Abstract
Background
We present the results of open reduction and internal fixation of intra-articular calcaneal fractures with Kirschner wires with some modifications.
Material and methods
A longitudinal study was done on 37 patients who had fallen from certain heights; the study subjects were predominantly construction workers. Forty-seven fractures of the study subjects were treated using a modified approach that includes incision and some tips in operative technique. Details of modification and their evaluation on the basis of restoration of heel shape with special attention to the lateral wall, radiological assessment of Bohler’s angle, varus and valgus movement of the heel, pain while walking, patient satisfaction assessment upon return to pre-injury work are elaborated in this paper. Duration of study was from January 2000 to May 2011.
Results
The fractures healed well with good radiological and functional outcomes, and patients returned to pre-injury work status in 4–6 months.
Conclusion
The need to change to the Kocher approach for the treatment of calcaneal fracture with right-angled incision and elevation of the lateral flap is not necessary if the surgical tips showed in this paper are followed meticulously to achieve a good soft tissue outcome initially and, eventually, a good bony radiological and functional outcome. As implants used are very cheap and affordable to workers of low socioeconomic status, the authors have developed this method and presently believe that this method is best for all classes of patients with the said problem.
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References
Kerkhoffs GM et al (2002) Functional treatment after surgical repair of acute Achilles tendon rupture: wrap vs work cast. Arch Orthop Trauma Surg 122:102–105
Potter MQ, Nunley JA (2009) Long-term functional outcomes after operative treatment for intra-articular fractures of the calcaneus. J Bone Joint Surg Am 91:1854–1860
American Academy of Orthopaedic Surgeons: OrthoInfo copyright 2010, page 2 of 7
Naik NP, Deshpande SB, Patil SV (2002) Mini approach for treatment of intra articular fracture of calcaneum. In: Canale ST (ed) Campbell’s operative orthopaedics, 10th edn, vol 4. Mosby, Maryland Heights, pp. 4230–4247
Sanders R, Gregory P (1995) Operative treatment of intra-articular fractures of calcaneus. Orthop Clin North Am 26:203
Ebraheim NA, Biyani A et al (1996) A pitfall of coronal computed tomographic imaging in evaluation of calcaneal fractures. Foot Ankle Int 17:503
Folk JW, Starr AJ, Early JS (1999) Early wound complications of operative treatment of calcaneus fractures: analysis of 190 fractures. J Orthop Trauma 13:369
Benirschke SK, Kramer PA (2004) Wound healing complications in closed and open calcaneal fractures. J Ortho Trauma 18(1):1–6
Zeman P et al (2008) Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach. Acta Chir Orthop Traumatol Cech 75(6):457–464
Longino D, Buckley RE (2001) Bone graft in the operative treatment of displaced intra-articular calcaneal fractures: is it helpful? J Orthop Trauma 15(4):280–286
Loucks C, Buckley R (1999) Bohler’s angle: correlation with outcome in displaced Intra-articular calcaneal fractures. J Orthop Trauma 13(8):554–558
Buckley R et al (2002) Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized multicenter trial. J Bone Joint Surg Ant 84:1733–1744
Dooley P, Buckley R, Tough S et al (2004) Bilateral calcaneal fractures: operative versus nonoperative treatment. Foot Ankle Int 25(2):47–52
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Naik, N.P., Deshpande, S.B. Evaluation of treatment of calcaneal fractures with a modified approach in a peripheral setting: a cost-effective model. Eur Orthop Traumatol 4, 153–160 (2013). https://doi.org/10.1007/s12570-013-0159-5
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DOI: https://doi.org/10.1007/s12570-013-0159-5