Clinical Outcome of Tongue Type Intra-Articular Calcaneal Fractures Managed with Percutaneous Screw Fixation
Adeel Ahmed Siddiqui,Irfan Muhammad Rajput, Javed Hussain Khaskheli, Muhammad Younis Pathan, Mariyam Adeel, Hina Khalil
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ABSTRACTIntroduction: Calcaneal fractures are a common category of tarsal bone fractures. Percutaneous screw fixation is an effective modality and offers excellent functional and radiological outcome with exceptionally low complication rate. In this study, we analyze the functional and radiological outcome of patients with tongue type calcaneal fractures managed using percutaneous screw fixation.Method: This is a prospective study conducted at the Department of Orthopedics, Civil Hospital Karachi during a duration of three years i.e January 2017 to January 2020. During the study duration, all patients presenting with tongue type calcaneal fractures were included in the study after taking informed consent. Inclusion criteria includes patients with uncomplicated tongue type calcaneal fractures among patients aged 20-65 years of age. Exclusion criteria includes patients with depression type fractures, open or infected fractures or calcaneal fractures in patients aged less than 20 or more than 65 years of age. Patients with multiple fractures were also excluded from the study. Percutaneous reduction and screw fixation was performed among all patients and functional outcome was analyzed.Results: Out of 34 cases, 26 were males while 8 were females. The mean age of patients was 41.8±9.97 years. The mean pre-operative Bohler’s angle was 16 degrees while mean post-operative Bohler’s angle was 36 degrees. The mean pre-operative Gissane angle was 121.3 degrees while mean post-operative Gissane angle was 112.8 degrees.Majority patients had excellent functional outcome i.e 64.7% (n=22). Good functional outcome was found in 26.4% (n=9) while 8% (n=3) had fair outcome. Post-operative complications were found in two patients. One patient had subtalar osteoarthritis which was managed by subtalar fusion while one patient had peroneal tendinitis.Conclusion:Percutaneous reduction and screw fixation technique offers promising results with good functional outcome and minimal complications. It should be routinely used for the management of tongue type calcaneal fracturesKeywords: Calcaneal fractures, percutaneous reduction, closed reduction.
Introduction: Calcaneal fractures are a common category of tarsal bone fractures. Percutaneous screw fixation is an effective modality and offers excellent functional and radiological outcome with exceptionally low complication rate. In this study, we analyze the functional and radiological outcome of patients with tongue type calcaneal fractures managed using percutaneous screw fixation.
Method: This is a prospective study conducted at the Department of Orthopedics, Civil Hospital Karachi during a duration of three years i.e January 2017 to January 2020. During the study duration, all patients presenting with tongue type calcaneal fractures were included in the study after taking informed consent. Inclusion criteria includes patients with uncomplicated tongue type calcaneal fractures among patients aged 20-65 years of age. Exclusion criteria includes patients with depression type fractures, open or infected fractures or calcaneal fractures in patients aged less than 20 or more than 65 years of age. Patients with multiple fractures were also excluded from the study. Percutaneous reduction and screw fixation was performed among all patients and functional outcome was analyzed.
Results: Out of 34 cases, 26 were males while 8 were females. The mean age of patients was 41.8±9.97 years. The mean pre-operative Bohler’s angle was 16 degrees while mean post-operative Bohler’s angle was 36 degrees. The mean pre-operative Gissane angle was 121.3 degrees while mean post-operative Gissane angle was 112.8 degrees.Majority patients had excellent functional outcome i.e 64.7% (n=22). Good functional outcome was found in 26.4% (n=9) while 8% (n=3) had fair outcome. Post-operative complications were found in two patients. One patient had subtalar osteoarthritis which was managed by subtalar fusion while one patient had peroneal tendinitis.
Conclusion:Percutaneous reduction and screw fixation technique offers promising results with good functional outcome and minimal complications. It should be routinely used for the management of tongue type calcaneal fractures
Keywords: Calcaneal fractures, percutaneous reduction, closed reduction.