Quality of Reduction of Displaced Intra-articular Calcaneal Fractures Using a Sinus Tarsi Versus Extensile Lateral Approach.

跟骨骨折 关节内 还原(数学) 外科 跟骨 脚踝 内固定 固定(群体遗传学)
作者
Gennadiy Busel,Hassan R. Mir,Stephanie Merimee,Raahil Patel,Omar H. Atassi,Guadalupe De La Fuente,David Donohue,Ben Maxson,Anthony Infante,Anjan R. Shah,D. W. Watson,Katheryne Downes,Roy Sanders
出处
期刊:Journal of Orthopaedic Trauma [Lippincott Williams & Wilkins]
卷期号:35 (6): 285-288 被引量:2
标识
DOI:10.1097/bot.0000000000001971
摘要

OBJECTIVE To evaluate the difference in the quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative Computed Tomography (CT) scans in displaced intra-articular calcaneal fractures (DIACFs). DESIGN Retrospective. SETTING Level 1 and level 2 academic centers. PATIENTS Consecutive patients undergoing operative fixation of DIACFs with postoperative CT scans and standard radiographs. METHODS Patients were identified based on Current Procedural Terminology code and chart review. All operative calcaneal fractures treated between 2012 and 2018 by fellowship-trained orthopaedic trauma surgeons were evaluated. Those with both postoperative CT scans and radiographs were included. Exclusion criteria included extra-articular fractures, malunions, percutaneous fixation, ORIF and primary fusion, and those patients without a postoperative CT scan. The Sanders classification was used. Cases were divided into 2 groups based on ELA versus STA. Bohler angle and Gissane angle were evaluated on plain radiographs. CT reduction quality grading included articular step off/gap within the posterior facet, and varus angulation of the tuberosity: CT reduction grading included: excellent (E): no gap, no step, and no angulation; good (G): 3 mm step, >10 mm gap, and/or >15° angulation. RESULTS Seventy-seven patients with 83 fractures were included. Average age was 42 years (range, 18-74 years), with 57 men. Four fractures were open. There were 37 Sanders II and 46 Sanders III fractures; 36 fractures were fixed using the STA, whereas 47 used the ELA. Average days to surgery were 5 for STA and 14 for ELA (P < 0.001). A normal Bohler angle was achieved more often with the ELA (91.5%) than with STA (77.8%) (P < 0.001). There was no difference by approach for Gissane angle (P = 0.5). ELA had better overall reduction quality (P = 0.02). For Sanders II, there was no difference in reduction quality with STA versus ELA (P = 0.51). For Sanders III, ELA trended toward better reduction quality (P = 0.06). CONCLUSIONS The ELA had a better overall reduction of Bohler angle on plain radiographs and of the posterior facet and tuberosity on postoperative CT scans. For Sanders type II DIACFs, there was no difference between STA and ELA. Importantly, for Sanders III DIACFs, ELA trended toward better reduction quality. In addition to fracture reduction, surgeon learning curve, early wound complications, and long-term outcomes must be considered in future studies comparing the ELA and STA. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
apckkk完成签到 ,获得积分10
2秒前
深情安青应助550190946采纳,获得10
3秒前
4秒前
5秒前
jbq完成签到 ,获得积分20
5秒前
YM完成签到,获得积分10
7秒前
生动柔发布了新的文献求助10
7秒前
大旭完成签到 ,获得积分10
8秒前
Fn完成签到 ,获得积分10
10秒前
zero完成签到,获得积分10
12秒前
瘦瘦谷兰完成签到,获得积分10
12秒前
zcz完成签到 ,获得积分10
13秒前
白嘉乐完成签到,获得积分10
14秒前
考研小白完成签到,获得积分10
14秒前
高妍纯完成签到 ,获得积分10
16秒前
18秒前
风中的丝袜完成签到,获得积分10
18秒前
赵赵完成签到,获得积分10
21秒前
21秒前
shiizii应助科研通管家采纳,获得10
22秒前
xuzj应助科研通管家采纳,获得10
22秒前
Mars应助科研通管家采纳,获得30
22秒前
Hello应助科研通管家采纳,获得10
22秒前
叶梓轩完成签到 ,获得积分10
22秒前
上官若男应助科研通管家采纳,获得10
22秒前
22秒前
22秒前
机智的锦程完成签到 ,获得积分10
23秒前
时尚俊驰发布了新的文献求助10
25秒前
华仔完成签到,获得积分10
25秒前
甜甜友容完成签到,获得积分10
29秒前
程哲瀚完成签到,获得积分10
29秒前
29秒前
副本完成签到 ,获得积分10
29秒前
淡然画笔完成签到,获得积分10
30秒前
生动柔完成签到,获得积分20
30秒前
雨天完成签到,获得积分10
31秒前
喜悦寒凝完成签到,获得积分10
31秒前
LLSSLL完成签到,获得积分10
32秒前
lenetivy发布了新的文献求助20
32秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038201
求助须知:如何正确求助?哪些是违规求助? 3575940
关于积分的说明 11373987
捐赠科研通 3305747
什么是DOI,文献DOI怎么找? 1819274
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022