Journal of Musculoskeletal Trauma

Avulsion Fractures in the Ankle and Foot: Gyeong Hoon Lim, Jae Won Kim, Sung Hyun Lee; J Korean Fract Soc 2024;37(2):102-116. Published online April 30, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.2.102

Abstract PDF: An avulsion fracture occurs when a muscle-tendon unit attached to a bone produces sufficient force to tear a fragment of the bone. If not treated properly, this injury can lead to deformity, nonunion, malunion, pain, and disability. Although avulsion fractures around the foot and ankle can occur anywhere there are tendon and ligament attachments, they are common in the anterior talofibular ligament, anterior-inferior tibiotalar ligament, calcaneal tuberosity, the base of the fifth metatarsal, and navicular bone. The optimal treatment for each fracture depends on the location and severity of the fracture. Conservative treatment involves limiting weight bearing for a period, splint immobilization, and using various orthoses. Surgical treatment is usually reserved for cases of severe displacement or when nonsurgical treatment has failed. The goals of surgery include reduction of the fracture fragment, prevention of nonunion or malunion and soft tissue injury, and early return to function. The decision for each treatment modality may depend on the patient demographics or preferences and the surgeon experience. This review summarizes previous and current views on the pathogenesis, diagnosis, and treatment of common avulsion fractures to guide the treatment and diagnosis.

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Outcomes of Minimally Invasive Surgery in Intra-Articular Calcaneal Fractures: Sanders Type III, Joint Depressive Type Calcaneal Fracture: Je Hong Ryu, Jun Young Lee, Kang Yeol Ko, Sung Min Jo, Hyoung Tae Kim; J Korean Fract Soc 2023;36(3):85-94. Published online July 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.3.85

Abstract PDF: Purpose
To evaluate the radiologic and clinical outcomes of a minimally invasive technique using the tarsal sinus approach in the management of Sanders type III, joint depressive type calcaneal fractures.
Materials and Methods
Between July 2011 and September 2019, data of 29 patients who underwent a minimally invasive procedure with the sinus tarsi approach for Sanders type III joint depressive intra-articular calcaneal fractures, and were followed up for more than 1 year were analyzed. We evaluated the radiologic outcomes by assessing the radiologic parameters (Böhler angle, Gissane angle, calca-neal length, calcaneal height, calcaneal width). We also evaluated the clinical outcomes based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the complications associated with the technique.
Results
The radiological results showed an improvement in the Böhler angle from 2.5° to 18.6° and the Gissane angle from 132.4° to 119.1° after the operation. The mean AOFAS score during the clini-cal evaluation was 79.5. We observed 13 cases of posttraumatic arthritis, 1 case of subtalar arthrodesis, and no case of wound complication.
Conclusion
Minimally invasive technique for Sanders type III joint depressive calcaneal fractures resulted in relatively satisfactory radiologic and clinical outcomes. Open reduction and internal fixation through the sinus tarsi approach reduce complications including wound problems. This approach offers satisfactory results without long-term complications.

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Current Treatment of Calcaneal Fractures and Dislocation: Dae Jin Nam, Sung Hyun Lee; J Korean Fract Soc 2022;35(2):74-82. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.74

Abstract PDF: Calcaneal fractures are the most common fractures occurring in the tarsal bone. In the past, surgical treatments were not preferred because they were accompanied by severe comminution and soft tissue complications. In recent years, there have been great advancements in the treatment of calcaneal fractures owing to the development of new surgical techniques and instruments. However, a standard treatment method has not yet been established. In this review article, we summarize the latest information on the indications and treatment methods of calcaneal fractures.

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Clinical Outcomes of Minimally Invasive Surgery in Sanders Type IV Intra-Articular Calcaneal Fractures: Jun Young Lee, Hyunwoong Jang, Young Wook Kim; J Korean Fract Soc 2019;32(4):181-187. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.181

Abstract PDF: PURPOSE
This study evaluated the radiologic and clinical results in patients who underwent minimal invasive surgery using sinus tarsi approach in Sanders type IV calcaneal fracture.
MATERIALS AND METHODS
This retrospective study evaluated 13 cases of Sanders type IV calcaneus fractures that were treated by minimal invasive surgery using the sinus tarsi approach from July 2012 to April 2017. Further, these cases could be followed up for more than 12 months. Bone union, radiologic parameters such as BÃ¶hler's angle, Gissane's angle, calcaneal height, length, and width, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the postoperative complications were evaluated.
RESULTS
Bony union was achieved in all the cases at the final follow up, and the mean union time was 5.5 months. One patient underwent reoperation for a surgical site infection, six patients had post traumatic arthritis, and two of them underwent subtalar joint fusion. The mean AOFAS ankle-hindfoot score was 81.2. At the final follow-up, the mean values of BÃ¶hler's angle and Gissane's angle were 20Â° and 119.8Â°, respectively, and the mean values of the calcaneus height, length, and width were 46.8 mm, 81.8 mm, and 45.6 mm, respectively.
CONCLUSION
Minimal invasive surgery using the sinus tarsi approach for Sanders type IV calcaneal fracture resulted in satisfactory anatomic reduction and stable fixation, and satisfactory clinical and radiologic results were obtained in most of the patients. Minimal invasive surgery is thought to reduce the soft tissue-related complications as compared to surgery using the extensile lateral approach.

