MINIMALLY INVASIVE FIXATION FOR JOINT DEPRESSION FRACTURES OF CALCANEUS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 21
Abstract
BACKGROUND Calcaneus is the most injured tarsal bone mainly due to axial load resulting in intra-articular fractures. The treatment of displaced intra-articular fractures with surgery using extensile approaches are fraught with complications as high as 30%. 30 patients with displaced intra articular fractures are treated with minimally invasive surgical approach with use of multiple K wires. Results using AOFAS scoring showed average score of 82.03 at 28 weeks. 13, 33% scored above 90, 40% scored 80-90 and 46.66% scored below 80. There is significant correlation between the AOFAS Score and age of the patient, smoking habit, Diabetes, restoration of Bohler’s angle after surgery and loss of reduction of the fracture during treatment. There is no significant association for sex, side or mechanism of injury and time of surgery since trauma with AOFAS scoring. Even though no association was seen for infection with smoking, Diabetes is found to be associated with increased infection rate. MATERIALS AND METHODS This study was conducted in Medical College Kottayam which is a tertiary referral centre in Orthopaedics during the time period from JAN 2013 TO DEC 2013.30 cases of fracture calcaneus with joint depression were selected for treatment. Open fractures, fracture in insensate or an immobile person, fracture presented after 3 weeks were excluded. Demographic profile of the patient, history of other co-morbid illnesses, personal history of addictions were recorded. Patients were thoroughly examined and radiological investigations including CT scanning were used. RESULTS During the study period 30 patients were treated for joint depression type of calcaneal fractures. Majority of patients were in the age group of 30-40 (60%) with a mean age of 35.53. Males constituted 90% of all the cases. 70% of injuries were due to fall from height. Right side was involved in 60% of cases. Only 40 % of cases were operated before 12 hours. Of the patients 3 were diabetic (10%) and 6 patients were smokers (20%) CONCLUSION Minimally invasive technique for the treatment of joint depression type of calcaneus fractures was able to produce results comparable to open techniques with a lower rate of serious complications. In the majority of cases, an almost identical Bohler’s angle and geometry of the calcaneus was achieved. Simple removal of the Kirschner wires and shorter surgery time decrease patient stress and must be recognized as an advantage of this minimally invasive technique. Thus, we feel that our minimally invasive technique is a viable alternative for the treatment of joint depression type of calcaneal fractures.
Authors and Affiliations
Tomichan M. C, Imith Kodungookaran
Keywords
Related Articles
- EP ID EP561174
- DOI 10.18410/jebmh/2018/341
- Views 61
- Downloads 0
DOPPLER STUDY IN HIGH-RISK PREGNANCIES IN THIRD TRIMESTER OF PREGNANCIES FOR PREDICTION OF ADVERSE PERINATAL OUTCOME
BACKGROUND Our study aimed to evaluate the Doppler value in third trimester of pregnancy where the features at risk is suspected. The patient with abnormal findings are identified and intervened for timely confinement. A...
COMPARISON OF 0.1% BUPIVACAINE WITH 2 MCG/ML FENTANYL AND 0.1% ROPIVACAINE WITH 2 MCG/ML FOR LABOUR ANALGESIA
BACKGROUND Epidural neuraxial blockade is an efficient and an easy method of administering labour analgesia without any adverse effects on the foetus. Labour analgesia thus helps the mother enjoy the delivery of her chil...
EVALUATION ON THE SAFETY OF TICAGRELOR AMONG INDIAN ACUTE CORONARY SYNDROME (ACS) PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION
BACKGROUND Ticagrelor is the novel class of anti-platelet drugs, has a simpler and faster metabolism (rapid onset of action), high potency and most importantly reversibility. The latter makes this drug safer in patients...
MANNHEIM PERITONITIS INDEX (MPI)- PREDICTING OUTCOMES IN CASES OF SECONDARY PERITONITIS FOLLOWING HOLLOW VISCOUS PERFORATION
BACKGROUND Secondary peritonitis is defined as infection of the peritoneal cavity due to spillage of organisms into the peritoneum, usually associated with bowel perforation and presents as acute abdomen. It is also term...
A COMPARATIVE STUDY BETWEEN APACHE II AND RANSON SCORING SYSTEMS IN PREDICTING THE SEVERITY OF ACUTE PANCREATITIS
BACKGROUND Acute pancreatitis is a condition which involves a wide variety of clinical signs and symptom. The course of which ranges from a mild self-limiting inflammatory process to a more fulminant course which could i...