Minimally invasive technique for acute fixation and subtalar fusion of displaced intra-articular calcaneus fractures.

Autor: Matuszewski PE; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky College of Medicine, 740 S. Limestone, Suite K401, Lexington, KY, USA., Phillips SA; Department of Orthopaedic Surgery, Mercy Health St. Vincent Medical Center, Toledo, OH, USA., Ulrich GL; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky College of Medicine, 740 S. Limestone, Suite K401, Lexington, KY, USA., Hautala GS; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky College of Medicine, 740 S. Limestone, Suite K401, Lexington, KY, USA., Bloomer AK; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC, USA., Hsu JR; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC, USA.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Aug; Vol. 34 (6), pp. 3355-3363. Date of Electronic Publication: 2024 Jun 03.
DOI: 10.1007/s00590-024-03879-w
Abstrakt: Displaced intra-articular calcaneus fractures (DIACFs) are difficult injuries to treat and are often encountered by orthopedic surgeons. For DIACFs treated nonoperatively or with open reduction internal fixation (ORIF), a common complication is painful subtalar arthritis and the need for a secondary subtalar fusion, which prolongs the overall recovery time. One treatment option to address this sequela involves ORIF with subtalar fusion as the primary treatment. We describe a reproducible, minimally invasive surgical technique for primary ORIF with subtalar fusion when the calcaneal tuberosity is amendable to cannulated screw fixation to treat these complex calcaneal fractures. Our technique offers advantages compared to other techniques in that it avoids screw traffic, allows easy bony compression of the subtalar joint, and minimizes soft tissue damage via percutaneous screw fixation. Fourteen fractured calcanei in 12 patients underwent our technique and all achieved bony union with a median time to fusion of 107.5 days (range, 54-530 days). Eight patients returned to work with the remaining 4 patients having an unknown work status at last follow-up, although 2 of these 4 patients resumed normal activities. Only 1 patient experienced a complication, which was an infection after achieving bony union, and was treated with successful hardware removal and our infection protocol. Overall, we conclude our surgical technique offers a successful option in the treatment of DIACFs when the calcaneal tuberosity is amendable to cannulated screw fixation.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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