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A S Ajai - One of the best experts on this subject based on the ideXlab platform.
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study of secondary Fracture lines a new evaluation system of comminution of Calcaneus Fracture
Orthopaedic Proceedings, 2018Co-Authors: A S AjaiAbstract:The lack of a universal, consistent protocol for the subjective, objective and radiographic evaluation of these injuries has hampered the comparison of results.Methods45 patients with complex Fractures of the Calcaneus were included in this prospective study, which was undertaken from July 2003 to December 2005. The Fracture classification of Essex-Lopresti was used. We also observed the extent of secondary Fracture lines extending from the primary shear line (on axial and external oblique plain radiographs) to establish comminution. The external oblique view for subtalar joint was performed with the patient supine, the knee at about 60 degree of flexion and the limb rotated externally 45 degree with a vertical X ray beam. All of these patients were managed by an external fixator using the principle of ligamentotaxis. Patients were evaluated by AOFAS.ResultsWe identified two broad patterns of secondary lines on plain X-rays:with anterior secondary Fracture lines andwith posterior secondary Fracture lines....
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study of secondary Fracture lines a new evaluation system of comminution of Calcaneus Fracture
Journal of Bone and Joint Surgery-british Volume, 2014Co-Authors: A S AjaiAbstract:The lack of a universal, consistent protocol for the subjective, objective and radiographic evaluation of these injuries has hampered the comparison of results. Methods 45 patients with complex Fractures of the Calcaneus were included in this prospective study, which was undertaken from July 2003 to December 2005. The Fracture classification of Essex-Lopresti was used. We also observed the extent of secondary Fracture lines extending from the primary shear line (on axial and external oblique plain radiographs) to establish comminution. The external oblique view for subtalar joint was performed with the patient supine, the knee at about 60 degree of flexion and the limb rotated externally 45 degree with a vertical X ray beam. All of these patients were managed by an external fixator using the principle of ligamentotaxis. Patients were evaluated by AOFAS. Results We identified two broad patterns of secondary lines on plain X-rays: with anterior secondary Fracture lines and with posterior secondary Fracture lines. There were 20 cases of tongue type and 25 of joint depression type Fracture pattern by the Essex-Lopresti classification. Forty two (93.4%) patients had Fractures with posterior secondary Fracture line and 3 (6.7%) patients had anterior secondary lines. The calcaneo-cuboid type of anterior secondary line pattern was present in 2 (4.5%) cases, and the plantar type in only 1 (2.5%) case. We observed posterior secondary line Type A pattern in 2 (4.5%) cases, depression / central depression type B in 20 (44.5%) cases, tongue shaped Type C pattern in 16 (36.5%) cases and Type D severely comminuted Fracture line pattern in 4 (8.7%) cases. Conclusion Comminution was significantly associated with prognosis and final outcome. Evaluation of secondary Fracture lines corresponds with comminution of Fractures of the Calcaneus and the final outcome of these Fractures. NO DISCLOSURES
Ming Cai - One of the best experts on this subject based on the ideXlab platform.
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comparing less invasive plate fixation versus screw fixation of displaced intra articular Calcaneus Fracture via sinus tarsi approach
International Orthopaedics, 2020Co-Authors: Changjun Guo, Zhengxiang Wang, Ming CaiAbstract:PURPOSE The purpose of this study was to compare the post-operative radiographic and clinical outcomes of less invasive plate fixation versus screw fixation of displaced intra-articular Calcaneus Fractures (DIACFs) via sinus tarsi approach. METHODS A total of 165 consecutive DIACFs that underwent open reduction internal fixation via sinus tarsi approach from 2013 to 2018 were reviewed at least a two year follow-up. The methods of fixation were divided into two groups: less invasive plate fixation versus screw fixation of Calcaneus Fracture (59 vs 106, respectively). The radiographic outcomes including pre- and post-operative Bohler's and Gissane's angles were evaluated. The post-operative function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, the Olerud and Molander Scale and the Visual Analogue Scale (VAS). The complications, the rates of implant removal and cost were also compared. RESULTS The average follow-up was 44.2 months in the plate groups and 47.9 months in the screw groups (P > 0.05). There was no significant difference in the Bohler's angle and Gissane's angle between the plate group and screw group during the pre-operation and the last follow-up. There was no significant difference in the final AOFAS score, Olerud and Molander score and VAS score between the two groups (P > 0.05). The total incidence of complications was 6.7% in the plate group and 6.6% in the screw group (P > 0.05). The rates of implant removal and total cost during the hospitalization in the plate group were significantly higher compared with screws group (P < 0.05). CONCLUSION The less invasive plate fixation versus screw fixation of DIACFs via sinus tarsi approach contributed comparable quality of reduction, complications and post-operative functional outcomes. The less invasive plate technique was significantly higher in terms of implant costs and the rate of implant removal.
