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Tun Hing Lui - One of the best experts on this subject based on the ideXlab platform.
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endoscopic lateral Calcaneal ostectomy and peroneal tendon decompression with the patient in the prone position as management of subfibular impingement after Calcaneal Fracture
Arthroscopy techniques, 2019Co-Authors: Kai Man Chu, Tun Hing LuiAbstract:Abstract Subfibular impingement is a common cause of lateral heel pain after Calcaneal Fracture. It can be caused by calcaneofibular impingement, peroneal impingement, or a combination thereof. It may not be easy to differentiate bony impingement from soft-tissue impingement. Simultaneous lateral Calcaneal ostectomy and peroneal tendon decompression may increase the chance of pain relief. The purpose of this Technical Note was to report the technical details of endoscopic lateral Calcaneal ostectomy and peroneal tendon decompression with the patient in the prone position. This technique is indicated for symptomatic subfibular impingement recalcitrant to conservative treatment. It has the advantages of being minimally invasive surgery and allowing early mobilization of the foot and ankle.
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endoscopic management of calcaneofibular impingement and posterior ankle impingement syndrome caused by malunion of joint depressed type Calcaneal Fracture
Arthroscopy techniques, 2018Co-Authors: Tun Hing Lui, Yuk Chuen Siu, Wai Kit NgaiAbstract:Identification of the correct source of symptoms is the key in formulating the correct treatment plan for heel pain after Calcaneal malunion. Calcaneofibular and posterior ankle impingements can occur due to malunion of a joint depressed-type Calcaneal Fracture. The purpose of this Technical Note is to report the technical details of posterior and lateral decompression through the posteromedial and posterolateral portals using posterior ankle endoscopy.
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posterior ankle impingement syndrome caused by malunion of joint depressed type Calcaneal Fracture
Knee Surgery Sports Traumatology Arthroscopy, 2008Co-Authors: Tun Hing LuiAbstract:Late complications after Calcaneal Fracture usually resulted in lateral heel pain. Malunion of joint depressed type Calcaneal Fracture can result in posterior ankle impingement pain. This is caused by the posterior Calcaneal bone spike formed just behind the posterior Calcaneal facet. We describe a technique to resect the offending posterior Calcaneal bone spike to relieve the posterior ankle impingement pain.
Tim Schepers - One of the best experts on this subject based on the ideXlab platform.
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managing the open Calcaneal Fracture a systematic review
Foot and Ankle Surgery, 2019Co-Authors: Kimberley E Spierings, Minoesch Min, Lynn E Nooijen, Michael P Swords, Tim SchepersAbstract:Abstract Introduction Open Fractures of the calcaneus are rare. They are mostly caused by high-energy trauma. There are several treatment options for Calcaneal Fractures. However, treatment of open Calcaneal Fractures might need a different approach, as open Calcaneal Fractures are associated with high rates of complications. The purpose of this study was to provide a literature overview on the management of open Calcaneal Fractures, and deduct a more standardized treatment algorithm. Material and methods A literature review was conducted in the databases of PubMed, EMBASE and the Cochrane Library for articles describing the management of open Calcaneal Fractures. Excluded were studies with less than 10 patients, studies describing combat injuries and reviews. Only articles published from 1998 to 2017 were included and there were no language restrictions. Results A total of 18 articles were included with 616 open Calcaneal Fractures in 598 patients. Most wounds were Gustilo grade III and most Fractures were Sanders type III. Definitive surgery was performed after a mean of 9.8 days and in most cases in the form of ORIF via ELA. The complication rate was 21% and the mean AOFAS score was 73.7 points. Conclusion The complication rates of open Calcaneal Fractures are high and increase with the severity of the wound. A treatment algorithm is suggested. However, to produce a more evidence-based protocol and achieve consensus for treatment, additional research should be done, preferably in the form of a prospective multicenter database.
