DOI QR코드

DOI QR Code

Use of Subtalar Arthroscopy in Intra-Articular Calcaneus Fractures

관절 내 종골 골절에서 거골하 관절경술의 이용

  • Inha Woo (Department of Orthopaedic Surgery, Yeungnam University Medical Center) ;
  • Chul Hyun Park (Department of Orthopaedic Surgery, College of Medicine, Yeungnam University)
  • 우인하 (영남대학교의료원 정형외과) ;
  • 박철현 (영남대학교 의과대학 정형외과학교실)
  • Received : 2023.02.16
  • Accepted : 2023.02.19
  • Published : 2023.03.15

Abstract

Displaced intra-articular calcaneal fractures are difficult to treat because of complex anatomy and high soft tissue complications. Various surgical approaches have been introduced to solve these problems, but the treatment remains complex. Recently, clinically and radiographically superior results were reported using a subtalar arthroscopy in reducing the posterior facet in both percutaneous and open approaches. In the percutaneous approach, the arthroscopically assistant percutaneous approach must be selected carefully for mild-to-moderately displaced fractures because of the limited view. In the open approach, there is little evidence of the utility of subtalar arthroscopy. Therefore, intraoperative arthroscopy should always be used in conjunction with fluoroscopy to achieve reduction and assess the internal fixation placement.

Keywords

Acknowledgement

This research was supported by a grant of the MD-Phd/Medical Scientist Training Program through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea

References

  1. Leite CBG, Macedo RS, Saito GH, Sakaki MH, Kojima KE, Fernandes TD. Epidemiological study on calcaneus fractures in a tertiary hospital. Rev Bras Ortop. 2018;53:472-6. doi: 10.1016/j.rboe.2018.05.014.
  2. Dhillon MS, Bali K, Prabhakar S. Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet Surg. 2011;95:171-81. doi: 10.1007/s12306-011-0114-y.
  3. Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma. 1992;6:252-65. doi: 10.1097/00005131-199206000-00022.
  4. Popelka V. [Current concepts in the treatment of intra-articular calcaneal fractures]. Acta Chir Orthop Traumatol Cech. 2019;86:58-64. Slovak. https://doi.org/10.55095/achot2019/009
  5. Kundel K, Funk E, Brutscher M, Bickel R. Calcaneal fractures: operative versus nonoperative treatment. J Trauma. 1996;41:839-45. doi: 10.1097/00005373-199611000-00012.
  6. Herscovici D Jr. Extensile lateral approach for the operative management of a displaced intra-articular calcaneus fracture. JBJS Essent Surg Tech. 2016;6:e34. doi: 10.2106/JBJS.ST.15.00067.
  7. Sanders R. Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 2000;82:225-50. doi: 10.2106/00004623-200002000-00009.
  8. Benirschke SK, Sangeorzan BJ. Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures. Clin Orthop Relat Res. 1993;(292):128-34. doi: 10.1097/00003086-199307000-00015.
  9. Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84:1733-44. doi: 10.2106/00004623-200210000-00001.
  10. Dhillon MS, Prabhakar S. Treatment of displaced intra-articular calcaneus fractures: a current concepts review. SICOT J. 2017;3:59. doi:10.1051/sicotj/2017044.
  11. Ebraheim NA, Elgafy H, Sabry FF, Freih M, Abou-Chakra IS. Sinus tarsi approach with trans-articular fixation for displaced intra-articular fractures of the calcaneus. Foot Ankle Int. 2000;21:105-13. doi:10.1177/107110070002100203.
  12. Femino JE, Vaseenon T, Levin DA, Yian EH. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: the limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery. Iowa Orthop J. 2010;30:161-7.
  13. Hospodar P, Guzman C, Johnson P, Uhl R. Treatment of displaced calcaneus fractures using a minimally invasive sinus tarsi approach. Orthopedics. 2008;31:1112. doi: 10.3928/01477447-20081101-08.
  14. Essex-Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. Br J Surg. 1952;39:395-419. doi: 10.1002/bjs.18003915704.
  15. Colson P, Houot R. [Westhues' method in treatment of calcaneal fractures]. Lyon Chir. 1954;49:1001-5. French.
  16. Rammelt S, Gavlik JM, Barthel S, Zwipp H. The value of subtalar arthroscopy in the management of intra-articular calcaneus fractures. Foot Ankle Int. 2002;23:906-16. doi: 10.1177/107110070202301004.
  17. Gavlik JM, Rammelt S, Zwipp H. Percutaneous, arthroscopically-assisted osteosynthesis of calcaneus fractures. Arch Orthop Trauma Surg. 2002;122:424-8. doi: 10.1007/s00402-002-0397-4.
  18. Parisien JS, Vangsness T. Arthroscopy of the subtalar joint: an experimental approach. Arthroscopy. 1985;1:53-7. doi: 10.1016/s0749-8063(85)80079-7.
  19. Lui TH, Tong SC. Subtalar arthroscopy: when, why and how. World J Orthop. 2015;6:56-61. doi: 10.5312/wjo.v6.i1.56.
  20. Park CH, Kim SY, Kim JR, Lee WC. Arthroscopic excision of a symptomatic os trigonum in a lateral decubitus position. Foot Ankle Int. 2013;34:990-4. doi: 10.1177/1071100712475062.
  21. Munoz G, Eckholt S. Subtalar arthroscopy: indications, technique and results. Foot Ankle Clin. 2015;20:93-108. doi: 10.1016/j.fcl.2014.10.010.
  22. Park CH. Role of subtalar arthroscopy for displaced intra-articular calcaneal fractures. Clin Podiatr Med Surg. 2019;36:233-49. doi:10.1016/j.cpm.2018.10.006.
  23. Keener BJ, Sizensky JA. The anatomy of the calcaneus and surrounding structures. Foot Ankle Clin. 2005;10:413-24. doi: 10.1016/j.fcl.2005.04.003.
  24. Viladot A, Lorenzo JC, Salazar J, Rodriguez A. The subtalar joint: embryology and morphology. Foot Ankle. 1984;5:54-66. doi:10.1177/107110078400500203.
  25. Pisani G, Pisani PC, Parino E. Sinus tarsi syndrome and subtalar joint instability. Clin Podiatr Med Surg. 2005;22:63-77, vii. doi: 10.1016/j.cpm.2004.08.005.
  26. Stephens MM, Sammarco GJ. The stabilizing role of the lateral ligament complex around the ankle and subtalar joints. Foot Ankle. 1992;13:130-6. doi: 10.1177/107110079201300304.
  27. Frey C, Gasser S, Feder K. Arthroscopy of the subtalar joint. Foot Ankle Int. 1994;15:424-8. doi: 10.1177/107110079401500804.
  28. Jerosch J. Subtalar arthroscopy--indications and surgical technique. Knee Surg Sports Traumatol Arthrosc. 1998;6:122-8. doi: 10.1007/s001670050084.
  29. Woon CY, Chong KW, Yeo W, Eng-Meng Yeo N, Wong MK. Subtalar arthroscopy and flurosocopy in percutaneous fixation of intraarticular calcaneal fractures: the best of both worlds. J Trauma. 2011;71:917-25. doi: 10.1097/TA.0b013e318202f1d0.
  30. Tornetta P 3rd. The Essex-Lopresti reduction for calcaneal fractures revisited. J Orthop Trauma. 1998;12:469-73. doi: 10.1097/00005131-199809000-00007.
  31. Pastides PS, Milnes L, Rosenfeld PF. Percutaneous arthroscopic calcaneal osteosynthesis: a minimally invasive technique for displaced intra-articular calcaneal fractures. J Foot Ankle Surg. 2015;54:798-804. doi: 10.1053/j.jfas.2014.12.033.
  32. Yeap EJ, Rao J, Pan CH, Soelar SA, Younger ASE. Is arthroscopic assisted percutaneous screw fixation as good as open reduction and internal fixation for the treatment of displaced intra-articular calcaneal fractures? Foot Ankle Surg. 2016;22:164-9. doi: 10.1016/j.fas.2015.06.008.
  33. Sivakumar BS, Wong P, Dick CG, Steer RA, Tetsworth K. Arthroscopic reduction and percutaneous fixation of selected calcaneus fractures: surgical technique and early results. J Orthop Trauma. 2014;28:569-76. doi: 10.1097/BOT.0000000000000157.
  34. Rammelt S, Amlang M, Barthel S, Gavlik JM, Zwipp H. Percutaneous treatment of less severe intraarticular calcaneal fractures. Clin Orthop Relat Res. 2010;468:983-90. doi: 10.1007/s11999-009-0964-x.
  35. Grun W, Molund M, Nilsen F, Stodle AH. Results after percutaneous and arthroscopically assisted osteosynthesis of calcaneal fractures. Foot Ankle Int. 2020;41:689-97. doi: 10.1177/1071100720914856.
  36. Gao D, Wong TM, Fang C, Leung FK, Li X, Jia B, et al. Arthroscopic-assisted percutaneous fixation of intra-articular calcaneal fractures using an intraoperative distraction device. J Orthop Surg (Hong Kong). 2021;29:2309499020979095. doi: 10.1177/2309499020979095.
  37. Gavlik JM, Rammelt S, Zwipp H. The use of subtalar arthroscopy in open reduction and internal fixation of intra-articular calcaneal fractures. Injury. 2002;33:63-71. doi: 10.1016/s0020-1383(01)00077-8.
  38. Park CH, Yoon DH. Role of subtalar arthroscopy in operative treatment of sanders type 2 calcaneal fractures using a sinus tarsi approach. Foot Ankle Int. 2018;39:443-9. doi:10.1177/1071100717746181.
  39. Schuberth JM, Cobb MD, Talarico RH. Minimally invasive arthroscopic-assisted reduction with percutaneous fixation in the management of intra-articular calcaneal fractures: a review of 24 cases. J Foot Ankle Surg. 2009;48:315-22. doi: 10.1053/j.jfas.2009.01.002.
  40. Gonzalez TA, Macaulay AA, Ehrlichman LK, Drummond R, Mittal V, DiGiovanni CW. Arthroscopically assisted versus standard open reduction and internal fixation techniques for the acute ankle fracture. Foot Ankle Int. 2016;37:554-62. doi: 10.1177/1071100715620455.