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures in Elderly Patients: Comparison of the Minimally Invasive Approach and Extensile Lateral Approach: Hong Ki Park, Jae Yoon Ko, Seung Kwan Lee, Jong Min Baik; J Korean Fract Soc 2019;32(3):135-142. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.135

Abstract PDF

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.

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Clinical and Radiological Outcomes of ‘Blocking Kirschner Wire Technique’ in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach
Jeong-Kil Lee, Chan Kang, Sang-Bum Kim, Gi-Soo Lee, Jung-Mo Hwang, Byung-Kuk An
Journal of the Korean Orthopaedic Association.2021; 56(3): 224. CrossRef

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Computed Tomography Image Analysis of the Fusion Site of Subtalar Arthrodesis for Traumatic Arthritis after a Displaced Intraarticular Calcaneal Fracture: Hong Gi Park, Jae Ang Sim, Han Soul Kim, Byung Hoon Lee; J Korean Fract Soc 2019;32(3):121-127. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.121

Abstract PDF: PURPOSE
The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography.
MATERIALS AND METHODS
The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017.
RESULTS
An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%).
CONCLUSION
Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.

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The Significance of Calcaneal Posterior Tuberosity Fragment Reduction When Treated with Open Reduction in Displaced Intra-Articular Calcaneal Fractures: Hong Ki Park, Jong Ryoon Baek, Jang Seok Choi, Sang Jin Lee, Je Won Paik; J Korean Fract Soc 2016;29(4):233-241. Published online October 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.4.233

Abstract PDF: PURPOSE
We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in BÃ¶hler's and Gissane angle with the uninjured side on the lateral view of both sides.
RESULTS
The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of BÃ¶hler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01.
CONCLUSION
The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures: Chul Hyun Park, Oog Jin Shon; J Korean Fract Soc 2016;29(3):221-231. Published online July 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.3.221

Abstract PDF

Calcaneal fractures are the most common type of tarsal fracture, and comminuted and bursting fractures are common due to the anatomic characteristics of the calcaneus. Assessment and treatment of calcaneal fractures has improved significantly over time. Despite advancements in surgical techniques and equipment, these fractures remain difficult to treat. In this review article, the physiopathology, classification, and surgical treatments of displaced intra-articular calcaneal fractures are updated.

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Current Treatment of Calcaneal Fractures and Dislocation
Dae Jin Nam, Sung Hyun Lee
Journal of the Korean Fracture Society.2022; 35(2): 74. CrossRef

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The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture: Sueng Hwan Jo, Jun Young Lee, Sang Ho Ha, Sung Won Cho, Sang Ha Park; J Korean Fract Soc 2013;26(2):126-132. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.126

Abstract PDF

PURPOSE
To evaluate the short term follow-up results of minimally invasive technique in the management of Sanders type II, III, and IV joint depressive calcaneal fracture.
MATERIALS AND METHODS
Between May 2008 and May 2011, we studied 17 cases undergoing treatment with minimally invasive technique with modified sinus tarsi approach for Sanders II, III, and IV joint depressive intra-articular calcaneal fracture and were followed up for more than 1 year. We evaluated the treatment result by assessing the radiologic parameters (Bohler angle, Gissane angle, and calcaneal height/width/length) and clinical outcomes (American Orthopaedic Foot and Ankle Society [AOFAS] score and visual analog scale [VAS]) and investigating the complication.
RESULTS
Radiological results improved from 7.9degrees to 19.8degrees in the Bohler angle after the operation. Satisfactory results were obtained in clinical assessment with average AOFAS score of 82.45 and the average VAS score of 3.94. We experienced 3 cases of complications, 1 case of superficial wound infection and radiologic findings of subtalar arthritis in 2 cases.
CONCLUSION
Minimally invasive technique may be a useful alternative surgical method in the management of Sanders type II, III, and IV joint depressive calcaneal fracture that cannot adopt extensile approach, which enable to obtain good radiological and clinical results.

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Outcomes of Minimally Invasive Surgery in Intra-Articular Calcaneal Fractures: Sanders Type III, Joint Depressive Type Calcaneal Fracture
Je Hong Ryu, Jun Young Lee, Kang Yeol Ko, Sung Min Jo, Hyoung Tae Kim
Journal of the Korean Fracture Society.2023; 36(3): 85. CrossRef
Towards uniformity in communication and a tailor-made treatment for displaced intra-articular calcaneal fractures
Tim Schepers
International Orthopaedics.2014; 38(3): 663. CrossRef

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Avulsion Fracture of Calcaneal Tubercle Treated with Cannulated Cancellous Screws and Wire: Surgical Technique: Chang Ho Yi, Jin Rok Oh; J Korean Fract Soc 2011;24(3):262-266. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.262

Abstract PDF: The incidence rate of calcaneal fracture consists about 2% of all fractures, and, of the fracture, calcaneal tubercle avulsion fracture is known to be rare. To treat non-displaced calcaneal tubercle avulsion fracture, conservative treatment such as cast fixation is applied. However, most cases accompany displacement of the avulsion fragment, and, usually, surgery is necessary to treat the displaced fracture. Although surgical fixation simply by cancellous screw or tension wire is widely used, fixation failure is potential complication in this method. Thus, this study wants to introduce a prospective and useful method that further strengthens the calcaneal fixation by using both cannulated screw and tension band wiring.

