A simple modified technique for screw fixation of displaced intra-articular calcaneus fracture through a sinus tarsi approach: a comparison with plate fixation.
Displaced intra-articular calcaneus fracture
Fixation
Plate
Screw
Sinus tarsi approach
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
18 Sep 2024
18 Sep 2024
Historique:
received:
06
06
2024
accepted:
13
09
2024
medline:
19
9
2024
pubmed:
19
9
2024
entrez:
18
9
2024
Statut:
epublish
Résumé
Plates and screws are frequently used for the fixation of displaced intra-articular calcaneus fracture (DIACF). In this study, we compared the outcomes of a modified screw fixation technique with plate fixation via a sinus tarsi approach (STA). A series of 187 DIACF patients who were treated via an STA using a plate fixation (n = 81) or a screw fixation (n = 106) were included. Screw fixation was done with two 2.7 mm screws and two 6.5 mm cannulated screws. Outcomes were evaluated radiographically and clinically. Clinical evaluations included pain assessment by Visual Analogue Scale (VAS) and functional assessment by the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire and Foot Function Index (FFI). The mean final VAS was smaller in the screw group (P = 0.01). The mean AOFAS and FFI scores were not significantly different between the two groups (P = 0.17 and P = 0. 19, respectively). The mean improvement of Bohler's angle, but not the Gissane's angle, was significantly greater in the screw group (P = 0.014 and P = 0.09, respectively). The mean improvement of calcaneal length and height were not significantly different between the two groups (P = 0.78 and P = 0.22, respectively). The hardware removal rate was 14.8% in the plate group and 3.8% in the screw group (P = 0.007). The modified screw fixation method provides lower pain, better radiographic outcome, and lower rate of hardware removal compared to plate fixation in the treatment of DIACF.
Sections du résumé
BACKGROUND
BACKGROUND
Plates and screws are frequently used for the fixation of displaced intra-articular calcaneus fracture (DIACF). In this study, we compared the outcomes of a modified screw fixation technique with plate fixation via a sinus tarsi approach (STA).
METHODS
METHODS
A series of 187 DIACF patients who were treated via an STA using a plate fixation (n = 81) or a screw fixation (n = 106) were included. Screw fixation was done with two 2.7 mm screws and two 6.5 mm cannulated screws. Outcomes were evaluated radiographically and clinically. Clinical evaluations included pain assessment by Visual Analogue Scale (VAS) and functional assessment by the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire and Foot Function Index (FFI).
RESULTS
RESULTS
The mean final VAS was smaller in the screw group (P = 0.01). The mean AOFAS and FFI scores were not significantly different between the two groups (P = 0.17 and P = 0. 19, respectively). The mean improvement of Bohler's angle, but not the Gissane's angle, was significantly greater in the screw group (P = 0.014 and P = 0.09, respectively). The mean improvement of calcaneal length and height were not significantly different between the two groups (P = 0.78 and P = 0.22, respectively). The hardware removal rate was 14.8% in the plate group and 3.8% in the screw group (P = 0.007).
CONCLUSION
CONCLUSIONS
The modified screw fixation method provides lower pain, better radiographic outcome, and lower rate of hardware removal compared to plate fixation in the treatment of DIACF.
Identifiants
pubmed: 39294635
doi: 10.1186/s12891-024-07873-5
pii: 10.1186/s12891-024-07873-5
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
750Informations de copyright
© 2024. The Author(s).
Références
Dhillon MS, Bali K, Prabhakar S. Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet surg. 2011;95(3):171–81.
doi: 10.1007/s12306-011-0114-y
pubmed: 21409502
Veltman ES, Doornberg JN, Stufkens SA, Luitse JS, van den Bekerom MP. Long-term outcomes of 1,730 calcaneal fractures: systematic review of the literature. J Foot Ankle Surg. 2013;52(4):486–90.
doi: 10.1053/j.jfas.2013.04.002
pubmed: 23663876
Sanders R. Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 2000;82(2):225–50.