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evaluation and quantification of geographical differences in wound complication rates following the extended lateral approach in displaced intra articular Calcaneal Fractures a systematic review of the literature
Injury-international Journal of The Care of The Injured, 2017Co-Authors: Manouk Backes, Kimberley E Spierings, Siem A Dingemans, R. Buckley, J. Carel Goslings, Tim SchepersAbstract:Abstract Introduction Calcaneal Fracture surgery is often performed via the extended lateral approach (ELA). Large differences are reported in literature on wound complication rates. Aim was to perform a systematic review on reported postoperative wound complication (POWC) and postoperative wound infection (POWI) rates following the ELA and evaluate and quantify geographical differences. Methods A literature search was conducted in the MEDLINE and EMBASE databases and Cochrane Library. Studies before 2000, with Results 3068 articles were identified of which 123 were included, with 8584 Calcaneal Fractures in 28 different countries. The average total number of POWC was 14.3%, with 3.8% of superficial and 2.2% of deep infections. The highest POWI rate was found in Europe (12.1%) and the lowest in North America (2.8%). A significant difference in incidence of deep POWI between continents was detected (median 0–3.8%). No differences were found in incidence of POWC and POWI between retro- and prospective studies (respectively p = 0.970, p = 0.748) or studies with 3 months (p = 0.01). Conclusion Large differences were detected in incidence of POWC and POWI following Calcaneal Fracture surgery with the ELA between countries and continents. We did not find a lower POWC or POWI rate in retrospective studies compared to prospective studies, larger studies or in studies in which more patients were treated annually. However, the rate of POWI was significantly lower in studies with a follow up of >3 months. We advise the use of a reliable postoperative complication registration system and uniformity in the use of standardized definitions of wound complications for Calcaneal Fracture surgery.
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effects of intra operative fluoroscopic 3d imaging on peri operative imaging strategy in Calcaneal Fracture surgery
Archives of Orthopaedic and Trauma Surgery, 2017Co-Authors: M S H Beerekamp, Manouk Backes, Tim Schepers, Niels W L Schep, Dirk T Ubbink, Jan S K Luitse, J. Carel GoslingsAbstract:Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in Calcaneal Fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby neglecting corrections after intra-operative fluoroscopic 2D-imaging (2D-imaging). The aim of this study was to assess the effects of additional 3D-imaging on intra-operative corrections, peri-operative imaging used, and patient-relevant outcomes compared to 2D-imaging alone. In this before–after study, data of adult patients who underwent open reduction and internal fixation (ORIF) of a Calcaneal Fracture between 2000 and 2014 in our level-I Trauma center were collected. 3D-imaging (BV Pulsera with 3D-RX, Philips Healthcare, Best, The Netherlands) was available as of 2007 at the surgeons’ discretion. Patient and Fracture characteristics, peri-operative imaging, intra-operative corrections and patient-relevant outcomes were collected from the hospital databases. Patients in whom additional 3D-imaging was applied were compared to those undergoing 2D-imaging alone. A total of 231 patients were included of whom 107 (46%) were operated with the use of 3D-imaging. No significant differences were found in baseline characteristics. The median duration of surgery was significantly longer when using 3D-imaging (2:08 vs. 1:54 h; p = 0.002). Corrections after additional 3D-imaging were performed in 53% of the patients. However, significantly fewer corrections were made after 2D-imaging when 3D-imaging was available (Risk difference (RD) −15%; 95% Confidence interval (CI) −29 to −2). Peri-operative imaging, besides intra-operative 3D-imaging, and patient-relevant outcomes were similar between groups. Intra-operative 3D-imaging provides additional information resulting in additional corrections. Moreover, 3D-imaging probably changed the surgeons’ attitude to rely more on 3D-imaging, hence a 15%-decrease of corrections performed after 2D-imaging when 3D imaging was available. No substantiation for cost reduction was found through reduction in peri-operative imaging or in terms of improved patient-relevant outcomes.
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wound infections following open reduction and internal fixation of Calcaneal Fractures with an extended lateral approach
International Orthopaedics, 2014Co-Authors: Manouk Backes, Tim Schepers, Jan S K Luitse, Suzan M H Beerekamp, Carel J Goslings, Niels W L SchepAbstract:Purpose Post-operative wound infections (PWI) following Calcaneal Fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF).
