Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Minimally Invasive Reduction and Pin Fixation Treatment for Displaced Intraarticular Calcaneal Fracture

최소 침습적 정복술 및 금속강선 고정술을 이용한 전위된 관절내 종골 골절의 치료

  • Lee, Jin-Young (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital. Hallym University School of Medicine) ;
  • Park, In-Heon (Department of Orthopedic Surgery, Gang-neung Dong-in General Hospital) ;
  • Kim, Gab-Lae (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital. Hallym University School of Medicine) ;
  • Kim, Tae-Hwa (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital. Hallym University School of Medicine) ;
  • Oh, Bum-Suk (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital. Hallym University School of Medicine)
  • 이진영 (한림대학교 강동성심병원 정형외과) ;
  • 박인헌 (강릉동인병원 정형외과) ;
  • 김갑래 (한림대학교 강동성심병원 정형외과) ;
  • 김태화 (한림대학교 강동성심병원 정형외과) ;
  • 오범석 (한림대학교 강동성심병원 정형외과)
  • Received : 2010.04.19
  • Accepted : 2010.05.13
  • Published : 2010.06.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

Keywords

References

  1. Barnard L. Nonoperative treatment of fractures of the calcaneus. J Bone joint Surg. 1963;45:865-7.
  2. Folk JW, Starr AJ, Early JS. Early wound complications of operative treatment of calcaneus fractures: analysis of 190 fractures. J Orthop Trauma. 1999;13:369-72. https://doi.org/10.1097/00005131-199906000-00008
  3. Benirschke SK, Sangeorzan BJ. Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures. Clin Orthop. 1993;292:128-34.
  4. Leung KS, Yuen KM, Chan WS. Operative treatment of displaced intra-articular fracture of the calcaneum. Mediumterm results. J Bone Joint Surg. 1993;75:196-201.
  5. Kim ES, Seo HM, Lee KM, et al. Result of surgical treatment of intra-articular fractures of the calcaneus. Based on CT classification and open reduction and internal fixation. J Korean Foot Ankle Soc. 2003;7:238-49.
  6. Sung CH, Park BM, Song KS, Kim HG, Kim JM, Kim TE. Operative treatment of intraarticular calcaneal fracture-Comparison of outcomes between open reduction and closed reduction. J Korean Fracture Soc. 2005;18:170-5.
  7. Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intraarticular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg. 2002;84: 1733-44.
  8. 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.
  9. Sandere R. Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg. 2000;82-A:225-50.
  10. 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
  11. Lowery RB, Galhoun JH. Fracture of calcaneus. Foot Ankle. 1996;17:230. https://doi.org/10.1177/107110079601700409
  12. Song KW, Lee GL, Lee JY, Lee KN, Seo EH. Result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. J Korean Foot Ankle Soc. 2008;12:93-9.
  13. Kim MH, Jung HG, Seo JB, Kim YJ, Yu JW. Surgical treatment of displaced intra-articular calcaneal fractures: Minimum of 2-year Follow-up. J Korean Fracture Soc. 2006;19:201-7.
  14. Heckman JD. Fracture and dislocations of the foot. In fractures in adult. Rockwood and Green. 3rd ed Philadelphia:JB Lippincott Co; 1984. 2103-31.
  15. Park IH, Lee KB, Song KW, Lee JY, Lee EJ, Park RS. Correlationship between degree of displacement and range of motion of the subtalar joint after calcaneal fracture. J Korean Foot Ankle Soc. 1998;2:19-29.
  16. Maskill JD, Bohay DR, Anderson JG. Calcaneus fractures: a review article. Foot Ankle Clin. 2005;10:463-89. https://doi.org/10.1016/j.fcl.2005.03.002
  17. Myers DB, Marshall RN, Palmer DG. Morphological and biochemical comparison of convex and concave articular surfaces from adult subtalar and midtarsal joints. Scand J Rheumatol.1983;12:119-23. https://doi.org/10.3109/03009748309102896
  18. Cave EF. Fractures of the Os Calcis: The problem in general. Clin Orthop. 1963;30:64-6.
  19. Guyer BH, Levinson EM, Fredricksson BE, Bailey GL, Formikel IM. Computed-tomography of calcaneal fractures: Anatomy, pathology dosimetry, and clinical relevance. American Journal of Roentgenology. 1985;145:911-9. https://doi.org/10.2214/ajr.145.5.911
  20. Choi JC, Lee KS, Kim BS, Park BY, Cha JH. Open reduction and internal fixation of intraarticular calcaneal fractures by the extended lateral approach. J Korean Orthop Assoc. 1997;32:370-5.
  21. Park BM, Kim NH, Han DY, Oh DS. A clinical study on the fractures of the calcaneus. J Korean Orthop Assoc. 1982;17: 697-703.
  22. Palmer I. The mechanism and treatment for the fractures of calcaneus. Open reduction with use of cancellous grafts. J Bone Joint Surg. 1948;30:2-8.
  23. 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.
  24. Stephenson JR. Surgical treatment of displaced intraarticular fractures of the calcaneus. A combined lateral and medial approach. Clin Orthop Relat Res. 1993;290:68-75.
  25. Stromsoe K, Mork E, Hem ES. Open reduction and internal fixation in 46 displaced intraarticular calcaneal fractures. Injury. 1998;29:313-6.
  26. McReynolds IS. The case for operative treatment of fractures of the Os Calcis. In: Controversies in Orthopedic Surgery. Philadelphia: Saunders; 1982. 232-54.
  27. Whittaker AH. Treatment of fractures of the os calcis by open reduction and internal fixation. Am J Surg. 1947;74:687-96. https://doi.org/10.1016/0002-9610(47)90225-0
  28. Hazlett JW. Open reduction of fractures of the calcaneum. Can J Surg.1969;12:310-7.
  29. Park IH, Lee KB, Song KW, Lee JY, Yum DH. Surgical treatment for intraarticular calcaneal fracture using posterior approach. J Korean Orthop Assoc. 1991;26:96-105.
  30. Freeman BJ, Duff S, Allen PE, Nicholson HD, Atkins RM. The extended lateral approach to the hindfoot. Anatomical basis and surgical implications. J Bone Joint Surg. 1998; 80:139-42. https://doi.org/10.1302/0301-620X.80B1.7987