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Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation: A Case Report: Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo; J Korean Fract Soc 2011;24(1):87-91. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.87

Abstract PDF

Although calcaneal fracture is relatively common in ankle injury, open intraarticular calcaneal fracture with dorsal dislocation of the navicular from talus is extremely rare and severe injury. There are few data which are available concerning the injury mechanism and treatment options. The purpose of this report is to describe a case with bilateral open transcalcaneal fracture with talonavicular dislocation and to discuss the prevalence, mechanism of this injury, and treatment options.

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Results in Operative Treatment of Open Calcaneal Fracture
Ba Rom Kim, Jun Young Lee, Donghyuk Cha
Journal of Korean Foot and Ankle Society.2021; 25(3): 133. CrossRef

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Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture: Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun; J Korean Fract Soc 2010;23(3):303-309. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.303

Abstract PDF

PURPOSE
To evaluate the surgical outcomes of open reduction and internal fixation of AO calcaneal plate in displaced intra-articular fractures of the calcaneus.
MATERIALS AND METHODS
From January 2004 to July 2007, 25 patients with 27 displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation using the AO calcaneal plate. Preoperative, postoperative evaluations and a follow-up after 1 year were done radiologically by the Bohler angle, Gissane angle, heel height and width among all patients. Their functional status was assessed by means of the Maryland foot score.
RESULTS
The mean Bohler angle, Gissane angle, heel height and width were restored comparing with preoperative data. However, in Sanders type IV, some losses of reduction occurred at 1 year follow-up (p<0.05). The mean Maryland foot scores were 85 points in type II, 82 points in type III and 63 points in type IV. Sanders types significantly affected the clinical results (p<0.05).
CONCLUSION
The AO calcaneal plate fixation using extensile L-shpaed lateral approach shows satisfactory radiologic and clinical results in the treatment of displaced intra-articular calcaneal fractures.

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Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw
Yong Seung Oh, Kyung Ho Lee, Jung Ho Kim, Myoung Jin Lee
Journal of Korean Foot and Ankle Society.2019; 23(3): 116. CrossRef
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
Gi-Soo Lee, Chan Kang, Deuk-Soo Hwang, Chang-Kyun Noh, Gi-Young Lee
Journal of Korean Foot and Ankle Society.2015; 19(1): 11. CrossRef

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Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation: A Comparative Study between Groups with and without Bone Graft: Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang; J Korean Fract Soc 2010;23(2):180-186. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.180

Abstract PDF

PURPOSE
This study compares the clinical results of open reduction and internal fixation with and without bone graft for the treatment of intra-articular calcaneal fractures.
MATERIALS AND METHODS
Twenty-five patients who had open reduction and internal fixation for intra-articular calcaneal fractures and available for at least 1 year of follow-up were included in this study. Fifteen cases were operated with bone graft. Period to bone union and functional evaluation score were compared between both groups with analysis of complications.
RESULTS
Bone union was achieved in all cases with average bone union time of 11.6 weeks and 12.8 weeks in group with and without bone graft respectively. Creighton-Nebraska Health Foundation (CNHF) functional score was 86.5 points and 80.3 points respectively. The period to bone union and the CNHF score in the comparison of two groups were statistically insignificant. Complications were observed in four cases of group without bone graft and 5 cases of group with bone graft.
CONCLUSION
This study indicates that bone graft does not play a significant role in bone union and functional outcome when intra-articular calcaneal fractures are treated with open reduction and internal fixation.

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures
Chul Hyun Park, Oog Jin Shon
Journal of the Korean Fracture Society.2016; 29(3): 221. CrossRef

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Avulsion Fracture of Calcaneal Apophysis in an Adolescent Gymnast: A Case Report: Youn Moo Heo, Whan Young Chung, Sang Bum Kim, Cheol Yong Park, Jin Woong Yi; J Korean Fract Soc 2009;22(4):288-291. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.288

Abstract PDF: The avulsion fracture of calcaneal apophysis by Achilles tendon in children is quite rare. It may occur with the injury of the apophysis on the calcaneal tuberosity in the children below the age of 12 to 15 before the union of the apophysis. The authors surgically treated a 14-year-old gymnast with the avulsion fracture of the calcaneal tuberosity who injured at the landing of the floor exercise. Radiographs at the fourteen months of follow-up showed slight irregularity of the calcaneal tuberosity but there were no pain or limitation of activity. We report a case with the review of literatures.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture: Jeong Seok Moon, Woo Chun Lee; J Korean Fract Soc 2009;22(1):13-18. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.13

Abstract PDF

PURPOSE
To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture.
MATERIALS AND METHODS
From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups.
RESULTS
There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications.
CONCLUSION
The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.

