A Comparative Study of Short-term Result Following Lateral Extensile Approach and Arthroscopic Assisted Reduction and Percutaneous Screw Fixation in Calcaneus Fracture
Keywords:
calcaneus fracture, surgical treatment in calcaneal fracture, arthroscopic assisted reduction and percutaneous screw fixation of calcaneusAbstract
Although calcaneus fracture is uncommon, it can create disability to the patients if they are treated improperly. Surgical treatment is the standard treatment in calcaneal fracture with subtalar joint involvement. The goals are anatomical reduction of articular surface of the subtalar joint and alignment of the heel in calcaneal axial view. Nowadays, the standard approach for calcaneal fracture treatment is by performing lateral extensile approach. This method benefit exploring almost every part of the joint and is easy to perform articular surface reduction. However, complications usually occur due to the poor blood supply of the surgical site. Therefore, minimally invasive techniques are developed. One of the most popular technique is arthroscopic assisted reduction and percutaneous screws fixation. This technique shows good outcome and less complication, based on the previous literatures. Our team was interested in comparing the conventional technique with arthroscopic technique.
Objective: The purpose of this study is to compare the result of two different surgical techniques in calcaneal fracture fixation.
Methods: We included 21 patients with 23 calcaneal (10 Sanders II and 13 Sanders III) fractures to perform these 2 techniques randomly and gather information in many perspectives during follow-ups. A total of 21 patients with 23 calcaneal fractures were randomly assigned to these two techniques, first group for conventional lateral extensile approach (12 cases) and second group for arthroscopic technique (11 cases). Days of hospitalization, complications, and healing time were recorded. VAS, AOFAS, and SF-36 were compared between groups at pre-operation, and during 12-60 weeks post operation. We followed up the patients in each group at 12th, 24th, 36th, and 48th week post-operative and collected data.
Results: Arthroscopic assisted reduction and percutaneous screws fixation group showed better pain relief and statistically significant AOFAS score at post operation. Moreover, hospital admission was shorter without any major complications. On the other hand, the difference of SF-36 was insignificant.
Conclusion: Arthroscopic assisted reduction and percutaneous screw fixation technique demonstrated benefit of early pain relief, improving AOFAS score, reducing the hospital length of stay, and less complications. Nevertheless, while performing this methods, surgeon should be aware of the possibility on failure of articular surface reduction and needs to convert to lateral extensile approach.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
