Functional outcomes of calcaneal fractures managed with external fixator application

2020 ◽  
Vol 18 (2) ◽  
pp. 09-13
Author(s):  
Sunil Malhotra ◽  
Keyword(s):  
External Fixator ◽  
Functional Outcomes ◽  
Calcaneal Fractures

scholarly journals Functional outcomes of the failed plate fixation in distal tibial fractures salvaged by hexapod external fixator

2018 ◽  
Vol 28 (8) ◽  
pp. 1617-1624
Author(s):  
Maketo Molepo ◽  
Annette-Christi Barnard ◽  
Franz Birkholtz ◽  
Kevin Tetsworth ◽  
Vaida Glatt ◽  
...  
Keyword(s):  
External Fixator ◽  
Functional Outcomes ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Distal Tibial Fractures

scholarly journals Minimally invasive reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular calcaneal fractures

2018 ◽  
Vol 3 (7) ◽  
pp. 418-425 ◽  
Author(s):  
Haroon Majeed ◽  
James Barrie ◽  
Wendy Munro ◽  
Donald McBride
Keyword(s):  
High Risk ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Percutaneous Fixation ◽  
Calcaneal Fractures ◽  
Minimally Invasive Reduction

The aim of this article is to systematically identify and analyse research evidence available to compare the outcomes of minimally invasive reduction and percutaneous fixation (MIRPF) versus open reduction and internal fixation (ORIF) for displaced intra-articular calcaneal fractures. Articles from 2000 to 2016 were searched through MEDLINE (PubMed), Cochrane Library, Embase, ScienceDirect, Scopus and ISI Web of Knowledge using Boolean logic and text words. Of the 570 articles identified initially, nine were selected including three randomized controlled trials and six retrospective comparative studies. All nine studies had a total of 1031 patients with 1102 displaced intra-articular calcaneal fractures. Mean follow-up was 33 months. Of these, 602 (54.6%) were treated with MIRPF and 500 (45.4%) were treated with ORIF. Overall incidence of wound-related complications in patients treated with MIRPF was 4.3% (0% to 13%) compared with 21.2% (11.7% to 35%) in the ORIF group Functional outcomes were reported to be better in the minimally invasive group in all studies; however, the results did not reach statistical significance in some studies. All the studies had methodological flaws that put them at either ‘unclear’ or ‘high’ risk of bias for multiple domains. Overall quality of the available evidence is poor in support of either surgical technique due to small sample size, flaws in study designs and high risk of bias for various elements. Individual studies have reported minimally invasive techniques to be an effective alternative with lower risk of wound complications and better functional outcomes. Cite this article: EFORT Open Rev 2018;3:418-425. DOI: 10.1302/2058-5241.3.170043

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 Outcomes of mono-lateral limb reconstruction system in infected non-union of long bones

2017 ◽  
Vol 4 (1) ◽  
pp. 27
Author(s):  
Anuj Induprakash Gajbhiye ◽  
Sidhant Goyal ◽  
M. Mohan Kumar ◽  
R. Dorai Kumar
Keyword(s):  
External Fixator ◽  
Functional Outcomes ◽  
Wound Dehiscence ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Long Bones ◽  
Additional Advantage ◽  
Limb Reconstruction ◽  
Non Union ◽  
Tract Infections

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">We planned to evaluate functional and radiological outcomes of mono-lateral limb reconstruction system for infected non-union of long bones and to analyse its complications occurring.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">It was a prospective study, conducted during period of September 2015 to August 2017 and consisted of 73 cases of these 60 cases were available for final assessment. This infected non-union were classified by AO classification and were treated with mono lateral limb reconstruction system. All the cases were evaluated by ASAMI criteria for bony and functional outcomes. Our mean follow up period was 16.8 months</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 60 cases of infected non-union with mono-lateral external fixator were followed for mean 16.8 months. According to these ASAMI criteria in our study 26.6% had excellent; 46.6% had good; 16.6% fair; and 10% poor bony outcome. And the functional outcomes were 13.3%, 60%, 16.6%, 10% were excellent, good, fair and poor respectively. <span lang="EN-IN">Among the cases 50% had pin tract infections and loosening. Two cases pin revision was done. Sinus tract got cleared in all cases except 6 where multiple sinus tracts were present and healing did not occur. There were no infections at the corticotomy site. Delay in the consolidation phase was present in all cases. There was no difficulty in transportation of bone. Post-operatively wound dehiscence in eight cases was managed with split skin graft cover. Limb length discrepancy upto 2.5 cms in lower limb was managed with modified footwear with heel and sole raise. Non-healing fractures united in mean 5.9 months after start of treatment. Non-union site united in 90% cases. </span><strong>Conclusions:</strong> <span lang="EN-IN">Mono-lateral limb reconstruction system is efficient method for treatment of infected non-union of long bones. It has an additional advantage of correcting limb length discrepancies which sometimes occur during the course of treatment.</span></p><p class="keywords"><strong>Keywords: </strong>Non-union, Infection, Long bones, Limb reconstruction system, External fixator</p>

scholarly journals Functional outcomes following the use of an inexpensive mini-external fixator device for phalangeal fractures

