Journal of Musculoskeletal Trauma

Clinical Outcomes of Minimally Invasive Surgery in Sanders Type IV Intra-Articular Calcaneal Fractures: Jun Young Lee, Hyunwoong Jang, Young Wook Kim; J Korean Fract Soc 2019;32(4):181-187. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.181

Abstract PDF: PURPOSE
This study evaluated the radiologic and clinical results in patients who underwent minimal invasive surgery using sinus tarsi approach in Sanders type IV calcaneal fracture.
MATERIALS AND METHODS
This retrospective study evaluated 13 cases of Sanders type IV calcaneus fractures that were treated by minimal invasive surgery using the sinus tarsi approach from July 2012 to April 2017. Further, these cases could be followed up for more than 12 months. Bone union, radiologic parameters such as BÃ¶hler's angle, Gissane's angle, calcaneal height, length, and width, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the postoperative complications were evaluated.
RESULTS
Bony union was achieved in all the cases at the final follow up, and the mean union time was 5.5 months. One patient underwent reoperation for a surgical site infection, six patients had post traumatic arthritis, and two of them underwent subtalar joint fusion. The mean AOFAS ankle-hindfoot score was 81.2. At the final follow-up, the mean values of BÃ¶hler's angle and Gissane's angle were 20Â° and 119.8Â°, respectively, and the mean values of the calcaneus height, length, and width were 46.8 mm, 81.8 mm, and 45.6 mm, respectively.
CONCLUSION
Minimal invasive surgery using the sinus tarsi approach for Sanders type IV calcaneal fracture resulted in satisfactory anatomic reduction and stable fixation, and satisfactory clinical and radiologic results were obtained in most of the patients. Minimal invasive surgery is thought to reduce the soft tissue-related complications as compared to surgery using the extensile lateral approach.

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The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture: Sueng Hwan Jo, Jun Young Lee, Sang Ho Ha, Sung Won Cho, Sang Ha Park; J Korean Fract Soc 2013;26(2):126-132. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.126

PURPOSE
To evaluate the short term follow-up results of minimally invasive technique in the management of Sanders type II, III, and IV joint depressive calcaneal fracture.
MATERIALS AND METHODS
Between May 2008 and May 2011, we studied 17 cases undergoing treatment with minimally invasive technique with modified sinus tarsi approach for Sanders II, III, and IV joint depressive intra-articular calcaneal fracture and were followed up for more than 1 year. We evaluated the treatment result by assessing the radiologic parameters (Bohler angle, Gissane angle, and calcaneal height/width/length) and clinical outcomes (American Orthopaedic Foot and Ankle Society [AOFAS] score and visual analog scale [VAS]) and investigating the complication.
RESULTS
Radiological results improved from 7.9degrees to 19.8degrees in the Bohler angle after the operation. Satisfactory results were obtained in clinical assessment with average AOFAS score of 82.45 and the average VAS score of 3.94. We experienced 3 cases of complications, 1 case of superficial wound infection and radiologic findings of subtalar arthritis in 2 cases.
CONCLUSION
Minimally invasive technique may be a useful alternative surgical method in the management of Sanders type II, III, and IV joint depressive calcaneal fracture that cannot adopt extensile approach, which enable to obtain good radiological and clinical results.

Citations

Citations to this article as recorded by

Outcomes of Minimally Invasive Surgery in Intra-Articular Calcaneal Fractures: Sanders Type III, Joint Depressive Type Calcaneal Fracture
Je Hong Ryu, Jun Young Lee, Kang Yeol Ko, Sung Min Jo, Hyoung Tae Kim
Journal of the Korean Fracture Society.2023; 36(3): 85. CrossRef
Towards uniformity in communication and a tailor-made treatment for displaced intra-articular calcaneal fractures
Tim Schepers
International Orthopaedics.2014; 38(3): 663. CrossRef

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Avulsion Fracture of Calcaneal Tubercle Treated with Cannulated Cancellous Screws and Wire: Surgical Technique: Chang Ho Yi, Jin Rok Oh; J Korean Fract Soc 2011;24(3):262-266. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.262

Abstract PDF: The incidence rate of calcaneal fracture consists about 2% of all fractures, and, of the fracture, calcaneal tubercle avulsion fracture is known to be rare. To treat non-displaced calcaneal tubercle avulsion fracture, conservative treatment such as cast fixation is applied. However, most cases accompany displacement of the avulsion fragment, and, usually, surgery is necessary to treat the displaced fracture. Although surgical fixation simply by cancellous screw or tension wire is widely used, fixation failure is potential complication in this method. Thus, this study wants to introduce a prospective and useful method that further strengthens the calcaneal fixation by using both cannulated screw and tension band wiring.

