Approach to Displaced Intra-Articular Calcaneus Fractures After Attempted Suicide Among Patients With Psychiatric Disorders: Nonsurgical or Surgical?

Autor: Yüce A; Department of Orthopaedics and Traumatology, Akçakale State Hospital, Şanlıurfa, Turkey. Electronic address: dr_aliyuce@hotmail.com., İğde N; Department of Orthopaedics and Traumatology, Akçakale State Hospital, Şanlıurfa, Turkey., İmren Y; Department of Orthopaedics and Traumatology, Istanbul Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey., Dedeoğlu SS; Department of Orthopaedics and Traumatology, Istanbul Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey., Gürbüz H; Department of Orthopaedics and Traumatology, Istanbul Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2022 Jul-Aug; Vol. 61 (4), pp. 780-784. Date of Electronic Publication: 2021 Dec 02.
DOI: 10.1053/j.jfas.2021.11.015
Abstrakt: Displaced intra-articular calcaneus fracture is one of the injurious events in psychiatric patients after high-jump suicide attempts. These patients are reported to have poorer compliance and worse postoperative outcomes compared to those with no psychiatric condition.  We aimed to compare nonsurgical and surgical treatment with respect to functional and radiological outcomes and complications in this patient. We evaluated medical records of 42 psychiatric patients who had displaced intra-articular calcaneal fractures after high-jump suicide attempt. 20 (54%) of these were treated nonsurgically and further 17 patients (46%) received surgical intervention. We compared to nonsurgical and surgical approaches statistically. The mean follow-up period were 30.4 ± 8.02 months and 31.8 ± 7.5 months in the nonsurgical and surgical groups, respectively. Böhler's angle was significantly higher in the surgical group (30.4 ± 6.4) than that in the nonsurgical group (16.1 ± 3.7) (p = .001). AOFAS scores and supination levels were significantly higher in the surgical group than that in the nonsurgical group (p ≤ .05). During the follow-up period, one patient from the surgical group re-attempted high-jump suicide and died, and another one caused the subtalar joint to re-collapse after full weightbearing on the first postoperative day. Surgical treatment of displaced intra-articular calcaneal fractures following a high-jump suicide attempt in psychiatric patients may not cause increased complication rates. However, behavioral manifestations of the psychiatric disorder might be associated with several complications. Should any surgical intervention be decided, minimal invasive approach would be the appropriate choice.
(Copyright © 2021 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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