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KMID : 0896720020060020201
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Journal of the Korean Society of Foot Surgery
2002 Volume.6 No. 2 p.201 ~ p.207
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Combined Percutaneous and Minimal on Internal Fixation of Calcaneal Fractures Using Extensile Lateral Approach
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Yu Sun-O
Kim Joo-Sung
Kim Jong-Jin
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Abstract
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Purpose:To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach.
Material and Methods :From March 2000 to February 2002, thirty-eighty displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society.
Results:The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type Ⅳ of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases
Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative case, all fractures healed without secondary displacement except 1 cases on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed.
Conclusions:Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.
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KEYWORD
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Calcaneal fracture, Extensile lateral approach, Percutaneous and minimal internal fixation
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