Management of Open Calcaneal Fractures with Medial Wounds by One‐Stage Sequential Reduction and Frame Structure Fixation Using Percutaneous Kirschner Wires

Autor:	Yong‐qiang Sui, Fei Li, Hai‐lei Yin, Hai‐yu Fan, Xu Gao, Rui Huang
Rok vydání:	2021
Předmět:	Adult Male medicine.medical_specialty Soft Tissue Injuries Percutaneous Kirschner wires Calcaneal fractures Fracture Fixation Internal Fractures Open Young Adult 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery medicine Humans Orthopedics and Sports Medicine Kirschner wire Percutaneous fixation Pain Measurement Fixation (histology) 030222 orthopedics Clinical Article Open injury business.industry Wound dehiscence Soft tissue Middle Aged medicine.disease Surgery Sanders classification lcsh:RD701-811 Calcaneus medicine.anatomical_structure Clinical Articles Female Ankle business 030217 neurology & neurosurgery Bone Wires
Zdroj:	Orthopaedic Surgery Orthopaedic Surgery, Vol 13, Iss 1, Pp 225-236 (2021)
ISSN:	1757-7861 1757-7853
Popis:	Objective To assess the clinical outcomes of open calcaneal fractures with medial wounds treated with one‐stage management, including early modern wound care, sequential reduction, and frame structure fixation using percutaneous Kirschner wires. Methods A total of 19 patients with open calcaneal fractures admitted to our hospital from May 2016 to March 2019 were selected in this study. Twelve type‐II and seven type‐IIIA medial open injuries were identified according to the classification of Gustilo and Anderson. Fractures were stratified by Sanders classification, including nine type‐II fractures, seven type‐III fractures, and three type‐IV fractures. All patients accepted one‐stage irrigation and debridement, sequential reduction of calcaneal fractures through the open medial wound, percutaneous Kirschner wire fixation, and primary closure of wounds covered with vacuum‐assisted closure (VAC) device. The Bohler angle, the Gissane angle, and the width of the calcaneus were compared before and after surgery. The functional results were evaluated according to the Paley and Hall score system, visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, Maryland Foot Score, and related complications. Results The follow‐up duration for all patients ranged from 14 to 28 months (mean, 22.7 months). The angle of Bohler and Giasane was increased from (−7.6° ± 15.0°) and (96.6° ± 7.6°) before surgery to (23.7° ± 6.1°) and (124.1° ± 7.1°) postoperatively (P Open calcaneus fractures with medial wound is treated by one‐stage sequential reduction and frame structure fixation using percutaneous Kirschner wires. This technique allows direct restoration of calcaneal morphology with a minimal invasion of soft tissues at an early stage.
Databáze:	OpenAIRE
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