A Novel Method of Simultaneous In Situ Decompression of Lateral Calcaneal Bulge and Subtalar Arthrodesis Via a Single Incision for Malunion After Calcaneal Fractures.

ABSTRACT:

Objective

The aim of this study was to introduce a novel method of simultaneous in situ decompression of lateral calcaneal bulge and subtalar arthrodesis via a single incision for malunion after calcaneal fractures and evaluate the feasibility of this method.

Methods

From September 2010 to October 2011, six patients (five males and one female) with malunion and delayed heel pain after conservative treatment of displaced intra-articular calcaneal fractures were included in our study. The mean age of the six patients was 32.9?years (range, 25-71?years). Patients were treated with this novel technique at our department and the functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scores during follow-up. Information of the six patients including surgical data and pre/postoperative function scores were retrospectively analyzed using SPSS 19.0 statistical software.

Results

The average operation time between wire insertion and incision suture was 42.2?±?11.5?min (range, 25-56?min). The blood loss in all patients was all less than 50?ml each. The average fluoroscopy time was 25.7?±?11.6?s (range, 11-43?s). No wound-related and other short-term complications were recorded. Six patients who were included in our study were followed for an average period of 66.2?±?4.7?months (range, 60-73?months). There was no patient lost to follow up. Heel pain was observed to be greatly improved preoperatively in all of the six patients. All patients restored to normal activity of life after surgery. Radiological evidence of fusion was observed in five patients. The average fusion time of these five patients was 3.5?months (range, 2-4?months). The remaining one failed to achieve fusion and the hardware removal was performed due to screw tail irritation. This patient was satisfied with the final outcomes subjectively after removal of hardware. The mean AOFAS scores at 24?months postoperative were 82.0?±?7.0, which was greatly improved compared to preoperative (44.8?±?10.7) (P?ConclusionsThe novel technique can effectively relieve the heel pain, prompt functional recovery, decrease the incidence of complications, simplify the surgical procedure, and shorten the learning curve. Therefore, the technique is a feasible and worthwhile alternative in treating malunion after calcaneal fractures.

SUBMITTER: Zhang T 

PROVIDER: S-EPMC7307231 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature