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Foot (Edinb). 2017 Jun;31:23-30. doi: 10.1016/j.foot.2017.01.008. Epub 2017 Feb 20.

Outcome evaluation of minimally invasive surgery versus extensile lateral approach in management of displaced intra-articular calcaneal fractures: A randomised control trial.

Author information

1
UCMS and GTB Hospital, India. Electronic address: ankit24388@gmail.com.
2
Department of Orthopaedics, PGIMER, Chandigarh, India. Electronic address: drdhillon@gmail.com.
3
Department of Orthopaedics, PGIMER, Chandigarh, India. Electronic address: sharad.ortho@gmail.com.
4
PGIMER, Chandigarh, India. Electronic address: rakeshjohn23@gmail.com.

Abstract

BACKGROUND:

Minimally invasive surgery has a significant and evolving role in the treatment of DIACFs, but there is limited literature on this topic.

OBJECTIVES:

To compare the clinico-radiological outcomes of DIACFs fixed with MIS technique with ORIF.

METHODS:

This randomised control trial (RCT) included 21 closed Sanders type 2 and 3 DIACFs which were selected from 70 who presented. Extensile lateral approach was used in the ORIF group; while MIS techniques included either percutaneous reduction or small incisions with indirect fragment manipulation.

MAIN OUTCOME MEASUREMENT:

AOFAS hindfoot score, pre-operative and postoperative radiology.

RESULTS:

There were 9 fractures in the Extensile group and 12 in the MIS group, with both groups having comparable demography, fracture classification, surgery delay & initial radiology. Bohler's angle improved after surgery by an average of 18.44 with ORIF and 14.67 with MIS (p=0.28). Mean AOFAS in the MIS group was 82.58 (66.67% good and 33.33% fair) and was 89.56 (44.44% excellent, 55.56% good, 0 fair/poor) with ORIF (p=0.034). Two patients who underwent ORIF had a major complication (one deep infection and Sural nerve injury each) while none in the MIS group.

CONCLUSIONS:

MIS methods minimized soft tissue complications and achieved comparable radiological reductions but clinical outcomes were poorer, with percutaneous methods having the worst outcomes.

KEYWORDS:

American Orthopaedic Foot and Ankle Score (AOFAS); Calcaneum fracture; Displaced intra-articular calcaneal fractures (DIACFs); Extensile lateral approach; Minimally invasive surgery (MIS)

PMID:
28324822
DOI:
10.1016/j.foot.2017.01.008
[Indexed for MEDLINE]

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