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Outcomes of Minimally Invasive Surgery in Intra-Articular Calcaneal Fractures: Sanders Type III, Joint Depressive Type Calcaneal Fracture
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Je Hong Ryu, Jun Young Lee, Kang Yeol Ko, Sung Min Jo, Hyoung Tae Kim
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J Korean Fract Soc 2023;36(3):85-94. Published online July 31, 2023
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DOI: https://doi.org/10.12671/jkfs.2023.36.3.85
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 Abstract
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- Purpose
To evaluate the radiologic and clinical outcomes of a minimally invasive technique using the tarsal sinus approach in the management of Sanders type III, joint depressive type calcaneal fractures.
Materials and Methods
Between July 2011 and September 2019, data of 29 patients who underwent a minimally invasive procedure with the sinus tarsi approach for Sanders type III joint depressive intra-articular calcaneal fractures, and were followed up for more than 1 year were analyzed. We evaluated the radiologic outcomes by assessing the radiologic parameters (Böhler angle, Gissane angle, calca-neal length, calcaneal height, calcaneal width). We also evaluated the clinical outcomes based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the complications associated with the technique.
Results
The radiological results showed an improvement in the Böhler angle from 2.5° to 18.6° and the Gissane angle from 132.4° to 119.1° after the operation. The mean AOFAS score during the clini-cal evaluation was 79.5. We observed 13 cases of posttraumatic arthritis, 1 case of subtalar arthrodesis, and no case of wound complication.
Conclusion
Minimally invasive technique for Sanders type III joint depressive calcaneal fractures resulted in relatively satisfactory radiologic and clinical outcomes. Open reduction and internal fixation through the sinus tarsi approach reduce complications including wound problems. This approach offers satisfactory results without long-term complications.
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Comparison of the Results between Plating and Intramedullary Nailing for Ipsilateral Fibular Fractures in Pilon Fractures
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Yong Jin Cho, Jun Young Lee, Jae Hwan Lim, Je Hong Ryu, Jung Ho Lee
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J Korean Fract Soc 2021;34(3):97-104. Published online July 31, 2021
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DOI: https://doi.org/10.12671/jkfs.2021.34.3.97
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Abstract
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- Purpose
To compare the results between plating and intramedullary nailing for ipsilateral fibular fractures in pilon fractures.
Materials and Methods
Among 124 patients with pilon fractures from November 2008 to March 2019, 50 patients with a fibular fracture were studied retrospectively and divided into two groups: Group A using a plate and Group B using a Rush pin. The radiological tests confirmed the fracture pat-terns (Rüedi–Allgöwer classification, AO/OTA classification) and evaluated the degree of reduction of fibular and tibial fractures after surgery. The American Orthopaedic Foot & Ankle Society (AOFAS) was examined for a clinical evaluation, and the complications were checked.
Results
The two groups showed similar distributions in gender, age, injury mechanism, diabetes, smoking, mean follow-up period, Rüedi–Allgöwer classification, AO/OTA classification, and open fracture.
The fibular fractures were classified as simple, wedge, multiple, and segmental, showing significant differences between the two groups (p=0.03). There was no difference in the Talocrural angle, Shenton line, and Dime sign. In the reduction of pilon fractures, the appropriate reduction was obtained in 22 cases (88.0%) for both groups. The AOFAS averaged 83.24 in Group A and 80.44 points in Group B, showing no significant difference in complications (nonunion, malunion, infection, and arthritis).
Conclusion
Regardless of how the fibular fracture was fixed, the reduction of pilon fractures in both groups showed good results. Both intramedullary nail and plate fixation could be a suitable fixation method for ipsilateral fibular fractures with a low risk of shortening in pilon fractures.
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