Diagnosis can be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning. The most successful results were in the patients who had had a subtalar arthrodesis. Scapula Fractures are uncommon fractures to the shoulder girdle caused by high energy trauma and associated with pulmonary injury, head injury, and increased injury severity scores.
#Calcaneus fracture orthobullets full
There was a trend (p = 0.07) that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Significantly displaced fractures often require orthopaedic intervention. Pain was partially relieved in thirty-eight (90 per cent) of the patients, function improved in thirty-five (83 per cent), and thirty-two (76 per cent) of the patients returned to work or to a pre-injury level of activity at a mean of eight months (range, four to sixteen months) after the operation. The majority consist of minor avulsion or stress fractures. The difference between the preoperative and postoperative rating scores was used to measure any improvement in function. Calcaneal fractures can be divided broadly into two types depending on whether there is articular involvement of the subtalar joint 2,7,8: extra-articular: 25-30. The patients were examined at a mean of thirty-two months (range, twenty-six to fifty-two months) after the operation. An in situ subtalar arthrodesis had been performed in fifteen patients a subtalar distraction bone-block arthrodesis, in fourteen a triple arthrodesis, in five a lateral calcaneal ostectomy, in seven a transection and proximal transposition of the sural nerve, in seven and a release of the tibial nerve, in five. Calcaneal fractures are the most common fracture of the tarsal bones and represent 1 to 2 of all fractures. The operations had been performed a mean of twenty-six months (range, six to seventy-two months) after the injury. BACKGROUND: The sustentacular fragment in displaced intra-articular calcaneal fractures has historically been portrayed as a constant fragment, bound to.
The resulting complications of infection, malunion, and nonunion, and the possible need for amputation, made most surgeons believe that treatment should be nonoperative.We retrospectively reviewed the results of the operative treatment of forty-three fractures of the calcaneus in forty-two patients (thirty-six men and six women). Anesthesia was not always effective, radiography and fluoroscopy were not well developed, antibiotics did not exist, and a sound understanding of the principles of internal fixation was lacking. Despite the fact that Böhler advocated open reduction in 1931, the principal reasons for the predominance of nonoperative treatment were the technical problems associated with operative treatment. Although initially they were enthusiastic about this technique, by the 1920s they had abandoned the treatment of acute fractures altogether and had turned instead to the treatment of healed malunions. Despite the fact that the calcaneus is the commonest tarsal bone fractured, many controversies exist in the literature regarding the management options. McLaughlin agreed, likening attempts at operative fixation to the “nailing of a custard pie to the wall.”76 Cotton and Wilson recommended closed treatment with use of a medially placed sandbag, a laterally placed felt pad, and a hammer to reduce the lateral wall and “reimpact” the fracture.
In this article, the current thinking regarding the treatment of these very difficult fractures will be reviewed.Īs early as 1908, Cotton and Wilson suggested that open reduction of a calcaneal fracture was contraindicated. Although modern operative intervention has improved the outcome in many patients, there still is no real consensus on classification, treatment, operative technique, or postoperative management. Many authors have reported that patients may be totally incapacitated for as long as three years and partially impaired for as long as five years after the injury. Most calcaneal fractures occur in male industrial workers, making the economic importance of this injury substantial.
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