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The Extensile Lateral Approach to the Calcaneus
Rohan Bhimani, Kush C. Shah, Rishin J. Kadakia
Techniques in Foot & Ankle Surgery.2023;[Epub] CrossRef
Extensile lateral versus sinus tarsi approach for calcaneal fractures
Chuangang Peng, Baoming Yuan, Wenlai Guo, Na Li, Heng Tian
Medicine.2021; 100(31): e26717. CrossRef
Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis
Andrea Seat, Christopher Seat
The Journal of Foot and Ankle Surgery.2020; 59(2): 356. CrossRef
Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw
Yong Seung Oh, Kyung Ho Lee, Jung Ho Kim, Myoung Jin Lee
Journal of Korean Foot and Ankle Society.2019; 23(3): 116. CrossRef
A systematic review and meta-analysis of the sinus tarsi and extended lateral approach in the operative treatment of displaced intra-articular calcaneal fractures
Tomasz L. Nosewicz, Siem A. Dingemans, Manouk Backes, Jan S.K. Luitse, J. Carel Goslings, Tim Schepers
Foot and Ankle Surgery.2019; 25(5): 580. CrossRef
Meta‐analysis of two surgical approaches for calcaneal fractures: sinus tarsi versus extensile lateral approach
Fei Zhang, Hongtao Tian, Shilun Li, Bo Liu, Tianhua Dong, Yanbin Zhu, Yingze Zhang
ANZ Journal of Surgery.2017; 87(3): 126. CrossRef
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
Gi-Soo Lee, Chan Kang, Deuk-Soo Hwang, Chang-Kyun Noh, Gi-Young Lee
Journal of Korean Foot and Ankle Society.2015; 19(1): 11. CrossRef
Open reduction and internal fixation with conventional plate via L-shaped lateral approach versus internal fixation with percutaneous plate via a sinus tarsi approach for calcaneal fractures – A randomized controlled trial
Shengli Xia, Yaogang Lu, Huizhong Wang, Zuming Wu, Ziping Wang
International Journal of Surgery.2014; 12(5): 475. CrossRef
Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation -A Comparative Study between Groups with and without Bone Graft-
Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang
Journal of the Korean Fracture Society.2010; 23(2): 180. CrossRef

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The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures: Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo; J Korean Fract Soc 2007;20(3):227-232. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.227

Abstract PDF

PURPOSE
To evaluate the relationship between radiographic parameters and clinical results after operative treatment of the displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
We analyzed 35 patients of unilateral displaced intraarticular calcaneal fractures who had operative treatment with minimum follow up of 1 year. At the last follow up, we measured the radiographic parameters including Bohler angle, Gissane angle, heel height, calcaneal length, talocalcaneal angle, talar declination angle, subtalar incongruity between normal and affected site. Clinical results were measured by Creighton-Nebraska Health Foundation Assessment Score (CNH). The correlation between the radiographic parameters and the clinical results were analysed by Pearson correlation method.
RESULTS
Among the all radiographic parameters we analyzed, only subtalar incongruity shows strong negative linear correlation with clinical results. The average difference of subtalar incongruity between normal and affected site was 0.54 mm (0~2.5) and the correlation coefficients with CNH score was -0.784 (p=0.002).
CONCLUSION
We suggest that the subtalar incongruity is significantly correlated with the clinical results after operative treatment of the displaced intraarticular calcaneal fractures.

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Results in Operative Treatment of Open Calcaneal Fracture
Ba Rom Kim, Jun Young Lee, Donghyuk Cha
Journal of Korean Foot and Ankle Society.2021; 25(3): 133. CrossRef
Measurement of Normal Calcaneus in Korean Cadavers: A Preliminary Report
Jung-Han Kim, Heui-Chul Gwak, Jeon-Gyo Kim, Yang Hwan Jung
Journal of Korean Foot and Ankle Society.2014; 18(1): 14. CrossRef

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Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate: Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon; J Korean Fract Soc 2007;20(1):1-5. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.1

Abstract PDF

PURPOSE
To evaluate the clinical efficacy of F-plate in displaced intra-articular fractures of calcaneus.
MATERIALS AND METHODS
Total 43 cases treated with F-plate and followed up at least six months postoperatively were reviewed. Radiographically, BÃ¶hler angle was measured and all cases were subdivided by Sanders classification. Each case was reviewed for the presence of local infection, traumatic arthritis, nonunion, and any breakage of plate or screw. Maryland foot score was used for clinical assessment and factors influencing on clinical results were determined.
RESULTS
The mean BÃ¶hler angle was improved from 0.5Â° (range: -24.7~35.5Â°) preoperatively to 25.8Â° (range: 14.2~38.6Â°) postoperatively and the angle at last follow-up was 23.5Â° (range: 10.2~37.5Â°), showing about 2.3 degree decline compared to postoperative BÃ¶hler angle. There were two cases of F-plate breakage and two cases of screw breakage but the metal breakage did not affect any change in BÃ¶hler angle. Other complications were; five cases of traumatic arthritis, one case of varus malunion and one case of deep wound infection. According to Maryland foot score, there were 10 excellent, 22 good, 10 fair and 1 poor result. Furthermore, Age, pre-operative BÃ¶hler angle and the patient's expectation on financial compensation had significant influences upon the clinical result.
CONCLUSION
F-plate fixation seems to yield firm fixation and satisfactory clinical results in the treatment of displaced intra-articular fractures of calcaneus.

