Minimal invasive surgery in the management of intra-articular calcaneal fractures: A retrospective comparison of screw fixation alone versus screw with small locking plate fixation techniques

Objective: The aim of this study was to compare clinical and radiological outcomes of screw fixation alone versus screw withsmall locking plate fixation techniques in the management of intra-articular calcaneal fractures by minimal invasive surgery.Methods: A total of 42 patients treated with minimally invasive surgery because of an intra-articular calcaneal fracture wereretrospectively reviewed and included in the study. The patient were then divided into two groups based on the implementedsurgical technique: Group A, 20 patients (16 male, 4 female; mean age = 43.41 ± 15.50) receiving screw fixation alone and group B,22 patients (17 male, 5 female; mean age = 43.38 ± 14.00) receiving screw with small locking plate fixation. The radiographicassessment included Bohler’s, Gissane, joint line parallel, and calcaneal varus angles at immediate post-operative and 2-yearfollow up period through the calcaneal axial and lateral foot radiographs.Results: There was a significant increase in joint line parallel angle from post-operative period to 2-year follow up in GroupA compared to Group B, mean (SD) 3.27 (2.15) degrees versus (vs) 0.44 (3.00) degrees, P = 0.025. No statistical significantdifference of the immediate, 2-year post-operative period and the change in Bohler’s−Gissane angle, calcaneal varus, and FAAMof ADL between groups were observed, P > 0.05. For time-point comparisons in each group, there was a significant loss ofcalcaneal varus and increase in joint line parallel angle from post-operative period to 2-year follow up in Group A, from mean(SD) 1.82 (11.22) to 4.41 (9.73) degrees and 4.09 (5.32) to 7.36 (5.24) degrees, P = 0.047 and

___

1. Luo X, Li Q, He S, He S. Operative versus nonoperative treatment for displaced intra-articular calcaneal fractures: A meta-analysis of randomized controlled trials. J Foot Ankle Surg. 2016;55:821-828. 10.1053/j.jfas.2016.01.035

2. Meena S, Gangary SK, Sharma P. Review article: Operative versus non-operative treatment for displaced intra-articular calcaneal fracture: A meta-analysis of Randomised controlled trials. J Orthop Surg. 2016;24(3):411- 416. 10.1177/1602400328

3. Zhang W, Lin F, Chen E, Xue D, Pan Z. Operative versus nonoperative treatment of displaced intra-articular calcaneal fractures: A meta-analysis of randomized controlled trial. J Orthop Trauma. 2016;30(3):e75-e81. 10.1097/BOT. 0000000000000446

4. Mehta CR, An VVG, Phan K, Sivakumar B, Kanawati AJ, Suthersan M. Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis. J Orthop Surg Res. 2018;13:243. 10.1186/s13018-018- 0943-6

5. Park J, Che JH. The sinus tarsi approach in displaced intra-articular calcaneal fractures. Arch Orthop Trauma Surg. 2017;137:1055-1065. 10.1007/s00402- 017-2714-y

6. Rammelt S, Zwipp H. Fractures of the calcaneus: current treatment strategies. Acta Chir Orthop et Traumatol Cechoslov. 2014;81(3):177-196.

7. van Hoeve S, Poeze M. Outcome of minimally invasive open and percutaneous techniques for repair of calcaneal fractures. A systematic review. J Foot Ankle Surg. 2016;55:1256-1263. 10.1053/j.jfas.2016.07.003

8. Gamal O, Shams A, Semaya AES A. A protocol for percutaneous transarticular fixation of sanders type ii and iii calcaneal fractures with or without an added mini-open approach. J Foot Ankle Surg. 2016;55:1202-1209. 10.1053/j.jfas.2016. 07.013

9. Giannini S, Cadossi M, Mosca M, et al. Minimally-invasive treatment of calcaneal fractures: a review of the literature and our experience. Injury. 2016;47(4): s138-s146. 10.1016/j.injury.2016.07.050

10. Cao L, Weng W, Song S, et al. Surgical treatment of calcaneal fractures of sanders type ii and iii by a minimally invasive technique using a locking plate. J Foot Ankle Surg. 2015;54:76-81. 10.1053/j.jfas.2014.09.003

11. Kir MC, Ayanoglu S, Cabuk H, et al. Mini-plate fixation via sinus tarsi approach is superior to cannulated screw in intra-articular calcaneal fractures: A prospective randomized study. J Orthop Surg. 2018;26(3):1-7. 10. 1177/2309499018792742

12. Mallya S, Kamath R, Hedge A, Annappa R. Can Bohler’s Angle predict the fuctional results of intra-articular displaced calcaneal fractures? J Clin Diagn Res. 2018;12(11):RC05-RC07.