doi: 10.2106/00004623-200002000-00009
pubmed: 10682732
Besch L, Schmidt I, Mueller M, Daniels-Wredenhagen M, Hilgert RE, Varoga D, Seekamp A. A biomechanical evaluation to optimize the configuration of a hinged external fixator for the primary treatment of severely displaced intraarticular calcaneus fractures with soft tissue damage. J Foot Ankle Surg. 2008;47(1):26–33.
doi: 10.1053/j.jfas.2007.10.014
pubmed: 18156061
Meng Q, Wang Q, Wu X, Peng A, Yan J. Clinical application of the sinus tarsi approach in the treatment of intra-articular calcaneal fracture. Medicine. 2018;97(13):e0175.
doi: 10.1097/MD.0000000000010175
pubmed: 29595648
pmcid: 5895366
Sharr PJ, Mangupli MM, Winson IG, Buckley RE. Current management options for displaced intra-articular calcaneal fractures: non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. A contemporary review. Foot Ankle Surg. 2016;22(1):1–8.
doi: 10.1016/j.fas.2015.10.003
pubmed: 26869492
Mehta CR, An VVG, Phan K, Sivakumar B, Kanawati AJ, Suthersan M. Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis. J Orthop Surg Res. 2018;13(1):243.
doi: 10.1186/s13018-018-0943-6
pubmed: 30249288
pmcid: 6154938
Shariatzadeh H, Valiollahi B, Mohammadpour M, Haghbin M. Outcomes of minimally-invasive sinus Tarsi Approach for the treatment of intra-articular calcaneal fracture. J Res Orthop Sci. 2020;7(2):47–54.
doi: 10.32598/JROSJ.7.2.689.1
Soni M, Mishra D. Sinus Tarsi Approach for Calcaneal Fracture Treatment: our experience with 36 consecutive cases. J Foot Ankle Surg (Asia Pacific). 2022;9(2):75–80.
doi: 10.5005/jp-journals-10040-1228
Guo C, Xu Y, Li C, Li X, Wang Z, Cai M, Xu X. Comparing less invasive plate fixation versus screw fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach. Int Orthop. 2021;45(9):2231–7.
doi: 10.1007/s00264-020-04867-5
pubmed: 33145609
Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, et al. Percutaneous cannulated screw fixation vs. plating with minimally invasive longitudinal approach after closed reduction for intra-articular tongue-type calcaneal fractures: a retrospective cohort study. Front Surg. 2022;9. https://doi.org/10.3389/fsurg.2022.854210
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.
doi: 10.1097/00003086-199305000-00012
Gupta A, Ghalambor N, Nihal A, Trepman E. The modified Palmer lateral approach for calcaneal fractures: wound healing and postoperative computed tomographic evaluation of fracture reduction. Foot Ankle Int. 2003;24(10):744–53.
doi: 10.1177/107110070302401003
pubmed: 14587988
Valiollahi BV, Salariyeh M. Management of intra-articular fractures of the calcaneus: introducing a new locking plate. J Res Orthop Sci. 2018;5(4). https://doi.org/10.5812/soj.7991
Kir MC, Ayanoglu S, Cabuk H, Dedeoglu SS, Imren Y, Karslioglu B, et al. Mini-plate fixation via sinus tarsi approach is superior to cannulated screw in intra-articular calcaneal fractures: a prospective randomized study. J Orthop Surg. 2018;26(3):2309499018792742.
doi: 10.1177/2309499018792742
Pitts CC, Almaguer A, Wilson JT, Quade JH, Johnson MD. Radiographic and postoperative outcomes of plate versus screw constructs in open reduction and internal fixation of calcaneus fractures via the sinus tarsi. Foot Ankle Int. 2019;40(8):929–35.
doi: 10.1177/1071100719848063
pubmed: 31088171
Eelsing R, Aronius LB, Halm JA, Schepers T. Implant Choice and outcomes of the Sinus Tarsi Approach for Displaced Intra-articular Calcaneal fractures. Foot Ankle Int. 2023;44(8):738–44.
doi: 10.1177/10711007231176276
pubmed: 37254513
pmcid: 10394952
Baca E, Koluman A. Modified percutaneous fixation for displaced intra-articular calcaneal fractures. Eklem Hastalik Cerrahisi. 2019;30(2):168–74.
doi: 10.5606/ehc.2019.66386
pubmed: 31291867