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Clinical and Radiological Outcomes of ‘Blocking Kirschner Wire Technique’ in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach
Jeong-Kil Lee, Chan Kang, Sang-Bum Kim, Gi-Soo Lee, Jung-Mo Hwang, Byung-Kuk An
Journal of the Korean Orthopaedic Association.2021; 56(3): 224. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef
Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation -A Comparative Study between Groups with and without Bone Graft-
Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang
Journal of the Korean Fracture Society.2010; 23(2): 180. CrossRef

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Primary Subtalar Arthrodesis for the Treatment of Intra-articular Calcaneal Comminuted Fractures: Hong Geun Jung, Yu Jin Kim, Suk Ha Jeon; J Korean Fract Soc 2006;19(4):418-423. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.418

Abstract

PURPOSE
To evaluate the functional outcomes of the severely comminuted intra-articular calcaneal fractures that were selectively treated with primary subtalar arthrodesis.
MATERIALS AND METHODS
This study is based on the 9 patients, 10 feet of intra-articular severely comminuted calcaneal fractures that were treated with open reduction and internal fixation with primary subtalar arthrodesis due to inability to reconstruct the subtalar articular surface with follow-up of more than 1 year. Postoperative clinical evaluation was performed with AOFAS Hindfoot functional scores. The patient satisfaction, returning to previous occupation and complications were also investigated.
RESULTS
Follow-up period was average 20.3 months. Overall AOFAS functional score at final follow-up was average 71.8 points and VAS pain score was 3.9. Fifty percent of the patients were satisfied with the surgery and 80% of the patients were able to return to their previous occupations at average 8.4 months after trauma. Post-operative complications were 2 cases of sural nerve injuries and 1 hindfoot valgus malunion.
CONCLUSION
We concluded that the primary subtalar arthrodesis is a viable surgical option for severely comminuted calcaneal fractures with favorable functional result and early returning of most patients to their previous occupations.

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Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures
Seung Hun Woo, Hyung-Jin Chung, Su-Young Bae, Sun-Kyu Kim
Journal of the Korean Orthopaedic Association.2017; 52(1): 49. CrossRef
Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation - A Case Report -
Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo
Journal of the Korean Fracture Society.2011; 24(1): 87. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef

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Medial Plantar Nerve Injury after Screw Fixation of the Calcaneus Fracture: Bong Cheol Kwon, Yong Woon Shin, Duck Joo Kwon, Nam Kyou Rhee; J Korean Fract Soc 2006;19(2):288-290. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.288

Abstract: We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.

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Surgical Treatment of Displaced Intra-articular Calcaneal Fractures: Minimum of 2-year Follow-up: Myung Ho Kim, Hong Geun Jung, Joong Bae Seo, You Jin Kim, Je Wook Yu; J Korean Fract Soc 2006;19(2):201-207. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.201

Abstract: PURPOSE
To evaluate the overall clinical features and postoperative functional results of the intra-articular calcaneal fractures at more than 2 years follow-up, and also to compare the results at postoperative 1 year with the results at more than 2-year follow-up.
MATERIALS AND METHODS
The study is based on 39 intra-articular calcaneal fractures (34 patients) that underwent surgical treatment from March 1997 to May 2002 with at least 2 years follow-up. The overall postoperative results were evaluated with Creighton-Nebraska functional scale. The comparison of results at postoperative 1 year was also performed with results at more than 2-year follow-up.
RESULTS
By Sanders classifications, there were 13 type II fractures (33.3%), 20 type III (51.3%), and 6 type IV fractures (15.4%). Average follow-up period was 35 months (range: 24~87 months) and at final follow-up of more than 2 years, Creighton-Nebraska score was average 76.0 (range: 30~100) which significantly improved from postoperative 1-year results of 67.1 (range: 22~95) (p<0.05).
CONCLUSION
The clinical outcome at more than 2 years after surgical treatment of intra-articular calcaneal fractures was quite promising, which significantly improved compared to 1-year results. Therefore, we concluded that functional results of calcaneal fractures should be evaluated at least 2 years after the treatment.

