A Study of Wound Healing in 402 Calcaneus Fracture Cases Using Precise Extensive L-Shaped Incision

Background: To investigate wound healing in 402 calcaneus fracture cases using precise extensive L-shaped incision.Method: We retrospectively analyzed 402 calcaneus fracture cases, involving patients who underwent heel bone reduction and internal fixation, using precise extensive L-shaped incision, at the second hospital of Shanxi medical university between January 2018 and December 2020. Postoperative would healing was evaluated using a self-designed skin margin grading system. Results: The patients experienced osseous healing after the surgery. A Maryland foot score of ≥90% was considered excellent. The skin margins from Grade I, II, III injuries healed spontaneously after dressing change. However, Grade IV injuries healed after debridement or removal of internal fixation.Conclusions: The precise extensive L-shaped incision, used in this study, allowed for fewer postoperative wound complications and lower incidence of skin necrosis.

The first experience of using customized fixators in the surgical treatment of abducto-plano-valgus foot deformity in children

Background. Abducto-plano-valgus foot deformity is one of the most common diseases affecting children and teens. Recently, various methods of surgical treatment have been proposed for the same. However, despite the availability of various operational methods, there are several contradictions in the feasibility and success of a particular operation. Aim. To improve the technique of Evans Calcaneal osteotomy through the use of customized heel bone fixators. Materials and methods. A total of 30 patients (42 feet) aged 915 years with abducto-plano-valgus foot deformity were included. We undertook clinical examination, X-ray, computed tomography, and experimental researches. The surgical treatment consisted of Evans Calcaneal osteotomy, with the use of the standard method of fixation in group 1 (n = 33 feet) and the use of a customized fixator in group 2 (n = 9 feet). Results. The improved technique of Evans Calcaneal osteotomy using a special customized fixator allowed making the necessary correction in 100% of cases. The period of restoration of the heel bone integrity was reduced by an average of 30% (p 0.05). The period of restoration of the support became faster by almost 45% (p 0.05). Conclusion. The use of a special customized fixator for Evans Calcaneal osteotomy could significantly improve the outcomes and shorted the treatment time for children with abducto-plano-valgus foot deformity.

Effectiveness of ESW T in Treatment of Heel Spurs

Introduction: Heel spurs are degenerative changes in the heel bone in the region of the medial process of the calcaneal tuberosity. More and more patients are now looking for ways to cope with the symptoms of heel spurs. The pain is located mainly underneath the heel or at the back of the heel. Patients experience the pain while walking; which often gets worse in the morning. The pain results from entesopathy in the region of the heel bone and from the inflammation of structures such as the plantar aponeurosis or the Achilles tendon. One of the ways of treating heel spurs is with a shockwave machine. Material and Methods: There were 42 patients involved in the study, 23 women and 19 men, aged 27-65. They were given shockwave treatment – ESWT seven times at one-week intervals. The electromagnetic shock wave in the Rosetta ESWT machine is targeted directly to the area which is painful, where the focus of inflammation is. Thus, the shock wave hits the inflamed spot directly without entering the adjacent tissue. For all the patients, measurements were made with the use of VAS, the 5-point Latinen questionnaire and algometry. Results: Shockwave therapy was found to be fairly effective and the results of the treatment were observed for longer periods compared to the results of more traditional methods of treatment. The patients experienced lower pain levels, both immediately after the last treatment session and one month after the therapy was completed.

Role of Agnikarma in the management of Calcaneal spur: A Case Report

Vatkantaka (Calcaneal spur ) is common source of heel pain causes excruciating type of pain in the heel and disability. Vatkantaka is one of the vatvyadhi. During walking or running on uneven road if the foot landed improperly, the vata ceases in khudukapradesh or gulf sandhi produces as if prick by the thorn hence it termed as a Vatkantaka. Calcaneus is the heel bone. When it is met with constant pressure, calcium deposition occurs beneath this bone and if the pressure continues, the deposition takes the shape of spur, causing pain. Pain on standing or while walking is the characteristic feature. People who need to stand for a long period of time, or those who walk on uneven surfaces tend to cause pressure beneath the heel bone, triggering calcaneal spur. Calcaneal spur condition of painful heel can be understood under the term Vatkantaka. In Ayurvedic literature. Acharya Sushruta has advised Agnikarma as a treatment modality for the management of Vatkantaka. This Agnikarma therapy is local management which relieves pain instantly I.e Sadyafaldayi chikitsa.