Avtor/Urednik		Andoljšek, M
Naslov		Open reduction and internal fixation of displaced intraarticular fractures of the calcaneus
Tip		članek
Vir		Orthopaedische Praxis
Vol. in št.		Letnik 41, št. 4
Leto izdaje		2005
Obseg		str. 192-6
Jezik		eng
Abstrakt		Aims: In a prospective study the author asked, what are the results of open reduction and internal fixafion (ORIF) in displaced intraarticular fractures of fhe calcaneus, and whether type of fracture and/or congruity in the subtalar joint influences these results. Method: Forty-three displaced intraarticular fractures of the calcaneus (30 type II, 10 type III and 3 type IV, Sanders) were operated through extensile lateral approach. After reduction of the subtalar joint and restoration of the calcaneus shape, the fracture was fixed with the calcaneal plate. Mostly, surgery was delayed (median day 7). Motion was encouraged immediately, partial weight-bearing started after 5 to 6 weeks, and full weight-bearing after 3 to 4 months. Following surgery subtalar joint was congruent in 33 (77%l) and non-congruent (within 2 mm) in ten fractures. Results: Thirty-six fractures were evaluafed 12 to 61 months postinjury. Functional results were satisfactory in 31 fractures (86%) and not satisfactory in five. All fractures with unsatisfactory results were comminutive (type III or IV). Four fractures with congruent subtalar joint had unsatisfactory, whereas eight of nine fractures with uncongruent joint had satisfactory results. Statistically, functional results of the comminuted fractures were significanfly worse. However, functional results of fractures with non-congruent joint were comparable to the results of fractures with congruent joint and analysis of variance showed that interaction of these two factors was not important. Conclusions: ORIF enables satisfactory results in the majority of displaced intraarticular fractures of the calcaneus. Comminution in the subtalar joint is a negative prognostic factor, furthermore, comminution is a negative prognostic factor irrespectless of the postreduction congruity in the subtalar joint, if step-off is less than 2 mm.
Deskriptorji		CALCANEUS ANKLE INJURIES FRACTURE FIXATION, INTERNAL BONE SCREWS BONE PLATES FRACTURES, COMMINUTED TREATMENT OUTCOME