Journal of Musculoskeletal Trauma

The prognostic factors in Tongue shaped calcaneal fractures treated by Essex-Lopresti method: Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Dong Wook Lee; J Korean Soc Fract 1999;12(2):328-334. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.328

Abstract PDF: There is a great difference in opinion regarding the treatment of intraarticular fractures of the calcaneus. In Essex-Lopresti method, a heavy Steinmann pin is introduced into the cancellous part of tongue fragment and the fracture is reduced by lifting the fragment by the level effect of the Steinmann pin. The authors had treated 38 cases in 36 patients with displaced intraarticular tongue shaped fractures using Essex-Lopresti axial fixation at our hospital from 1993 to 1997. We obtained the following results. 1. Of 36 patients, 31 patients were male and 5 female 2. The main cause of fractures were fall from height in 86 percent of cases and spine injury was associated in 8 cases(22%). 3. The favorable result was obtained in 29 cases(76%). 4. The poor prognostic factors in functional outcome were old age, comminution of fracture, osteoporosis and the loss of correction in B.. ohler angle at postoperative and follow up Xrays.

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Essex-Lopresti Axial Fixation for Intra-articular Calcaneal Fractures: Young Do Koh, Jong Oh Kim; J Korean Soc Fract 1998;11(2):371-377. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.371

Abstract PDF: Fracture of the calcaneus is quite common, and displace intraarticular fractures can be associated with serious and prolonged disability. However, there still a great deal of controversy regarding the treatment of intraarticular fractures of calcaneus. Authors had treated 41 cases of 32 patients with displaced intraarticular calcaneal fractures using Essex-Lopresti axial fixation at Ewha Woman's University Mokdong Hospital from September, 1993 to February, 1996, and analyzed the functional results after the minimum 2 year follow-up. The results as follows; 1. Of 41 intraarticular calcaneal fractures, 27 fractures were tongue type and 14 fractures were joint depression type according to Essex-Lopresti classification. 2. Postoperatively Bohler angle was restored to mean 24.5degree intongue type, and to mean 13.8degree in joint depression type. 3. The reduction loss of Bohler angle was 7% in tongue type and 18.8% in joint depression type at the final follow-up. 4. The satisfactory results were obtained in 77.7% of tongue type and in 49.9% of joint depression type.

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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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