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 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 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 ◽  
Vol 21 (1) ◽  
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 2 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. Level of evidence IV

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 Options ◽  
Treatment Modalities ◽  
Wound Complications ◽  
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, as in open reduction and internal fixation (ORIF) via different approaches, including a number 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 2016 were included in this study. The patients’ protocols were retrospectively reviewed, and the data, including demographic parameters, cause of injury, and the time between the accident and the first operative treatment were analyzed. 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=236) 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. Additionally, our arthrodesis rate was comparable to that in the literature. Trial Registration: Not applicable, level of evidence IV.

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 Options ◽  
Treatment Modalities ◽  
Wound Complications ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Invasive Treatment ◽  
Entire Study ◽  
Operation Rate ◽  
Fracture Of The Calcaneus

Abstract Background: A fracture of the calcaneus can be a painful and disabling injury. Treatment modalities may be conservative or operative, as in open reduction and internal fixation (ORIF) via different approaches, including a number 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 (xxx institution blinded xxx) over a 9-year period. Methods: All patients with calcaneal fractures treated at the (xxx institution blinded xxx) between 2007 and 2016 were included in this study. The patients’ protocols were retrospectively reviewed, and the data, including demographic parameters, cause of injury, and the time between the accident and the first operative treatment were analyzed. 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=236) 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. Additionally, our arthrodesis rate was comparable to that in the literature.

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.

Short-Term Radiographic Outcomes of Calcaneus Fractures Treated With 2-Incision, Minimally Invasive Approach

2019 ◽  
Vol 40 (9) ◽  
pp. 1060-1067
Author(s):  
Snow B. Daws ◽  
Kaitlin Neary ◽  
Gregory Lundeen
Keyword(s):  
Minimally Invasive ◽  
Sensory Nerve ◽  
Case Series ◽  
Fracture Reduction ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Calcaneus Fractures ◽  
Böhler’S Angle

Background: The treatment of displaced, intra-articular calcaneus fractures is controversial. The extensile lateral approach has been historically preferred because it provides excellent exposure and visualization for fracture reduction. However, soft tissue complications with this approach can lead to poor outcomes for patients. Recently, there has been an interest in the minimally invasive treatment of calcaneus fractures. The purpose of the present study was to determine the radiographic reduction of displaced, intra-articular calcaneus fractures and the rate of complications using a 2-incision, minimally invasive approach. Methods: A dual-incision, minimally invasive approach with plate and screw fixation was utilized for the treatment of 32 patients with displaced, intra-articular calcaneus fractures. Preoperative and postoperative calcaneal measurements were taken to assess fracture reduction. Additionally, a retrospective chart review was performed to assess for complications. Results: The mean preoperative Bohler’s angle measurement was 12.9 (range, –5 to 36) degrees and the final postoperative Bohler’s angle was 31.7 (range, 16-40) degrees. One patient (3.1%) had postoperative numbness related to the medial incision in the calcaneal branch sensory nerve distribution. Two patients (6.2%) had a wound infection treated with local wound care and oral antibiotics, while 1 patient (3.1%) had a deep infection that required a secondary surgery for irrigation and debridement. Two patients (6.2%) returned to the operating room for removal of symptomatic hardware. Conclusion: Operative fixation of displaced, intra-articular calcaneus fractures treated with a 2-incision, minimally invasive approach resulted in acceptable fracture reduction with a minimal rate of complications. Level of Evidence: Level IV, retrospective case series.

scholarly journals The Novel and Minimally Invasive Treatment Modalities for Female Pelvic Floor Muscle Dysfunction; Beyond the Traditional

2018 ◽  
Vol 35 (5) ◽  
pp. 358-366
Author(s):  
Yiğit Akın ◽  
Matthew Young ◽  
Muhammad Elmussareh ◽  
Nickolaus Charalampogiannis ◽  
Ali Serdar Gözen
Keyword(s):  
Minimally Invasive ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Minimally Invasive Treatment ◽  
Treatment Modalities ◽  
Muscle Dysfunction ◽  
The Novel ◽  
Invasive Treatment ◽  
Female Pelvic Floor

scholarly journals Sinus Tarsi Approach for Open Treatment and Internal Fixation of Displaced Intra-articular Calcaneal Fractures in High-Risk Patients: The New Gold Standard?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0015
Author(s):  
James P. Davies ◽  
W. Bret Smith ◽  
Steven Steinlauf ◽  
Mary Millikin
Keyword(s):  
High Risk ◽  
Gold Standard ◽  
Wound Complication ◽  
Lateral Approach ◽  
Wound Complications ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Extensile Lateral Approach

Category: Ankle, Diabetes, Hindfoot, Trauma Introduction/Purpose: Intra-articular calcaneal fractures offer unique challenges. Wound problems and infection are significant complications in the surgical treatment of calcaneal fractures which in turn can be debilitating to patients and outcomes. The literature suggests varying wound complication rates but 21% up to 33% using the traditional extensile lateral approach in some studies. The extensile lateral approach has historically been accepted as the gold standard for fixation and treatment of these fractures. Recently there has been resurgent interest in alternative approaches to the fixation of intra-articular calcaneal fractures. Of interest is the potential of the sinus tarsi approach to decrease wound complications while having comparable reduction quality to the higher wound risk extensile lateral approach. Methods: A multi-center retrospective chart review study was implemented. The study objective was to review wound complication of the sinus tarsi approach compared with outcomes from the traditional extensile approach for fixation of displaced intra-articular calcaneal fractures. Specifically; examining a population of patients considered at high risk for wound issues, comparing radiographic and clinical outcomes. Results: In the high-risk group, only one primary complications resulted, including one patient with a history of an open fracture. All fractures healed with adequate maintenance of alignment. Chi- squared analysis resulted in a statistically significant difference in complication rates between sinus tarsi and the traditional extensile lateral approach at the 95% confidence level. Conclusion: In both high-risk and lower-risk cohorts of patients, a low rate of infection and wound problems was encountered. A limited approach through a sinus tarsi incision provides a viable option to treat displaced intra-articular calcaneus fracture patients with risk factors for wound issues. The patients all healed both their soft tissue wounds and fractures. Functional return was consistent with other study populations. Our study adds another cohort of patient data demonstrating the advantage of the sinus tarsi approach when compared to the extensile lateral in terms of decreased wound complications while maintaining quality of reductions and clinical outcomes.

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