J Korean Fract Soc.  2007 Apr;20(2):178-183. 10.12671/jkfs.2007.20.2.178.

Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method

• Kong GM
• Suh BH
• Kim DJ

• KMID: 2295577
• DOI: http://doi.org/10.12671/jkfs.2007.20.2.178

Abstract

PURPOSE
To evaluate the result of joint depression type of intraarticular calcaneal fractures treated with Essex-Lopresti method.
MATERIALS AND METHODS
From March 2001 to February 2005, Thirty two patients' joint depression type of intraarticular calcaneal fractures which treated with Essex-Lopresti method were clinically and radiographically evaluated retrospectively.
RESULTS
According to Creighton-Nebraska Health Foundation Assessment Score (C-N score), there were 5 excellent, 11 good, 6 fair and 10 poor results. Böhler angle was corrected from 10.3 degrees to 24.5 degrees. There was a positive correlation between size of depressed fragment and C-N score (p<0.01).
CONCLUSION
Essex-Lopresti method can substitute open reduction methods in joint depression type of intraarticular calcaneal fractures which have relatively large depressed joint fragments.

Keyword

Calcaneal fracture; Joint depression type; Essex-Lopresti method

MeSH Terms

Depression*
Joints*
Methods*
Retrospective Studies

Figure

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  Fig. 1 These photographs show methods of measurement of the size of depressed fragment (A), Böhler angle (B) and calcaneal width (C).

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  Fig. 2 Preoperative lateral radiograph (A) and CT scan (B) of a 43 year-old male patient show joint depression type of intraarticular calcaneal fracture. Preoperative Böhler angle is 11.6 degrees and the size of depressed joint fragment is 13.5 mm. Postopertive radiograph (C) shows increased Böhler angle to 30.5 degrees. Nineteen month follow-up radiogragh (D) shows good alignment of subtalar joint and 30 degrees of Böhler angle. Final C-N score is 85 points.

Reference

1. Bernstein SA. Late sequelae of calcaneal fractures. Clin Podiatr Med Surg. 2000; 17:81–96.

2. Crosby LA, Fitzgibbons T. Computerized tomography scanning of acute intra-articular fractures of the calcaneus. A new classification system. J Bone Joint Surg Am. 1990; 72:852–859.

3. Crosby LA, Fitzgibbons T. Intraarticular calcaneal fractures. Results of closed treatment. Clin Orthop Relat Res. 1993; 290:47–54.

4. Essex-Lopresti P. The mechanism, reduction technique and results of os calcis. Br J Surg. 1952; 39:395–419.

5. Kwak KD, Cho HO, Lim DH, Ahn SM, Jang JH. Modified Essex-Lopresti reduction for the displaced intraarticular calcaneal fractures. J Korean Soc Foot Surg. 2003; 7:109–114.

6. Lance EM, Carey EJ Jr, Wade PA. Fractures of the os calcis treatment by early mobilization. Clin Orthop Relat Res. 1963; 30:76–90.

7. Miller WE. Pain and impairment considerations following treatment of disruptive os calcis fractures. Clin Orthop Relat Res. 1983; (177):82–86.

8. Myerson M, Quill GE Jr. Late complications of fractures of the calcaneus. J Bone Joint Surg Am. 1993; 75:331–341.

9. Pozo JL, Kirwan EO, Jackson AM. The long-term results of conservative management of the severely displaced fractures of the calcaneus. J Bone Joint Surg Br. 1984; 66:386–390.

10. Ross SD, Sowerby MR. The operative treatment of fractures of the os calcis. Clin Orthop Relat Res. 1985; 199:132–143.

11. Sanders R. Displaced intraarticular fractures of the calcaneus. J Bone Joint Surg Am. 2000; 82:225–250.

12. 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.

13. Sung CH, Park BM, Song KS, Kim HG, Kim JM, Kim TE. Operative treatment of intraarticular calcaneal fractures-comparison of outcomes between open reduction and closed reduction. J Korean Fract Soc. 2005; 18:170–175.

14. Tornetta P 3rd. The Essex-Lopresti reduction for calcaneal fractures revisited. J Orthop Trauma. 1998; 12:469–473.

15. Yoon HK, Jeon KP, Kang KH, Kim JI, Kim DS, Song KS. Essex-Loprestis axial pinning in the treatment of intraarticular calcaneal fracture. J Korean Soc Fract. 1999; 12:344–350.