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Evaluation of Rotational Displacement of the Posterior Facet on the Sagittal Plane in Computed Tomographic Images of Calcaneal Fractures: Su Young Bae, Yi Kyoung Shin, Jong Oh Kim, Jung Hee Lee, Churl Woo Lee, Jae Hung Shin; J Korean Fract Soc 2005;18(2):165-169. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.165

Abstract PDF

PURPOSE
To find out whether or not the computed tomographic (CT) classification systems of the calcaneal fracture are efficient in illuminating displaced posterior facet fragment and the degree of displacement can be evaluated by analyzing serial CT images.
MATERIALS AND METHODS
Seventy-seven hundred calcaneal fractures were classified by CT classification systems including Sanders classification, and the sagittal rotation angle of the posteior facet fragment was measured on the plain lateral radiograph. Among the serial axial CT images, a number of images with the cortical bone embedded in the cancellous portion were recorded and any significant relationship between each data were evaluated.
RESULTS
The conventional CT classification systems are rather insufficient in illuminating the extent of sagittal rotatory displacement. However, the number of CT images in which the cortical radiodensity was observed showed a significantly related with the degree of displacement.
CONCLUSION
The conventional CT classification of the calcaneal fractures is unsatisfactory in expressing the degree of sagittal rotatory displacement of the posterior facet fragment; this problem may be alleviated by observing the number of axial CT images in which cortical radiodensity was revealed within the calcaneal body.

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Tricortical-allobone Grafting in Screw Fixation for Intra-articular Calcaneal Fracture via Ollier Approach
Taejung Bang, Su-Young Bae, Seung Hun Woo, Hyung-Jin Chung
Journal of Korean Foot and Ankle Society.2017; 21(1): 27. CrossRef
The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture
Kiwon Young, Jin Su Kim, Jinseon Moon
Journal of Korean Foot and Ankle Society.2014; 18(3): 119. CrossRef

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Penetration of Joints by Screws on Anterior Process of Calcaenus: Choong Hyeok Choi, Il Hoon Sung, Bong Geun Lee, Doo Jin Paik, Dong Won Kim; J Korean Fract Soc 2004;17(3):257-260. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.257

Abstract PDF: PURPOSE
This study was performed to determine the involvement of joints by screws, inserted on the anterior process of the calcaneus, using cadaveric specimens.
MATERIALS AND METHODS
An L-shaped lateral incision was performed on 32 embalmed feet (16 cadavers). An H-plate was applied on lateral wall of the calcaneus and it's anterior margin was located at 4 mm posterior to the lateral margin of the calcaneocuboidal joint. 3.5 mm cortical screws were inserted perpendicularly to the lateral calcaneal wall through the plate. Each calcaneus was dissected and taken out from the foot, and whether the tips of screws penetrated joints on the anterior process was evaluated.
RESULTS
11 (17.2%) of 64 screws, inserted on the anterior process, penetrated joints. Among them, seven screws involved the calcaneocuboidal joint and four screws penetrated the anterior facet of the subtalar joint. In two cases, both joints were penetrated by screws.
CONCLUSION
This study shows that joint surfaces could be penetrated by screws inserted from the lateral surface on the anterior process of the calcaneus. Care should be given to selecting the length and insertional angle of screws. Intraoperative radiography would be needed to observe the articular surface on the anterior process, when screws were inserted to the anterior process close to the calcaneocuboidal joint.

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Postoperative Evaluation of Displaced Intra-articular Calcaneal Fractures by Computed Tomography: Woo Sik Kim, Kwang Kyoon Kim, Whan Yong Chung, Woo Suk Lee, Yong Chan Kim, Taek Soo Jeon, Dae Hwan Kim, Seong Jin Cho, Chul Mok Hwang; J Korean Fract Soc 2004;17(3):249-256. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.249

Abstract PDF

PURPOSE
The purpose of the present study was to define the factors that affect the treatment and clinical result of displaced calcaneal fracture with use of the pre- operative and final follow-up computed tomography scanning.
MATERIALS AND METHODS
Present study included the 17 patients(18 feet) whom we performed surgery for displaced intra-articular calcaneal fracture at our institution between March 2000 and March 2002 and had a minimum follow-up of 12 months. For all patients, the Bohler's angle and posterior facet incongruity were measured with computed tomography pre- and post-operatively. The Creighton-Nebraska Health Foundation Assessment Scale for Fractures of the Calcaneus (CN scale) was used to evaluate the clinical results.
RESULTS
Of all eighteen fractures, the clinical results were excellent in three (16.6%), good in six (33.3%), fair in six (33.3%), and poor in three (16.6%). The Bohler's angle averaged 21degrees, 15degrees, 27degrees, 25degrees at final follow-up in each above clinical result group. The step-off averaged 1.0, 1.6, 3.9 and 6.0 mm and the average range of motion of the subtalar joint at final follow-up were 85, 76, 60 and 45% of normal. CT evaluation showed intra-articular screws in the posterior subtalar joint in three (16.6%) of the eighteen fractures but their average clinical result was good (80.3 points).
CONCLUSION
The restoration of the congruity and range of motion of posterior subtalar joint are considered important factor that affect clinical result.

