Dynamic and functional gait analysis of severely displaced intra-articular calcaneus fractures treated with a hinged external fixator or internal stabilization
| Autor: | Deike Varoga, Katharina Oehlert, Guenther Mathiak, Birgit Radke, Lutz Besch, Michael Mueller, Ralf-Erik Hilgert, Mark Daniels-Wredenhagen, Andreas Seekamp |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty External Fixators medicine.medical_treatment Fracture Fixation Internal Fractures Bone Gait (human) Fracture Fixation medicine Internal fixation Humans Orthopedics and Sports Medicine Prospective Studies Gait Reduction (orthopedic surgery) business.industry Soft tissue Surgery Sanders classification Calcaneus medicine.anatomical_structure Treatment Outcome Gait analysis Female Ankle business |
| Zdroj: | The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 47(1) |
| ISSN: | 1067-2516 |
| Popis: | The purpose of this article was to assess functional gait outcome. Fifty-five patients with severely displaced intra-articular calcaneus fractures and soft tissue damage were evaluated prospectively with computerized dynamic pedography and a clinical scoring scale. The treatment protocol assigned 30 patients to open reduction and internal fixation (ORIF) and 25 to closed reduction and stabilization with a biomechanically tested hinged external fixator. Gait parameter was evaluated by measuring plantar pressure distribution, length of a double-step, double-step duration, standing duration, effective foot length, and width of gait. Pedographic measurements were performed with a custom-made gait analysis system (medilogic Gangas, Berlin, Germany). Results were graded by an extended protocol of questionnaires and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scales. Radiographs were reviewed according to the Sanders classification at the time of follow-up (7.3 years). All measurements were statistically analyzed ( t test; Mann-Whitney U test). Aberrations were associated with all calcaneal fractures in both groups. Dynamic gait analysis showed gait asymmetry in all patients. The type of treatment (ORIF or a hinged fixator) of severely displaced calcaneus fractures did not affect gait analysis nor result in significantly different ( P > .05) patient outcome scores. The gait analysis system allows a valid dynamic pedographic measurement. The hinged external fixator can be recommended in displaced intra-articular calcaneal fractures with severe soft tissue damage to reduce complications associated with ORIF. ACFAS Level of Clinical Evidence: 2c. |
| Databáze: | OpenAIRE |
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