Sueng-Hwan Jo; Jun-Young Lee; Sang-Ho Ha; Sung-Won Cho; Sang-Ha Park

doi:10.12671/jkfs.2013.26.2.126

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Original Article
The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture: Sueng-Hwan Jo, M.D., Jun-Young Lee, M.D., Sang-Ho Ha, M.D., Sung-Won Cho, M.D., Sang-Ha Park, M.D.; Journal of the Korean Fracture Society 2013;26(2):126-132.
DOI: https://doi.org/10.12671/jkfs.2013.26.2.126
Published online: April 22, 2013

Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.

Address reprint requests to: Jun-Young Lee, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea. Tel: 82-62-220-3147, Fax: 82-62-226-3379, leejy88@chosun.ac.kr

• Received: July 19, 2012 • Revised: September 17, 2012 • Accepted: January 14, 2013

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Abstract
REFERENCES

Abstract

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 (Böhler 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 7.9° to 19.8° in the Böhler 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.
Key words: Calcaneus fracture, Joint depressive Intra-articular fracture, Minimally invasive technique

REFERENCES

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Fig. 1

(A) Exposure of posterior facet using the sinus tarsi approach with 3-5 cm size skin incision.

(B) Intra-operative lateral fluoroscope image shows posterior facet reduction using schantz-pin.

(C) Lateral fluoroscope image shows stabilized posterior facet fragment with a 4.5 cannulated screw.

(D) Other fragment fixation with a 6.5 cannulated screw.

Fig. 2

Methods of measurement of Gissane angle, calcaneal length (A), Böhler angle, calcaneal height (B) and calcaneal width and heel varus angle (C).

Fig. 3

(A, B) Preoperative lateral radiograph and computed tomography (CT) image of a 40 year old male patient shows Sanders IIIab type joint depression calcaneal fracture. Preoperative Böhler angle is 2.2 degrees and Gissane angle is 108.8 degrees.

(C) Postoperative radiograph shows increased Böhler angle to 15.8 degrees and Gissane angle to 116.1 degrees.

(D, E) After twelve months, a follow-up lateral radiograph shows Böhler angle 14.6 degrees and CT image shows complete bone union and good alignment of subtalar joint.

Table 1

Dermographic Data of the Patients

F/U: Follow up.

Table 2

Dermographic Data of the Patients Classified by Cause and Accompanied Injury

Table 3

The Result of Radiologic Assessment

Table 4

The Result of Clinical Assessment of AOFAS Score and VAS

AOFAS: American Orthopaedic Foot and Ankle Society, VAS: Visual Analog Scale.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

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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The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture

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

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The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture

Fig. 1 (A) Exposure of posterior facet using the sinus tarsi approach with 3-5 cm size skin incision. (B) Intra-operative lateral fluoroscope image shows posterior facet reduction using schantz-pin. (C) Lateral fluoroscope image shows stabilized posterior facet fragment with a 4.5 cannulated screw. (D) Other fragment fixation with a 6.5 cannulated screw.

Fig. 2 Methods of measurement of Gissane angle, calcaneal length (A), Böhler angle, calcaneal height (B) and calcaneal width and heel varus angle (C).

Fig. 3 (A, B) Preoperative lateral radiograph and computed tomography (CT) image of a 40 year old male patient shows Sanders IIIab type joint depression calcaneal fracture. Preoperative Böhler angle is 2.2 degrees and Gissane angle is 108.8 degrees. (C) Postoperative radiograph shows increased Böhler angle to 15.8 degrees and Gissane angle to 116.1 degrees. (D, E) After twelve months, a follow-up lateral radiograph shows Böhler angle 14.6 degrees and CT image shows complete bone union and good alignment of subtalar joint.

Fig. 1

Fig. 2

Fig. 3

The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture

Table 1

Dermographic Data of the Patients

F/U: Follow up.

Table 2

Dermographic Data of the Patients Classified by Cause and Accompanied Injury

Table 3

The Result of Radiologic Assessment

Table 4

The Result of Clinical Assessment of AOFAS Score and VAS

AOFAS: American Orthopaedic Foot and Ankle Society, VAS: Visual Analog Scale.

Table 1 Dermographic Data of the Patients

F/U: Follow up.

Table 2 Dermographic Data of the Patients Classified by Cause and Accompanied Injury

Table 3 The Result of Radiologic Assessment

Table 4 The Result of Clinical Assessment of AOFAS Score and VAS

AOFAS: American Orthopaedic Foot and Ankle Society, VAS: Visual Analog Scale.