Clinics in podiatric medicine and surgery
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Clin Podiatr Med Surg · Apr 2019
ReviewSinus Tarsi Approach with Subcutaneously Delivered Plate Fixation for Displaced Intra-Articular Calcaneal Fractures.
Displaced intra-articular calcaneal fractures can be treated with open reduction and internal fixation through various methods, including the extensile lateral approach, sinus tarsi approach, percutaneous reduction and fixation, external fixation, and calcaneoplasty. Although the gold standard is the extensile lateral approach, this method has significant wound-healing complications associated with it. Literature shows that the reduction achieved through minimally invasive techniques is equal to that achieved with the extensile lateral approach, while reducing the amount of postoperative complications. This article outlines a technique that uses the sinus tarsi approach with subcutaneous plate fixation.
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Clin Podiatr Med Surg · Apr 2019
ReviewPrimary or Secondary Subtalar Arthrodesis and Revision of Calcaneal Nonunion with Minimally Invasive Rigid Internal Nail Fixation for Treatment of Displaced Intra-Articular Calcaneal Fractures.
Primary or secondary subtalar joint arthrodesis after displaced intra-articular calcaneal fractures makes use of talocalcaneal large-diameter screw fixation after an eventual correction of geometric hindfoot deformity. Despite this procedure usually having a successful functional outcome, potential complications occur, including nonunion and malalignment, with an unknown rate of loss of correction or implant migration during the healing period. Angular stable fixation of the subtalar joint arthrodesis with an interlocking nail applied in a minimally invasive technique affords maintenance of the hindfoot position until osseous healing occurs. The key steps of the surgical technique are described.
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Clin Podiatr Med Surg · Apr 2019
ReviewJoint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures.
Displaced intra-articular calcaneal fractures represent life-altering injuries. Difficulty obtaining and maintaining calcaneal morphology and the significant risk of wound healing complications with an extensile lateral incision exist. ⋯ Spontaneous conversion to primary subtalar joint arthrodesis using the same instrumentation remains unique to this system. This article reviews open and percutaneous approaches for joint-sparing and primary arthrodesis procedures to treat Sanders IV fracture patterns.
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Clin Podiatr Med Surg · Apr 2019
ReviewSinus Tarsi Approach with Screws-Only Fixation for Displaced Intra-Articular Calcaneal Fractures.
Treatment of displaced intra-articular calcaneal fractures has changed numerous times in the last decades. Currently, less invasive surgery has reemerged and is increasingly used. The sinus tarsi approach is most commonly used. ⋯ The results in the literature show overall similar functional outcome compared with the extended lateral approach, however with a significant reduction in wound complications. This article deals with the sinus tarsi approach in which the reduction is fixated using screws only. Indications, surgical technique, and possible pitfalls are discussed.
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Clin Podiatr Med Surg · Apr 2019
ReviewIntraoperative Reduction Techniques for Surgical Management of Displaced Intra-Articular Calcaneal Fractures.
Fractures of the calcaneus are detrimental injuries, often caused by high-energy trauma. To best restore the functionality of a limb and allow normal ambulation, it is recommended to repair displaced intra-articular calcaneus fractures surgically. ⋯ Traditionally, calcaneal fractures have been repaired through a lateral extensile incision that has been shown to have a high percentage of wound healing complications. In recent times, there has been a shift toward minimally invasive and sinus tarsi incisional approaches in the repair of calcaneus fractures.