Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Operative Treatment of Tongue Type Intra-articular Calcaneal Fractures: Comparison of the Open Reduction and Essex-Lopresti Technique

관절면을 침범한 설상형 종골골절의 수술적 치료: 관혈적 및 Essex-Lopresti 술식에 따른 비교

  • Shin, Dong-Eun (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University) ;
  • Yoon, Hyung-Ku (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University) ;
  • Han, Soo-Hong (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University) ;
  • Choi, Woo-Jin (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University) ;
  • Ahn, Chang-Soo (Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University) ;
  • Ok, Hyun-Soo (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University)
  • 신동은 (차의과학대학교 분당차병원 정형외과학교실) ;
  • 윤형구 (차의과학대학교 분당차병원 정형외과학교실) ;
  • 한수홍 (차의과학대학교 분당차병원 정형외과학교실) ;
  • 최우진 (차의과학대학교 분당차병원 정형외과학교실) ;
  • 안창수 (차의과학대학교 구미차병원 정형외과학교실) ;
  • 옥현수 (차의과학대학교 분당차병원 정형외과학교실)
  • Received : 2010.10.20
  • Accepted : 2010.11.18
  • Published : 2010.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To analyze the clinical and radiological results of operative treatment in patients with tongue type intra-articular calcaneal fracture, and to compare the open reduction and Essex-Lopresti technique. Materials and Methods: We examined a consecutive series of 42 patients who received surgical treatment for tongue type calcaneal fracture (24 cases of the open reduction and 18 cases of the Essex-Lopresti technique) and the postoperative data was compared with a minimum 1 year follow-up. The clinical outcome was analyzed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and Salama's criteria. The preoperative, postoperative, and last follow-up changes in the Bohler angle was radiologically analyzed. Results: There were no significant differences between the two groups in terms of the clinical and radiological results at the last follow-up. However, for the Sander's type 3 and 4 fractures, the open reduction group showed more improvement of AOFAS score and less reduction loss in the Bohler angle. Conclusion: Although the clinical results were good irrespective of surgical technique, the open reduction and internal fixation can improve clinical outcome and reduce the reduction loss as compared with the Essex-Lopresti technique in the comminuted tongue type calcaneal fracture.

Keywords

References

  1. Harty M. Anatomic considerations in injuries of the calcaneus. Orthop Clin N Am. 1973;4:179-83.
  2. 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
  3. Burdeaux BD. Reduction of calcaneal fractures by the McReynolds medial approach technique and its experimental basis. Clin Orthop Relat Res. 1983;177:87-103.
  4. Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma. 1992;6:252-65. https://doi.org/10.1097/00005131-199206000-00022
  5. Kitaoka HB, Alexander I, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349-53. https://doi.org/10.1177/107110079401500701
  6. Salama R, Benamara A, Weissman SL. Functional treatment of intra-articular fractures of the calcaneus. Clin Orthop. 1976;115:236-40.
  7. Omoto H, Sakurada K, Sugi M, Nakamura K. A new method of manual reduction for intra-articular fracture of the calcaneus. Clin Orthop. 1983;177:104-11.
  8. Miller ME. Surgical management of calcaneal fractures: indications and techniques. Instr Course Lect.1990;39:161-65.
  9. Hall MC, Pennal GF. Primary subtalar arthrodesis in the treatment of severe fractures of the calcaneum. J Bone Joint Surg. 1960;42:336-43.
  10. Pennal GF, Tadav MP. Operative treatment of comminuted fractures of the os calcis. Orthop Clin N Am. 1973;4:197- 211.
  11. McReynolds IS. Trauma to the os calcis and heel cord. In: Jahss MH, ed. Disorders of the foot. Philadelphia:WB Saunders; 1982. 1497-1542.
  12. Stephenson JR. Treatment of displaced intra-articular fractures of the calcaneus using medial and lateral approaches, internal fixation, and early motion. J Bone Joint Surg. 1987;69:115-30.
  13. Bohler L. Diagnosis, pathology, and treatment of fractures of the os calcis. J Bone Joint Surg. 1931;13:75-89.
  14. Hermann OJ. Conservative therapy for fracture of the os calcis. J Bone Joint Surg. 1937;19:709-18.
  15. Arnensen A. Treatment of fractures of the os calcis with traction and manipulation. Acta Chir Scand. 1966;132:566-73.
  16. Giachino AA, Uhthoff HK. Intra-articular fracture of the calcaneus. J Bone Joint Surg. 1989;71:784-7.
  17. Maxfield JE, McDermott FJ. Experiences with the palmer open reduction of fractures of the calcaneus. J Bone Joint Surg. 1955;37:99-106.
  18. Ross SDK, Sowerby MRR. The operative treatment of fractures of the os calcis. Clin Orthop. 1985;199:132-43.
  19. Paley D, Hall H. Calcaneal fracture controversies: can we put humpty dumpty together again? Orthop Clin N Am. 1989;20:665-77.
  20. Chung HJ, Ahn JK, Bae SY, Jung H. Operative treatment of intraarticular calcaneal fractures using extensile lateral approach. J Korean Foot Ankle Soc. 2009;13:60-7.
  21. Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;290:87-95.