Cohort study on the percutaneous treatment of displaced intra-articular fractures of the calcaneus
| Autor: | Frits M. van der Linden, Stefan W. de Vroome |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Adolescent Intra-Articular Fractures Arthrodesis medicine.medical_treatment Cohort Studies Fracture Fixation Internal Young Adult Postoperative Complications Interquartile range medicine Humans Minimally Invasive Surgical Procedures Orthopedics and Sports Medicine Aged Retrospective Studies business.industry Middle Aged Surgery Sanders classification Calcaneus medicine.anatomical_structure Treatment Outcome Cohort Female Ankle business Cohort study |
| Zdroj: | Footankle international. 35(2) |
| ISSN: | 1944-7876 |
| Popis: | Background:To reduce the high rate of soft tissue complications in the treatment of displaced intra-articular fractures of the calcaneus, several minimally invasive techniques have been developed. Little evidence exists on the clinical outcome of these techniques.Methods:We performed a study on a cohort of 46 fractures treated by the 3-point distraction technique. In 41 fractures, clinical outcome was available. Fractures were classified according to the Essex-Lopresti and Sanders classifications. The clinical outcome was determined using the 3 most frequently used outcome scores.Results:The clinical outcome of our cohort of percutaneous treated intra-articular calcaneal fractures was good to excellent in 69% with the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS) score. This percentage increases to 100% for tongue type fractures alone but decreases to 52% for joint depression type fractures. Infectious complications occurred in 1 (2.4%) and secondary arthrodesis was needed in 3 fractures (7.3%). The Sanders classification showed no prognostic value. The Essex-Lopresti classification was a strong prognosticator with a median AOFAS score of 92 (interquartile range [IQR], 87.8-97.8) for tongue type fractures and 75 (IQR, 63.0-85.0) for joint depression type fractures ( P < .001).Conclusion:The treatment of displaced intra-articular calcaneal fractures by the 3-point distraction technique was an acceptable alternative to open surgery and other percutaneous techniques. It had a low amount of infectious complications with comparable outcome to open treatment. The computed tomography-based Essex-Lopresti classification had a strong prognostic value when fractures were treated by the 3-point distraction technique. The results of this study support the use of the 3-point distraction technique, especially in tongue type fractures.Level of Evidence:Level IV, retrospective case series. |
| Databáze: | OpenAIRE |
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