Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Operative Treatment of Intraarticular Calcaneal Fractures using Extensile Lateral Approach

광범위 외측 도달법을 이용한 관절내 종골 골절의 수술적 치료

  • Chung, Hyung-Jin (Department of Orthopedic Surgery, Inje University College of Medicine, Sanggye Paik Hospital) ;
  • Ahn, Jong-Kuk (Department of Orthopedic Surgery, Inje University College of Medicine, Sanggye Paik Hospital) ;
  • Bae, Su-Young (Department of Orthopedic Surgery, Inje University College of Medicine, Sanggye Paik Hospital) ;
  • Jung, Hoon (Department of Orthopedic Surgery, Inje University College of Medicine, Sanggye Paik Hospital)
  • 정형진 (인제대학교 의과대학 상계백병원 정형외과학교실) ;
  • 안종국 (인제대학교 의과대학 상계백병원 정형외과학교실) ;
  • 배서영 (인제대학교 의과대학 상계백병원 정형외과학교실) ;
  • 정훈 (인제대학교 의과대학 상계백병원 정형외과학교실)
  • Published : 2009.06.15
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Abstract

Purpose: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. Materials and Methods: From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. Results: The average Bohler angle was restored from $6.8^{\circ}$ to $23.5^{\circ}$ and Gissane angle was improved from $116.4^{\circ}$ to $113.5^{\circ}$ after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. Conclusion: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.

Keywords

References

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