ◽  
Cox Regression ◽  
Artery Bypass ◽  
Management Strategies ◽  
Coronary Artery Aneurysms ◽  
Kaplan Meier

BackgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.MethodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.ResultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.ConclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

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