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KMID : 0361620210560030224
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Journal of the Korean Orthopaedic Association
2021 Volume.56 No. 3 p.224 ~ p.233
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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
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Lee Jeong-Kil
Kang Chan
Kim Sang-Bum
Lee Gi-Soo
Hwang Jung-Mo
An Byung-Kuk
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Abstract
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Purpose: The purpose of this study was to retrospectively evaluate the effect of ‘Blocking Kirschner Wire (K-Wire) Technique’, which has been developed to reduce protrusion of the lateral wall, in maintaining the level of reduction through clinical and radiological outcomes.
Materials and Methods: Twenty-two patients with displaced intra-articular calcaneal fractures who used the blocking K-wire to maintain reduction (group A) and 44 patients that did not use blocking K-wire and were paired in 1:2 ratio with those Group A patients (group B), between January 2015 and December 2017 were enrolled in the study. All surgical procedures were performed via the extended sinus tarsi approach, and internal fixation using cannulated screws, Steinmann pins and K-wires was performed. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale and postoperative recovery of exercise ability were compared for postoperative clinical outcomes.
The radiological results were compared the Bohler angle, Gissane angle, calcaneal height and width, step off of posterior calcaneal joint, and the degree of protrusion of the lateral wall. Moreover, postoperative complications in both groups were compared.
Results: There were no significant differences in the clinical outcomes of the two groups (p=0.924, p=0.961). The amount of Bohler angle, Gissane angle, calcaneal height and width, and step off of posterior calcaneal joint from the radiological results was not significantly different between the two groups (p=0.170, p=0.441, p=0.230, p=0.266, and p=0.400). However, the degree of protrusion of the lateral wall was 1.78 mm and 4.95 mm in group A and group B, respectively, and the difference between the two groups was significant (p=0.017).
Although sural nerve entrapment and painful exostosis were more frequent in group B, they were occurred in a non-significant manner (p=0.293, p=0.655).
Conclusion: Most of the clinical and radiological results as well as the complications were not significantly different between the two groups. However, the degree of protrusion of the calcaneus lateral wall in group A was promising. The ‘Blocking K-Wires Technique’ established by the authors may be an effective surgical option for maintaining the reduction of the lateral wall protrusion in displaced intraarticular calcaneal fractures.
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KEYWORD
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calcaneus, intra-articular fractures, lateral wall protrusion, extended sinus tarsi approach, Kirschner wire blocking
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