2012 ◽  
Vol 10 (8) ◽  
pp. S63
Author(s):  
Suzanne Thomson ◽  
Lisa Ng ◽  
David Howarth ◽  
Max Coutinho ◽  
Sahan Rannan-Eliya
Keyword(s):  
External Fixator ◽  
Functional Outcomes ◽  
Phalangeal Fractures

MANAGEMENT OF INTRA-ARTICULAR CALCANEAL FRACTURES WIILIZAROV RING FIXATIO

2021 ◽  
pp. 40-43
Author(s):  
Nirottam Singh ◽  
Jagdish Jagdish ◽  
Hemant Jain ◽  
Kishore Raichandani
Keyword(s):  
Functional Outcomes ◽  
Operating Time ◽  
Anatomic Reconstruction ◽  
X Rays ◽  
Calcaneal Fractures ◽  
Type Iv ◽  
Fall From Height ◽  
Pin Tract Infection ◽  
Böhler’S Angle

Objective: Calcaneal fractures are caused by a high velocity force to the heel, mostly in road trafc accidents or fall from height. Debate continues regarding the best management of calcaneal fractures. We aim at evaluating the radiological and functional outcomes of displaced intra-articular calcaneal fractures treated with Ilizarov ring xation. Methods: intra-articular calcaneal Eighteen consecutive patients with fractures [Sanders type II (10), Sanders type III(6), and Sanders type IV (2)] were treated with the Ilizarov ring xator from Sep 2017 to June 2020. Patients were evaluated in terms of associated injuries and x-rays of anteroposterior, lateral and axial views of the calcaneus. CT scan was done to assess the amount of comminution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society (AOFAS) scale. Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement of calcaneal height and width. Results: At average follow-up of 18.5 months, average AOFAS score was 80.5 (range 71 to 90), with 6.25% having excellent, 75% having good, 12.5% having fair and 6.25%having poor results. All patients had stable ankle joint with all having dorsiexion and plantar exion more than 30°. All patients are able to wear their previous size shoes. The mean Bohler's angle, mean Gissane's angle, calcaneal height and width were 21.5°, 126.3°, 4.36 cm and 3.80cm respectively at nal follow-up. Four patients had supercial pin tract infection. One patient had collapse of posterior facet after removal of xator with peroneal tendinitis. All fractures united and none needed secondary bone grafting. Patients returned to work on an average of 5.5 months. Conclusion: Ilizarov external ring xation gives good functional outcomes, manifested by restoring near normal anatomic reconstruction of morphology and alignment of the calcaneus. The added advantages of these procedures are the considerably shortened operating time and hospital stay, no need of highly equipped operation theatres and the reduced risk of complications related to surgical exposure.

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.

Minimally-Invasive Repair of Bilateral Calcaneal Fractures with Unilateral External Fixation: A Case Report

2016 ◽  
Vol 106 (sp1) ◽  
pp. 10-10
Author(s):  
Louis V. DeFazio ◽  
Guido A. LaPorta
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Operating Room ◽  
External Fixator ◽  
Weight Bearing ◽  
Calcaneal Fracture ◽  
Calcaneal Fractures ◽  
Percutaneous Approach ◽  
Soft Tissue Envelope ◽  
Percutaneous Repair

INTRODUCTION AND OBJECTIVES: Calcaneal fractures are a serious injury with significant associated morbidity. Bilateral calcaneal fractures complicate issues even further, due to the physical disability that the patient is left with. One of the major issues with any calcaneal fracture is the risk of soft tissue compromise caused by the traumatic nature of the injury. A percutaneous approach allows the soft tissue envelope to remain viable, while still fixating the fractures. The purpose of this presentation is to highlight the use of percutaneous repair, the role of external fixation in calcaneal fractures, and lastly discuss the outcome for this particular patient. METHODS: A 26 year-old male presented to the office with bilateral calcaneal fractures, approximately 1 week after sustaining a fall from a height of 12 feet. The patient was brought to the operating room after spending approximately 2 weeks in bilateral posterior splints with Jones compressive dressings. The right calcaneal fracture was fixated percutaneously with 4 screws. The left calcaneal fracture was fixated percutaneously with 3 screws, as well as an Ilizarov external fixator. Approximately 8 weeks later, the patient returned to the operating room for removal of the external fixator and a cast application to the left lower extremity. RESULTS: The patient continued to progress and was subsequently transitioned into bilateral CAM walkers. In the following weeks, the patient was again upgraded to full weight-bearing with physical therapy. The fracture sites were completely consolidated with minimal to no pain in his bilateral heels and full ambulation. CONCLUSIONS: Percutaneous repair, along with external fixation, offers a viable alternative to ORIF for calcaneal fractures. A percutaneous approach also does not disrupt the potentially fragile soft tissue envelope in a calcaneal fracture. Although this outcome is positive, larger controlled studies are needed to confirm percutaneous approaches and external fixation in the realm of a calcaneal fracture.

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