calcaneus fractures
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2022 ◽  
pp. 107110072110586
Author(s):  
Ainsley K. Bloomer ◽  
R. Randall McKnight ◽  
Nicholas R. Johnson ◽  
David M. Macknet ◽  
Meghan K. Wally ◽  
...  

Background: The management of displaced intraarticular calcaneus fractures (DIACFs) is a difficult problem with disappointing results from open reduction internal fixation (ORIF). Alternatively, ORIF with primary subtalar arthrodesis (PSTA) has gained increasing popularity. The purpose of this study is to review patient-centered and radiographic outcomes of ORIF plus PSTA using only screws through a sinus tarsi approach. Methods: A retrospective study of patients who underwent ORIF+PSTA for DIACFs was conducted. The same surgical technique was used in all cases consisting of only screws; no plates were used. Delayed surgeries past 8 weeks were excluded. Demographic and radiographic data were collected including worker’s compensation claims. Plain radiographs were used to characterize injuries and review outcomes. Results: Seventy-nine DIACFs underwent PSTA with a median follow-up of 200 days (n = 69 patients). Median time to weightbearing was 57.5 days postoperatively. Ten fractures were documented as Sanders II, 36 as Sanders III, and 32 as Sanders IV. Sixty-eight fractures (86.1%) achieved fusion on radiographs at a median of 126.5 (range, 54-518) days. Thirty-nine fractures (57.3%) demonstrated radiographic fusion in all 3 predefined locations. Nine of the 14 worker’s compensation patients returned to work within the period of observation. There were 8 complications: 3 requiring a secondary operation. Eleven of 79 fractures treated did not go on to achieve radiographic union. Conclusion: In this retrospective case series, we found that screws-only primary subtalar arthrodesis for the treatment of DIACFs through a sinus tarsi approach was associated with relatively high rates of return to work and radiographic fusion. Level of Evidence: Level IV, retrospective case series.


Author(s):  
Blake Wallace ◽  
Avneesh Chhabra ◽  
Anish Narayanan ◽  
David O'Neill ◽  
Yin Xi ◽  
...  

2021 ◽  
Vol 32 (2) ◽  
pp. 428-436
Author(s):  
Fahri Emre ◽  
Ceyhun Çağlar ◽  
Özgür Kaya

Objectives: This study aims to evaluate the mid-term clinical, functional, radiological, and socioeconomic outcomes of calcaneus fractures treated with open reduction-internal fixation (ORIF) versus minimally invasive percutaneous fixation (MIPF). Patients and methods: A total of 48 patients (34 males, 14 females; mean age: 44.05 years; range, 19 to 64 years) who underwent either ORIF or MIPF for calcaneus fractures between January 2010 and January 2016 were retrospectively analyzed. The patients were divided into two groups as the ORIF group (n=36) and MIPF group (n=12). The American Orthopaedic Foot & Ankle Society (AOFAS) score, Maryland Foot Score (MFS), and the Short Form-36 (SF-36) scores were assessed for the clinical assessment. The mean duration of operation, mean length of hospitalization, pedobarographic gait analysis, the incidence of contralateral knee pain, increased shoe size, and change of profession due to significant heel pain were also evaluated. The Böhler’s angle, Gissane angle, and calcaneal varus were measured for radiological assessment. Results: There was a significant difference in the mean operation time (p=0.001) and length of hospitalization (p=0.001) between the two groups. There was no significant difference between the pre- and postoperative third-year Böhler’s and Gissane angles (p=0.05, p=0.07, p=0.09, respectively). There were no significant differences between the postoperative first-, second-, and third-year AOFAS, MFS, and SF-36 scores (p=0.57, p=0.55 p=0.85, p=0.64, p=0.21, p=0.51, p=0.20, p=0.15, p=0.22, respectively). Thirteen patients in the ORIF group and five patients in the MIPF group changed their job due to significant heel pain. The increased shoe size was correlated with the residual calcaneal varus (p=0.001). Conclusion: Both methods have pros and cons in the treatment of calcaneal fractures. Although MIPF is more advantageous in terms of operation duration and length of hospitalization, more favorable radiological results can be obtained with ORIF. Calcaneal varus should be corrected to prevent the increased shoe size and contralateral knee pain.


Author(s):  
João F. Almeida ◽  
Cláudia Vale ◽  
Tânia Gonzalez ◽  
Tiago M. Gomes ◽  
Xavier Martin Oliva

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