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ORIF dislociranih intraartikularnih zlomov petnice = ORIF of dislocated intraarticular fractures of the calcaneus
Andoljšek, Matej
Backaround: More and more, open reduction, internal fixation and early motion (ORIF) is advocated for dislocated intraarticular fractures of the calcaneus. In prospective study the author asked, what ...are the results of ORIF with the calcaneal plate in intraarticular fractures of the calcaneus, and whether typeof fracture and/or congruity in the subtalar joint influence these results. Methods: Forty-three intraarticular fractures of the calcaneus (30 Type II, 10 Type III and 3 Type IV according to Sanders) were operated throughextensile lateral approach. After reduction of the subtalar joint and restoration of the calcaneus shape, the fracture was fixed with the calcaneal plate. Mostly, surgery was delayed for a few days until soft tissues recuperate. After surgery, subtalar joint was congruent in 33 (77%) and noncongruent (within 2mm) in ten fractures. Motion of the ankle and the subtalar joint was encouraged immediately, partial weight bearing after 5-6 weeks and full weight bearing after 3-4 month. Results: Functional results of 36 fractures with a representative type distribution were evaluated 12 to 61 months postinjury. Functional results were satisfactory in 31 fractures (86%) and not satisfactory in five (14%). All fractures with unsatisfactory results were comminutive (Type III or IV). Four fractures with congruent joint had unsatisfactory, and eight of nine fractures with uncongruent joint had satisfactory result. Statistically, functional results of the comminuted fractures were significantly worse (p= 0,002; Fisher exact test). However, functional results of fractures with non-congruent joint were comparable to the results of fractures with congruent joint. (Abstract truncated 2000 characters).
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