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Subtalar versus triple arthrodesis after intra-articular Calcaneal Fractures
Strategies in Trauma and Limb Reconstruction, 2010Co-Authors: Tim Schepers, Brenda C. T. Kieboom, Gert H. J. M. Bessems, Lucas M. M. Vogels, Esther M. M. Lieshout, Peter PatkaAbstract:Depending upon initial treatment, between 2 and 30% of patients with a displaced intra-articular Calcaneal Fracture require a secondary arthrodesis. The aim of this study was to investigate the effect of subtalar versus triple arthrodesis on functional outcome. A total of 33 patients with 37 secondary arthrodeses (17 subtalar and 20 triple) with a median follow-up of 116 months were asked to complete questionnaires regarding disease-specific functional outcome (Maryland Foot Score, MFS), quality of life (SF-36) and overall satisfaction with the treatment (Visual Analogue Scale, VAS). Patient groups were comparable considering median age at Fracture, initial treatment (conservative or operative), time to arthrodesis, median follow-up, and post-arthrodesis radiographic angles. The MFS score was similar after subtalar versus triple arthrodesis (59 vs. 56 points; P = 0.79). No statistically significant difference was found for the SF-36 (84 vs. 83 points; P = 0.67) and the VAS (5 vs. 6; P = 0.21). Smoking was statistically significantly associated with a non-union (χ^2 = 6.60, P = 0.017). The current study suggests that there is no significant difference in functional outcome between an in situ subtalar or triple arthrodesis as a salvage technique for symptomatic arthrosis after an intra-articular Calcaneal Fracture. Smoking is a risk factor for non-union.
Paul J. Hecht - One of the best experts on this subject based on the ideXlab platform.
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mr imaging findings of entrapment of the flexor hallucis longus tendon
American Journal of Roentgenology, 2001Co-Authors: Lawrence D Lo, Keith L. Wapner, Mark E. Schweitzer, Paul J. HechtAbstract:OBJECTIVE. In this retrospective study, we describe the MR imaging patterns of various causes of flexor hallucis longus tendon entrapment.CONCLUSION. Entrapment of the flexor hallucis longus tendon may be due to an enlarged os trigonumtarsitarsi, Calcaneal Fracture, and soft-tissue scar. These disorders have characteristic imaging findings that may be revealed on MR imaging.
Wai Kit Ngai - One of the best experts on this subject based on the ideXlab platform.
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endoscopic management of calcaneofibular impingement and posterior ankle impingement syndrome caused by malunion of joint depressed type Calcaneal Fracture
Arthroscopy techniques, 2018Co-Authors: Tun Hing Lui, Yuk Chuen Siu, Wai Kit NgaiAbstract:Identification of the correct source of symptoms is the key in formulating the correct treatment plan for heel pain after Calcaneal malunion. Calcaneofibular and posterior ankle impingements can occur due to malunion of a joint depressed-type Calcaneal Fracture. The purpose of this Technical Note is to report the technical details of posterior and lateral decompression through the posteromedial and posterolateral portals using posterior ankle endoscopy.
Tiansheng Sun - One of the best experts on this subject based on the ideXlab platform.
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less wound complications of a sinus tarsi approach compared to an extended lateral approach for the treatment of displaced intraarticular Calcaneal Fracture a randomized clinical trial in 64 patients
Medicine, 2016Co-Authors: Yongzhi Guo, Qinghua Sang, Hao Wang, Jianzheng Zhang, Zhi Liu, Tiansheng SunAbstract:Background We conducted a prospective randomized clinical trial to compare the clinical and radiological outcomes of the sinus tarsi and extended lateral approaches for the surgical treatment of displaced intraarticular Calcaneal Fractures. Methods Between January 2009 and January 2014, patients with displaced intraarticular Calcaneal Fracture were randomly assigned to receive surgical treatment by the sinus tarsi approach or the extended lateral approach using block randomization. We recorded and analyzed data on demographics, time to surgery, wound complications, Bohler angles pre- and postoperatively, and American Orthopedic Foot & Ankle Society score. Results Sixty-four patients met the inclusion criteria and were randomly assigned to the 2 groups: 32 patients underwent sinus tarsi approach, and 32 patients the extended lateral approach. Baseline characteristics of both groups were similar. The time to surgery in the sinus tarsi approach group was significantly shorter than in the extended lateral approach group (P = 0.04). The wound complication rates were 6.3% and 31.2% in the sinus tarsi approach and extended lateral approach groups, respectively, which was significantly different (P = 0.01). Regarding the clinical outcomes, the groups did not differ significantly on walking visual analogue scale or American Orthopedic Foot & Ankle Society scores at 6 months and 1 year postoperatively. No significant differences existed between groups regarding the Bohler angle at different times and reduction quality of the articular surface and the medial wall. Conclusion Compared with the extended lateral approach, the sinus tarsi approach decreased wound complications and preoperative waiting time, and achieved similar functional and radiological outcomes for displaced intraarticular Calcaneal Fractures.