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Medial Plantar Nerve Injury after Screw Fixation of the Calcaneus Fracture: Bong Cheol Kwon, Yong Woon Shin, Duck Joo Kwon, Nam Kyou Rhee; J Korean Fract Soc 2006;19(2):288-290. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.288

Abstract: We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.

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Operative Treatiment with Open Reduction and Heterogenous bone graft to the Acute Displaced Intra-articular Calcaneus Fractures: Moon Jib Yoo, Suk Joo Lyu, Sung Churl Lee, Hong Geun Jung, Soon Haeng Kwon, Jeong Wan Kim, Myung Ho Kim; J Korean Soc Fract 1998;11(3):611-616. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.611

Abstract PDF: The calcaneus is the most frequently fractured tarsal bone. Although there were many reports of treatment using variable methods, but no definite general agreement to the treatment method of the intra-articular calcaneus fracture. From May. 1995 to Apr. 1997, 14 displaced intra-articular fractures of the calcaneus in 12 patients underwent open reduction and heterogenous bone graft (Lubboc, TRANSPHYTO S.A., France) at the Dept. of Orthopaedic Surgery, Dankook University Hospital The fractures were 13 joint depression type and 1 tongue type fractures according to the classification of Essex-Lopresti. The average follow-up was 20 months and clinical assessment underwent by Clinical Assessment Rating system of Hutchinson and Huebner; we got a satisfactory results for the treatment of displaced intra-articular calcaneus fracture by open reduction and heterogenous bone graft. We didn't need harvesting autograft by use of heterogenous bone graft into bone defect site instead of autograft. Our purpose of using heterogenous bone were filling of defect and internal fixation. We used minimal skin incision and minimal internal fixation device, so reduced complications such as wound edge necrosis and peroneal entrapment caused by entensile appraoch. There were no posterior facet depression and decreased B hler angle for 1 year follow up.

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Modified Technique of Essex-Lopresti Axial Fixation for Calcaneal Fracture: Woo Koo Junng, Byung Seol Kim, Kee Joon Na; J Korean Soc Fract 1995;8(2):391-398. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.391

Abstract PDF: In Essex-Lopresti conventional method, a heavy Steinmann pin is introduced into the cancellous part of tongue fragment and with knee flexed,the fracture is reduced by lifting upward on the pin. However it is hard to restore the anatomical position in the body of calcaneus because the tip of pin, positioned on cancellous part of tongue fragment, could not make adequate force on distal fragment especially in the case of osteoporosis or aged patients. Authors made one modification that the tip of pin was introduced from the upper tuberosity through the fracture site into the plantar cortical surface of posterior fragment and the fragment was lifted superiorly It was easy to reduce fracture by the lever arm effect, which made counter forces on anterior and posterior fragments against mechanism of fracture simultaneously. The authors had treated the 35 cases of 31 patients with displaced intra-articular calcaneal fractures using the modified techique of Essex-Lopresti axial fixation at Seoul Eul-Ji General Hospital from April 1989 to January 1993 and analyzed 31 cases of 21 patients after the follow-up from 12 months to 38 months (mean 16.5 months). The results were as follows; 1. Among 31 cases, 22 were tongue type and 9 were comminuted fracture with the joint depression. 2. Bohlers angle was changed from -5.4 in average preoperatively to 30.5 in average postoperatively. 3. according to Rowe evaluations, the clinical results were evaluated as excellent in 9, good in 13, fair in 7, poor in 2 cases. 4. Two poor cases were the joint depression type, which showed decreased Biihlers angle during follow up period. 5. In 7 cases, traumatic arthritis was developed on subtalar joint radiologically but there was no clinical need of subtalar fusion clinically 6. One case required the excision of traumatic bony spur. 7. There was no operative infection.

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