3 years ago

Treatment of intraarticular calcaneal fractures by reconstruction plate. Results and complications of 86 fractures

J. Diranzo-garcía, X. Bertó-martí, L. Castillo-ruiperez, V. Estrems-díaz, L. Hernández-ferrando, J. Villodre-jiménez, A. Bru-pomer

Publication date: July–August 2018

Source: Revista Española de Cirugía Ortopédica y Traumatología (English Edition), Volume 62, Issue 4

Author(s): J. Diranzo-García, X. Bertó-Martí, L. Castillo-Ruiperez, V. Estrems-Díaz, L. Hernández-Ferrando, J. Villodre-Jiménez, A. Bru-Pomer

Abstract
Objective

To evaluate the results of surgical treatment of intraarticular calcaneal fractures, and also to analyse the variables that influence the final clinical and radiological outcomes as well as the complications.

Material and methods

We retrospectively analysed 86 intraarticular calcaneal fractures in 78 patients, who underwent surgery with an extended lateral approach and reconstruction plate. The mean age was 48 years (16–74 years) and the mean follow-up was 4.6 years (9–99 months); 54 patients (69.2%) suffered falls from less than 3 m in height or banal injuries and 24 patients (30.8%) falls from more than 3 m in height or high energy-accidents. According to the Sanders classification we operated 12 (15%) type II, 54 (62.8%) type III and 20 (23.2%) type IV fractures.

Results

The postoperative mean AOFAS score was 73.9 points, with good or excellent results in 57% of the patients. Twelve cases (14%) suffered surgical wound complications and 11 (12.8%) required subtalar arthrodesis. Significantly better results were obtained in the patients younger than 30 years old, patients that fell from less than 3 m in height and patients with Sanders fractures types II and III compared to type IV, which were associated with higher rate of subtalar arthrodesis.

Conclusions

We consider that open reduction and internal fixation of intraarticular fractures of the calcaneus with reconstruction plate is a valid treatment alternative. Given the complications described and the secondary subtalar arthrodesis rate, we recommend a meticulous technique carried out by experienced surgeons.

Resumen
Objetivo

Evaluar los resultados del tratamiento quirúrgico de las fracturas intraarticulares de calcáneo. Analizar las variables que influyen en el resultado clínico y radiológico final, así como las complicaciones dadas.

Material y métodos

Analizamos de forma retrospectiva 86 fracturas intraarticulares de calcáneo en 78 pacientes, intervenidas en nuestro servicio mediante abordaje lateral extendido y placa de reconstrucción. La edad media fue de 48 años (16-74 años) y el seguimiento medio de 4,6 años (9-99 meses); 54 pacientes (69,2%) sufrieron caídas de menos de 3 m de altura o traumatismos banales, y 24 (30,8%) de más de 3 m o accidentes de alta energía. Según la clasificación de Sanders, intervinimos 12 fracturas (15%) tipo II, 54 (62,8%) tipo III y 20 (23,2%) tipo IV.

Resultados

La puntuación AOFAS media postoperatoria fue de 73,9 puntos (42-98 puntos), con resultados buenos o excelentes en el 57% de los casos; 12 casos (14%) presentaron complicaciones a nivel de la herida quirúrgica y 11 (12,8%) precisaron una artrodesis subastragalina. Obtuvimos resultados significativamente mejores en pacientes menores de 30 años, pacientes con caídas de menos de 3 m de altura y pacientes con fracturas tipos II y III de Sanders respecto a las tipo IV, asociándose a estas una mayor tasa de artrodesis subastragalina.

Conclusiones

Consideramos la reducción abierta y fijación interna de las fracturas intraarticulares de calcáneo con placa de reconstrucción una alternativa vigente. Dadas las complicaciones descritas y la tasa de artrodesis subastragalina secundaria, recomendamos una técnica meticulosa por parte de cirujanos experimentados.

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.