Citations

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography
Joon-Sang Eom, Young-Deuk Joo, Seong-Jun Kim, Min-Ho Shin, Dong-Oh Lee, Hong-Geun Jung
Journal of Korean Foot and Ankle Society.2014; 18(4): 165. CrossRef

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Avulsion Fracture of Calcaneus in Diabetic Patients: Sung Jin Park, Nam Yong Choi, In Tak Chu, Suk Ku Han, Ki Ho Nah, Hyun Seok Song, Jung Ho Kim; J Korean Fract Soc 2004;17(2):173-176. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.173

Abstract PDF

Avulsion fracture of the calcaneal tuberosity is an uncommon injury. Usually it occurs from indirect trauma, and can be seen in old patients with osteoporosis or in patients with diabetic neuropathy. Follow-up studies showed fracture healing in most cases, but skeletal deformity may develop in some cases. Therefore we should do plain X-ray evaluations in diabetic patients with foot and ankle pain, even though there have been no definite trauma history. Four cases of calcaneus avulsion fracture were treated operatively in diabetic patients, and reported.

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Avulsion Fracture of Calcaneal Apophysis in an Adolescent Gymnast : A Case Report
Youn Moo Heo, Whan Young Chung, Sang Bum Kim, Cheol Yong Park, Jin Woong Yi
Journal of the Korean Fracture Society.2009; 22(4): 288. CrossRef

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Mechanical Properties of F Plate in Intraarticular Calcaneal Fractures: Kyu Hyun Yang, Young Hee Park, Jung Hoon Won, Dae Ya Kim; J Korean Fract Soc 2004;17(2):167-172. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.167

Abstract PDF

PURPOSE
We evaluated the mechanical properties of F plate fixation comparing with Y plate and a screw fixation for the intraarticular calcaneal fractures using synthetic bones.
MATERIALS AND METHODS
Using 12 synthetic calcaneal bones, newly designed F plate was compared with the Y-plate, most commonly used, regarding the change of Bohler angle and the displacement of the thalamic fragments of the calcaneus after axial compressive loading by Instron 6022.
RESULTS
Y plate fixation lost 8degrees of Bohler angle in average after axial compressive load and 2.6degrees in F plate fixation. Thalamic fragments were displaced 1.72 mm in average in Y plate fixation group and 0.73 mm in F plate fixation group.
CONCLUSION
F plate offered more firm fixation than Y plate in the intraarticular calcaneal fracture in the aspect of maintaining the Bohler angle and preventing displacement of the thalamic fragments of calcaneus against axial compressive loading.

Citations

Citations to this article as recorded by

The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture
Kiwon Young, Jin Su Kim, Jinseon Moon
Journal of Korean Foot and Ankle Society.2014; 18(3): 119. CrossRef
Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon
Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef

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Open Reduction using Lateral Approach in Displaced Intra-articular Fracture of Calcaneus: Kyung Jin Song, Keun Ho Yang, Joo Hong Lee; J Korean Soc Fract 2002;15(4):446-454. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.446

Abstract PDF: PURPOSE
This study was designed to investigate the usefulness of lateral approach for accurate reduction and rigid internal fixation in comminuted intra-articular fractures of calcaneus.
MATERIALS AND METHOD
Twenty patients(21 cases) who had intra-articular fracture of calcaneus and underwent an open reduction and internal fixation using lateral approach were enrolled. Using Essex-Lopresti classification, all cases were intra-articular fracture, which joint depression type was 17 cases and 4 of severe comminuted tongue type. We compared the preoperative and postoperative change of B o h l e r 's angle and clinical results were analyzed using Paley and Halls evaluation protocol and scoring system.
RESULTS
The average B ohler 's angle was restored from 2.8 to 25.1 after operations and clinical results classified 4 well, 12 good, 4 fair, 1 poor cases. Postoperative complications were 2 cases of wound dehiscence, 1 of infection and one had sural nerve injury. Late complications included 3 cases of limitation of motion of ankle that disturb usual activity, 3 of sustained pain and 2 of traumatic arthritis and 2 cases had 2 complications at the same patients.
CONCLUSION
The lateral approach is valuable for the comminuted intra-articular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint, and also with little morbidity of neurovascular injury.

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Operative Treatment of Intraarticular Calcaneal Fractures Combined with Multiple Injuries using Closed Reduction and Cannulated Screw Fixation: Dae Moo Shim, Tae Kyun Kim, Soo Uk Chae, Seok Hyun Kweon; J Korean Soc Fract 2002;15(4):439-445. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.439

Abstract PDF: PURPOSE
To evaluate the radiological and clinical results of closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries.
MATERIALS AND METHODS
We reviewed 15 cases of 13 patients intraarticular calcaneal fractures combined with multiple injuries which were treated with closed reduction and cannulated screw percutaneous fixation between June 1998 to June 2001 and minimum follow up period of 12 months(12-27 months). The results were based on the assessment criteria of Salama and the analysis of Bohler 's angle, states of subtalar joint and deformities of calcaneus. Based on the Sanders classification, there were 2 cases(13%) of type I, 9 cases(60%) of type II and 4 cases(27%) of type III.
RESULTS
The preoperative Bohler 's angles were between 5 degrees to 35 degrees, postoperative Bohler 's angles were between 15 degrees to 45 degrees and the last follow up Bohler 's angles were between 15 degrees to 40 degrees . The postoperative complication of subtalar arthritis were developed in 5 cases and deformities of calcaneus were developed in 4 cases. Based on the assessment criteria of Salama, the functional results were excellent in 2 cases, good in 8 cases, fair in 3 cases, and poor in 2 cases.
CONCLUSION
The closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries was thought to be a useful method of treatment at the state of not delayed operating time and not position changing.