James B. Carr - One of the best experts on this subject based on the ideXlab platform.
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Surgical Treatment of the Intra-Articular Calcaneus Fracture
The Orthopedic clinics of North America, 1994Co-Authors: James B. CarrAbstract:The acute displaced intra-articular Calcaneus Fracture should be approached on a rational basis. Minimally displaced Fractures are best treated with early motion and delayed bearing of weight. Reconstructible, displaced Fractures are probably best treated with exact open reduction and internal fixation, assuming contraindications such as poor skin condition or underlying disease are not present. The severely displaced, Sanders-type IV Fractures remain a dilemma, and these may demonstrate a role for primary fusion in select instances. If one chooses to treat a Calcaneus Fracture surgically, it should be recognized that the result will be related to the exactness of the reduction. This surgery is very challenging, with an arduous learning curve. Importantly, if one cannot obtain an anatomic reduction, the patient may have been better off treated nonoperatively.
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Varus of the talus in the ankle mortise secondary to Calcaneus Fracture. A case report.
Clinical Orthopaedics and Related Research, 1991Co-Authors: James B. CarrAbstract:Varus displacement of the talus in the ankle mortise secondary to a Calcaneus Fracture was observed in a 33-year-old man. Similar to the Calcaneus Fracture-dislocation, the mechanism involved inferior and medial displacement of the talus into the body of the Calcaneus. The patient's ankle deformity was not corrected by a lateral ankle ligament reconstruction. Correction required a distraction subtalar bone block fusion. Successful reconstruction of the hindfoot after Calcaneus Fractures requires a careful analysis of the pathologic lesion. In this unusual case, correction required restoration of lost hindfoot bone structure.
Changjun Guo - One of the best experts on this subject based on the ideXlab platform.
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comparing less invasive plate fixation versus screw fixation of displaced intra articular Calcaneus Fracture via sinus tarsi approach
International Orthopaedics, 2020Co-Authors: Changjun Guo, Zhengxiang Wang, Ming CaiAbstract:PURPOSE The purpose of this study was to compare the post-operative radiographic and clinical outcomes of less invasive plate fixation versus screw fixation of displaced intra-articular Calcaneus Fractures (DIACFs) via sinus tarsi approach. METHODS A total of 165 consecutive DIACFs that underwent open reduction internal fixation via sinus tarsi approach from 2013 to 2018 were reviewed at least a two year follow-up. The methods of fixation were divided into two groups: less invasive plate fixation versus screw fixation of Calcaneus Fracture (59 vs 106, respectively). The radiographic outcomes including pre- and post-operative Bohler's and Gissane's angles were evaluated. The post-operative function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, the Olerud and Molander Scale and the Visual Analogue Scale (VAS). The complications, the rates of implant removal and cost were also compared. RESULTS The average follow-up was 44.2 months in the plate groups and 47.9 months in the screw groups (P > 0.05). There was no significant difference in the Bohler's angle and Gissane's angle between the plate group and screw group during the pre-operation and the last follow-up. There was no significant difference in the final AOFAS score, Olerud and Molander score and VAS score between the two groups (P > 0.05). The total incidence of complications was 6.7% in the plate group and 6.6% in the screw group (P > 0.05). The rates of implant removal and total cost during the hospitalization in the plate group were significantly higher compared with screws group (P < 0.05). CONCLUSION The less invasive plate fixation versus screw fixation of DIACFs via sinus tarsi approach contributed comparable quality of reduction, complications and post-operative functional outcomes. The less invasive plate technique was significantly higher in terms of implant costs and the rate of implant removal.
Sharad Prabhakar - One of the best experts on this subject based on the ideXlab platform.
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Controversies in Calcaneus Fracture management: a systematic review of the literature
MUSCULOSKELETAL SURGERY, 2011Co-Authors: Mandeep S Dhillon, Kamal Bali, Sharad PrabhakarAbstract:Despite the fact that the Calcaneus is the commonest tarsal bone Fractured, many controversies exist in the literature regarding the management options. This stems from the fact that the understanding of the Fracture pattern has evolved only recently, surgical approaches have lately been standardized, surgical timing has become more clear, and newer implants are regularly being introduced. Despite the significant advances, complications and controversies related to this common Fracture abound. The present paper looks at all aspects of modern management options of Calcaneus Fractures and tries to review the literature with regard to the controversial issues that still persist.