Functional outcome after calcaneus fractures: a comparison between polytrauma patients and isolated fractures
| Autor: | Xavier Bertó-Martí, José Diranzo-García, Antonio Silvestre-Muñoz, Vicente Estrems-Díaz, Pablo Renovell-Ferrer, Luis Barrera-Puigdorells, Antonio Brú-Pomer |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Context (language use) Comorbidity 03 medical and health sciences Fracture Fixation Internal Fractures Bone Young Adult 0302 clinical medicine Calcaneal fracture Medicine Internal fixation Humans Foot Injuries General Environmental Science Aged Retrospective Studies 030222 orthopedics Trauma Severity Indices business.industry Multiple Trauma 030208 emergency & critical care medicine Recovery of Function Middle Aged medicine.disease Polytrauma Health Surveys Surgery Sanders classification Calcaneus Open Fracture Reduction medicine.anatomical_structure Treatment Outcome Orthopedic surgery Quality of Life General Earth and Planetary Sciences Female Ankle business Follow-Up Studies |
| Zdroj: | Injury. 48 |
| ISSN: | 1879-0267 |
| Popis: | Background Displaced intra-articular calcaneal fractures (DIACFs) can have long-term consequences in terms of foot pain and disability. This injury frequently occurs in the context of polytrauma patients and its influence in long-term functional prognosis is well known. The purpose of this study is to compare the etiology, severity, and functional outcome of the operated DIACFs between polytrauma patients and isolated cases. Methods Eighty-six patients with operated displaced intra-articular calcaneal fractures through open reduction and internal fixation (ORIF) were managed at our institution between January 1, 2008 and December 31, 2015. Eighty patients completed the follow-up, nine of them with both calcaneus operated (89 calcaneus) by ORIF with a plate. Two groups were established; one included 11 (14%) polytrauma patients, three of them with operated bilateral calcaneus, and 69 (86%) patients without polytrauma diagnosis. Severity of trauma, injury patterns, psychiatric background, associated fractures, second surgeries and functional questionnaire (adjusted American Orthopedic Foot and Ankle Society - AOFAS - ankle-hindfoot scale and SF-36) were collected. A detailed comparative statistical analysis is provided. Results There was significant statistical relationship between polytrauma patients and those with psychiatric comorbidities, severe trauma or severe injury, but not with second surgeries, later subtalar arthrodesis or outcome measures. Only calcaneal fractures with comminution according to Sanders classification was associated with second surgeries and later subtalar arthrodesis. The AOFAS score was solely related to trauma severity (71.5 vs 77; p = 0.29) and calcaneal fracture's comminution according to Sanders classification (79.4 type II and 79.3 type III vs 69.2 type IV; p = 0.000 and p = 0.008, respectively) and SF-36 score only with trauma severity (67.4 vs 78.1; p = 0.00) and psychiatric comorbidities (62.2 vs 75.8; p = 0.048). Conclusion No differences in outcome measures and second surgeries were found between polytrauma patients and isolated fractures. For DIACFs, the severity of the impact was correlated with a higher number of second surgeries and worse functional outcomes. Following a DIACF, patients with psychiatric comorbidities presented worse health-related quality of life than people without this background. |
| Databáze: | OpenAIRE |
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