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

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)
Publication Information
Journal of Trauma and Injury / v.18, no.1, 2005 , pp. 64-69 More about this Journal
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
Calcaneus; Intra-articular fracture; Lateral approach;
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