Minimally invasive open reduction and percutaneous fixation of intra-articular calcaneal fractures

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

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Prospective randomized trial comparing open reduction and internal fixation with minimally invasive reduction and percutaneous fixation in managing displaced intra-articular calcaneal fractures

International Orthopaedics ◽

10.1007/s00264-014-2501-0 ◽

2014 ◽

Vol 38 (12) ◽

pp. 2505-2512 ◽

Cited By ~ 30

Author(s):

Venkatesan Sampath Kumar ◽

Kanniraj Marimuthu ◽

Suresh Subramani ◽

Vijay Sharma ◽

John Bera ◽

...

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Randomized Trial ◽

Open Reduction ◽

Prospective Randomized Trial ◽

Percutaneous Fixation ◽

Calcaneal Fractures ◽

Minimally Invasive Reduction

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Early Minimally Invasive Percutaneous Fixation of Displaced Intra-Articular Calcaneal Fractures With a Percutaneous Angle Stable Device

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2014.08.021 ◽

2015 ◽

Vol 54 (1) ◽

pp. 51-56 ◽

Cited By ~ 13

Author(s):

Alberto Battaglia ◽

Pompeo Catania ◽

Stefano Gumina ◽

Stefano Carbone

Keyword(s):

Minimally Invasive ◽

Percutaneous Fixation ◽

Calcaneal Fractures ◽

Angle Stable

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20190512 ◽

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.

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