13. Law GW, Yeo NEM, Yeo W, Koo K, Chong KW. Subtalar arthroscopy and fluoroscopy in percutaneous fixation of intra-articular calcanal fractures: Long-term outcomes. J Orthop Surg. 2017;25(1):1-6. 10.1177/ 2309499016684995

14. Loucks C, Buckley R. Bohler’s angle: correlation with outcome in displaced intra-articular calcaneal fractures. J Orthop Trauma. 1999;13(8):554-558. 10. 1097/00005131-199911000-00007

15. Mulcahy DM, McCormack DM, Stephens MM. Intra-articular calcaneal fractures: Effect of open reduction and internal fixation on the contact characteristics of the subtalar joint. Foot Ankle Int. 1998;19:842-848. 10.1177/ 107110079801901209

16. Paley D, Hall H. Intra-articular fractures of the calcaneus. A critical analysis of results and prognostic factors. J Bone Joint Surg Am. 1993;75:342-354. 10.2106/ 00004623-199303000-00005

17. Harnroongroj T, Harnroongroj T, Suntharapa T, Arunakul M. The new intra-articular calcaneal fracture classification system in term of sustentacular fragment configurations and incorporation of posterior calcaneal facet fractures with fracture components of the calcaneal body. Acta Orthop Traumatol Turc. 2016;50:519-526. 10.1016/j.aott.2016.08.007

18. Harnroongroj T, Chuckpaiwong B, Angthong C, Nanakorn P, Sudjai N, Harnroongroj T. Displaced articular calcaneus fractures: Classification and fracture scores: a preliminary study. J Med Assoc Thai. 2012;95(3):13-24.

19. Harnroongroj T, Tangmanasakul E, Choursamran N, Sudjai N, Harnroongroj T. Measurement technique of calcaneal varus from axial view radiograph. Indian J Orthop. 2015;49(2):223-226. 10.4103/0019-5413.152489

20. Arunakul M, Arunakul P, Suesiritumrong C, Angthong C, Chernchujit B. Validity and reliability of Thai version of the foot and ankle ability measure (FAAM) subjective form. J Med Assoc Thai. 2015;98(6):561-567.

21. Harnroongroj T, Jiamamornrat S, Tharmviboonsri T. Characteristics of anterior inferior calcaneal cortex. Foot Ankle Surg. 2019;25(3):323-326. 10.1016/j.fas. 2017.12.009

22. Waikakul S, Aresanasuwan T, Makadilog S, et al. A new recommendation for handling and care of human allogenic bone graft (at Siriraj hospital) to reduce post-operative complication. J Med Assoc Thai. 2016;99(11):1173-1179.

23. Duymus TM, Mutlu S, Mutlu H, Ozel O, Guler O, Mahirogullari M. Need for bone grafts in the surgical treatment of displaced intra-articular calcaneal fractures. J Foot Ankle Surg. 2017;56:54-58. 10.1053/j.jfas.2016.08.004

24. Zheng W, Xie L, Xie H, Chen C, Chen H, Cai L. With versus without bone grafts for operative treatment of displaced intra-articular calcaneal fractures: A meta-analysis. Int J Surg. 2018;59:36-47. 10.1016/j.ijsu.2018.09.016
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

The influence of central pain modulation on postoperative outcomes after shoulder surgery: A systematic review

Tiziano INNOCENTI, Diego RISTORI, Patrizia GALANTINI, Marco TESTA, Mauro Di BARI

Factors associated with the development of re-tear following arthroscopic rotator cuff repair: A retrospective comparative study

Erdal UZUN, Abdulhamit MİSİR, Turan Bilge KIZKAPAN, Mustafa ÖZÇAMDALLI, Hazım SEKBAN, Ahmet GÜNEY

Evaluation of critical shoulder angle and acromion index in patients with anterior shoulder instability and rotator cuff tear

Nazım KARAHAN, Barış YILMAZ, Ahmet ÖZTERMELİ, Murat KAYA, Serda DUMAN, Esin Derin ÇİÇEK

Effects of vertebral fusion on levels of pro-inflammatory and catabolic mediators in a rabbit model of intervertebral disc degeneration

Davut DUMANLIDAĞ, Didem KELEŞ BARTIK, Gülgün OKTAY, Can KOŞAY

Minimal invasive surgery in the management of intra-articular calcaneal fractures: A retrospective comparison of screw fixation alone versus screw with small locking plate fixation techniques

Narutchai CHOTIKKAKAMTHORN, Apisan CHANAJIT, Theerawoot THARMVIBOONSRI, Bavornrit CHUCKPAIWONG, Thos HARNROONGROJ

Internal fixation for osteochondritis dissecans lesions of the knee in patients with physeal closure

Mehmet DEMİREL, Gökhan POLAT, Ali ERŞEN, Mehmet AŞIK, Önder İsmet KILIÇOĞLU

Efficacy of calcium phosphate cementing in the surgical treatment of Sanders Type II and III calcaneal fractures using screw fixation with sinus tarsi approach

Cemil KAYALI, Fırat OZAN, Taşkın ALTAY, Hüseyin Gökhan KARAHAN, Kamil YAMAK, Soner ÖZDEMİR

Post-traumatic double crush pudendal nerve entrapment syndrome after fracture of the pelvis: A case report

Ömer AYIK, Erol KOZANOĞLU, Yavuz ÖNOL, Hayati DURMAZ

Bilateral brachial artery infiltration by tumoral calcinosis: A case report

Ali CAVİT, Serkan ÇAPKIN, Kutay YILMAZ, Tufan KALELİ

Can developmental dysplasia of the hip be identified in the prenatal period? A pilot study: Ultrasonographic evaluation and postnatal follow-up results of fetal hips in the third trimester

Erdal KOMUT, Sinan ZEHİR