J Korean Fract Soc.  2019 Jul;32(3):135-142. 10.12671/jkfs.2019.32.3.135.

Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures in Elderly Patients: Comparison of the Minimally Invasive Approach and Extensile Lateral Approach

• Park HK
• Ko JY
• Lee SK
• Baik JM

• KMID: 2453066
• DOI: http://doi.org/10.12671/jkfs.2019.32.3.135

Abstract

PURPOSE
As the functional demands for activities in elderly patients are increasing according to their life extension, the need for surgical treatment is also increasing in elderly patients with displaced intra-articular calcaneal fractures. In addition to the extensile lateral approach (ELA), which is a surgical procedure that showed good results on intra-articular calcaneal fractures, the minimally invasive approach (MIA) also showed an outstanding result. This study compared the radiological and clinical results of intraarticular calcaneus fractures in elderly patients in two groups: ELA and MIA.
MATERIALS AND METHODS
Thirty patients aged over 65 years with intra-articular calcaneus fractures, who could be followed-up more than 14 months, were included in this study. Thirteen patients of the MIA group and 17 patients of the ELA group were analyzed retrospectively using radiological and clinical assessments.
RESULTS
No significant difference in union time, posterior facet reduction accuracy, subtalar osteoarthritis frequency, Bohler angle, calcaneal width, American Orthopaedic Foot and Ankle Society score, visual analogue scale score, 36-item short form survey, and foot function index was observed between the two groups. The p-value of the average height of the calcaneus correction, average length of calcaneal correction, and average loss of correction length were <0.001, 0.005, and 0.015, respectively. The incidence of complications, including soft tissue necrosis and bone infection, were 23.1% in the ELA group and none in the MIA group.
CONCLUSION
The clinical outcomes were similar in the two groups. The degree of reduction of fracture showed a better result in the MIA group than the ELA group. Furthermore, there were no complications in the MIA group, whereas the ELA group showed some complications.

Keyword

Calcaneus; Displaced intraarticular calcaneal fracture; Extensile lateral approach; Minimally invasive approach

MeSH Terms

Aged*
Ankle
Calcaneus
Foot
Humans
Incidence
Life Expectancy
Necrosis
Osteoarthritis
Retrospective Studies

Figure

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  Fig. 1. Minimally invasive approach. (A, C, E) Lateral radiographs of the calcaneus. (B, D, F) Axial radiographs of the calcaneus.

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  Fig. 2. Extensile lateral approach. (A) Lateral radiograph of the calcaneus. (B) Axial radiograph of the calcaneus.

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  Fig. 3. (A) Lateral radiograph of the calcaneus shows measurements of the Böhler angle, calcaneal height, calcaneal length. (B) Axial radiograph of the calcaneus shows measurements of the calcaneal width.

Reference

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