Percutaneous Reduction and Hollow Screw Fixation Versus Open Reduction and Internal Fixation for Treating Displaced Intra-Articular Calcaneal Fractures.

Abstract

BACKGROUND We investigated the outcomes of displaced intra-articular calcaneal fractures (DIACFs) treated by percutaneous reduction and hollow screw fixation (PRHCF) versus open reduction and internal fixation (ORIF). MATERIAL AND METHODS Seventy-one patients were randomly allocated to group A (by PRHCF) and group B (by ORIF). Operative time, visual analogue scale (VAS) score, time from injury to operation, postoperative hospital stay, preoperative and postoperative radiographic measurements, and complications were recorded. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scores. RESULTS Finally, 59 patients were followed up for at least 12 months (range, 12-24 months). Group A showed significantly more advantages than group B in term of operative time, intraoperative blood loss, time to operation, postoperative hospital stay, and postoperative pain relief during the first 3 days (P<0.001). However, more intraoperative fluoroscopy was required in group A than in group B (P<0.001). The calcaneal width, height, length, Böhler angle, and Gissane angle in each group were significantly improved postoperatively (all P<0.001), although not significantly different in the postoperative comparisons between both groups. The AOFAS scores were slightly superior in group A than in group B (88.3 vs. 86.4, P=0.08). The rate of incidence of postoperative complications was lower in group A than in group B (3.2% vs. 10.8%, respectively; OR, 0.28, 95% CI, 0.03 to 2.84), although there was no significant difference (P=0.337). CONCLUSIONS PRHCF showed comparable clinical and radiological outcomes as ORIF, demonstrating it is a safe and effective alternative in treating DIACFs.

• Authors: Ming Li, Xiaodong Lian, Weijie Yang, Kai Ding, Lin Jin, Zhenqin Jiao, Lijie Ma, Wei Chen
• Journal: Medical science monitor : international medical journal of experimental and clinical research (Med Sci Monit) Vol. 26 Pg. e926833 (Nov 04 2020) ISSN: 1643-3750 [Electronic] United States
• PMID: 33147205 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Topics

• Adult
• Bone Screws
• Calcaneus (diagnostic imaging, pathology, surgery)
• Female
• Fracture Fixation, Internal (adverse effects)
• Fractures, Bone (diagnostic imaging, surgery)
• Humans
• Intra-Articular Fractures (diagnostic imaging, surgery)
• Male
• Middle Aged
• Open Fracture Reduction (adverse effects)
• Postoperative Complications (etiology)
• Visual Analog Scale
• Young Adult