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Surgical Treatment of Displaced Intra-articular Fracture of the Calcaneus using a Y-plate: Han Jun Lee, Soo Yong Kang, Jong Won Kim; J Korean Soc Fract 2002;15(4):433-438. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.433

Abstract PDF

PURPOSE
To investigate the results of surgical treatment of displaced intra-articular fracture of the calcaneus using a Y-plate.
MATERIALS AND METHOD
We have studied 22 patients who underwent surgical treatment of displaced intra-articular fracture of the calcaneus in our hospital from March, 1998 to August, 2000. The fractures were identified according to Eastwood classification, there were 8 cases of type I, 10 cases of type II and 4 cases of type III. The axial and Bohler angle of lateral views were compared preoperative and postoperative period. Functional evaluation was measured by Carr 's method.
RESULT
The average Bohler angle before the operation was 5 degrees and after the operation it has been up to 28 degrees. In functional evaluation, 3 cases were excellent, 15 cases were good, and 4 cases were fair.
CONCLUSION
Fixation using a Y-plate can be used easily for restoration of anatomical dimension of the calcaneus in the operative treatment of displaced intra-articular fracture. It could be helpful for firmer fixation of the posterior facet.

Citations

Citations to this article as recorded by

Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef
Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon
Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef

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The Radiologic Evaluation of Treatment Outcome in Intra-articular Calcaneal Fracture by Open Reduction without Bone Graft: Kwang Soon Song, Si Hyun Jeon, Jae Hong Chun; J Korean Soc Fract 2002;15(2):226-233. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.226

Abstract PDF

PURPOSE
The purpose of this study was to investigate the efficacy of bone graft use in the treatment of displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
We analysed retrospectively 40 displaced intra-articular calcaneal fractures, which had undergone open reduction and internal fixation without bone graft from June 1989 to July 1998. Radiological assessments were made from the lateral view of the affected calcaneus, recording the Bohler angle, the Gissane angle and ratio of height/width of the calcaneus. Matching criteria included Essex-Lopresti classification, method of fixation, age, and sex.
RESULT
The mean preoperative Bohler angle was -7 degrees(standard deviation [S D ] 1 8 degrees), postoperative Bohler angle was 21 degrees(SD 7 degrees), last follow-up Bohler angle was 1 9 degrees(SD 7 degrees). Bohler angle increased a mean 28 degrees(maximum 70 degrees, minimum 2 degrees). The preoperative Gissane angle was 104 degrees(SD 17.87 degrees), postoperative Gissane angle was 1 0 6 . 2 degrees(SD 10.07 degrees), last follow-up Gissane angle was 104.48 degrees(SD 10.1 degrees). The preoperative ratio of height/width of the calcaneus was 0.568(SD 0.076), postoperative ratio was 0.637(SD 0.037), last follow-up ratio was 0.648(SD 0.038). There was no significant differences in fracture pattern, method of fixation, age, and sex(P>0.05).
CONCLUSION
The result of this study showed that there was no significant change in serial radiologic evaluation. Bone graft was not served to the effectiveness or security in the treatment of displaced intra-articular calcaneal fractures.

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Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef

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Operative Treatment of Intraarticular Calcaneus Fractures with extensile lateral approach: Dong Kyu Shin, Yong Woon Kim; J Korean Soc Fract 2001;14(3):440-449. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.440

Abstract PDF: PURPOSE
Through the analysing intraarticular calcaneal fractures operated with extensile lateal approach and lateral plate fixation we tried to find the factors related to the result and to prove the usefulness of this treatment method. MATERIAL AND METHOD: We reviewed 50 intraarticular calcaneal fractures which were treated with this method between July 1995 and December 1998. We analysed the relationship between the fracture type and the accuracy of posterior facet reduction and between the accuracy of reduction and the clinical result. We also analysed the complication rate.
RESULT
We gained anatomical reduction in 64% among all cases. There was significant relationship statistically between the Sanders fracture type and accuracy of reduction(p=0.001). There were also significant relationship statistically between the Sanders fractrure type and the clinical result(p=0.045) and between the accuracy of reduction and clinical result(p=0.001). It was also possible to regain the calcaneal height, width and Bohler angle through this treatment method. There was only one wound complication which was skin necrosis and was treated with dressing and finally skin graft.
CONCLUSION
Sanders classification was very useful and reasonable for this kind of fracture. The accuracy of reduction of posterior facet was very important to clinical result. This treatment method for the calcaneal fracture was useful in the term of regain of anatomical components of calcaneus such as posterior facet congruency, calcaenal height, width and Bohler angle with acceptable rate of serious complication.

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