Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Surgical Treatment Using a Lateral Approach in Intra-articular Fractures of the Calcaneus

외측 도달법을 이용한 관절내 종골 골절의 수술적 치료

  • Koh, Young-Do (Department of Orthopedic Surgery, College of Medicine, Ewha Woman's University) ;
  • Jeong, Hoon (Department of Orthopedic Surgery, Seoul Red-Cross Hospital) ;
  • Kwon, Young-Sam (Department of Orthopedic Surgery, Seoul Red-Cross Hospital)
  • 고영도 (이화여자대학교 의과대학 정형외과학교실) ;
  • 정훈 (서울적십자병원 정형외과) ;
  • 권영삼 (서울적십자병원 정형외과)
  • Received : 2005.05.26
  • Accepted : 2005.06.27
  • Published : 2005.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: We report the radiologic and the clinical results for surgical treatment of calcaneal fractures involving the subtalar joint. Methods: We evaluated the findings of radiographs and computed tomographs of 39 patients (40 cases) with intra-articular calcaneal fractures. The fractures were treated with open reduction via an extended lateral approach and internal fixation using a plate. We assessed the radiologic results, such as the $B{\ddot{o}}hler$ angle, the Gissane angle, and the height/width ratio. We assessed the clinical results based on the critieria of Salama et al. Results: According to the Essex-Lopresti classification, 9 cases were classified as tongue type and 31 cases as joint depression type. According to the Sanders classification, 10 cases were classified as type IIA, 4 cases as IIB, 16 cases as IIIAB, 4 cases as IIIAC, and 6 cases as type IV. The mean preoperative $B{\ddot{o}}hler$ angle was 7.7, the mean postoperative $B{\ddot{o}}hler$ angle was 21.1, and the mean last follow-up $B{\ddot{o}}hler$ angle was 16.8. Clinical results classified as 10 excellent, 13 good, 11 fair, and 6 poor. Conclusion: In the treatment of intra-articular fractures of the calcaneus, open reduction via an extended lateral approach seems to be a useful method in that it can provide direct exposure of the subtalar joint with little morbidity.

Keywords

References

  1. Essex-Lopresti P. The mechanism, reduction, technique and results in fractures of the os calcis. Br J Surg 1952;39:395-419 https://doi.org/10.1002/bjs.18003915704
  2. Sanders R, Sigvard T, Hansen ST, McReynold JS. Trauma to the calcaneus and its tendon. In Disorders of the foot and ankle. Jahss, M.H.(ed). Philadelphia, W B Saunders Co: 2326-2360, 1991
  3. Rockwood CA, Green DP, Bucholz RW, Heckman JD. Rockwood and Green's Fractures in adults. 4th ed. Philadelphia: Lippincott-Raven, 1991
  4. Ross ERS, Peddy P. Current controversies in intra-articular calcaneal fractures. Inter J of Orthop Trauma 1994;4:52-56
  5. Rowe CR, Sakellarides HT. Fractures of the os calcis. A long-term follow-up study of 146 patients. JAMA 1963;184:920-923 https://doi.org/10.1001/jama.1963.03700250056007
  6. Stephenson JR. Treatment of displaced intraarticular fractures of the calcaneus using medial and lateral approaches, internal fixation and early motion. J Bone Joint Surg 1987;69-A:115-130
  7. Salama R, Benamara A, Weissman SL. Functional treatment of intra-articular fractures of the calcaneus. Clin Orthop 1976;115: 236-240
  8. Chung SS, Seo JG, Park YS, Lee CS, Hwang TK. Intra-articular fracture of the calcaneus : Analysis of result of operative treatment and prognostic factor. J Korean Fracture Soc 1998;11:865-872 https://doi.org/10.12671/jksf.1998.11.4.865
  9. Carr JB, Hamilton JJ, Bear LS. Experimental intraarticular calcaneal fractures: Anatomic basis for a new classification. Foot Ankle 1989;10:81-87 https://doi.org/10.1177/107110078901000206
  10. King RE. Axial pin fixation of fractures of the os calcis(Method of Essex-Lopresti). Orthop Clin N Am 1973;4:185-188
  11. Ross SDK, Sowerby MRR. The operative treatment of fractures of the os calcis. Clin Orthop 1985;184:132-143
  12. Pennel GF, Yadav MP. Operative treatment of comminuted fractures of the os calcis. Orthop Clin N Am 1973;4:193-195
  13. Huang PJ, Huang HT, Chen TB, Chen JC, Lin YK, Cheng YM, Lin SY. Open reduction and internal fixation of displaced intra-articular fractures of the calcaneus. J Trauma 2002;52:946-950 https://doi.org/10.1097/00005373-200205000-00021
  14. Paley D, Hall H. Intra-articular fractures of the calcaneus. J Bone Joint Surg 1993;75-A: 342-354
  15. Crosby AL, Fitzgibbons T. Intraarticular calcaneal fractures. Results of closed treatment. Clin Orthop 1993;290:47-54
  16. McReynolds IS. Fractures of the os calcis involving the subtalar joint treated by open reduction and internal fixation with staples using a medial approach. J Bone Joint Surg 1976;58A:733-736
  17. Paley D, Hall H. Calcaneal fracture controversies. Can we put humpty dumpty together again? Clin Orthop North Am 1989;20:665- 677
  18. Banard L. Non-operative treatment of fractures of the calcaneus. J Bone Joint Surg 1963;45-A:865-867
  19. Edwin RS. Symposium. Treatment of fractures of the calcaneus. J Bone Joint Surg 1963;45-A:863