TY - JOUR
T1 - Complications following the extended lateral approach for calcaneal fractures do not influence mid- to long-term outcome
AU - de Groot, R.
AU - Frima, A. J.
AU - Schepers, T.
AU - Roerdink, W. H.
PY - 2013
Y1 - 2013
N2 - Open reduction and internal fixation (ORIF) of intra-articular calcaneal fractures through an extended lateral approach is frequently accompanied by a high complication rate. However, ORIF currently provides the best long-term clinical results. The aim of this study was twofold: (1) to evaluate both mid- to long-term clinical and radiological results of a consecutive series treated by ORIF and (2) to determine the influence of short-term complications on long-term clinical outcome. Patients with a displaced intra-articular calcaneal fracture, treated with ORIF, through an extended lateral approach, in a level-2 trauma centre between 1995 and 2008 were evaluated for the study. The long-term functional outcome (American Orthopaedic Foot & Ankle Society (AOFAS), 36-Item Short-Form Health Survey (SF-36) and Visual Analogue Scale (VAS)) and radiographic results (e.g., Böhler and Gissane angle, height, width and joint reduction) were determined. Short- and long-term complications were documented. A total of 57 patients matched the inclusion criteria, from which 39 patients agreed to participate in this study (68%). The median follow-up was 6.5 years (range 2-16 years). Based on the AOFAS hindfoot score, 74% of the patients had a good-to-excellent long-term clinical result. Radiological results were satisfying with a median postoperative Böhler angle of 26° and 25° at follow-up. Complications occurred in 32% of all patients; mainly wound-healing problems were noted. Short-term complications did not influence mid- to long-term clinical results (p>0.05). Anatomic reconstruction of the calcaneus was associated with improved long-term clinical results (p <0.05). Despite the high complication rate following ORIF of a calcaneal fracture, complications do not affect mid- to long-term clinical outcome. Surgical treatment should focus on restoring the anatomy. Level of evidence: Therapeutic level IV
AB - Open reduction and internal fixation (ORIF) of intra-articular calcaneal fractures through an extended lateral approach is frequently accompanied by a high complication rate. However, ORIF currently provides the best long-term clinical results. The aim of this study was twofold: (1) to evaluate both mid- to long-term clinical and radiological results of a consecutive series treated by ORIF and (2) to determine the influence of short-term complications on long-term clinical outcome. Patients with a displaced intra-articular calcaneal fracture, treated with ORIF, through an extended lateral approach, in a level-2 trauma centre between 1995 and 2008 were evaluated for the study. The long-term functional outcome (American Orthopaedic Foot & Ankle Society (AOFAS), 36-Item Short-Form Health Survey (SF-36) and Visual Analogue Scale (VAS)) and radiographic results (e.g., Böhler and Gissane angle, height, width and joint reduction) were determined. Short- and long-term complications were documented. A total of 57 patients matched the inclusion criteria, from which 39 patients agreed to participate in this study (68%). The median follow-up was 6.5 years (range 2-16 years). Based on the AOFAS hindfoot score, 74% of the patients had a good-to-excellent long-term clinical result. Radiological results were satisfying with a median postoperative Böhler angle of 26° and 25° at follow-up. Complications occurred in 32% of all patients; mainly wound-healing problems were noted. Short-term complications did not influence mid- to long-term clinical results (p>0.05). Anatomic reconstruction of the calcaneus was associated with improved long-term clinical results (p <0.05). Despite the high complication rate following ORIF of a calcaneal fracture, complications do not affect mid- to long-term clinical outcome. Surgical treatment should focus on restoring the anatomy. Level of evidence: Therapeutic level IV
U2 - https://doi.org/10.1016/j.injury.2013.06.014
DO - https://doi.org/10.1016/j.injury.2013.06.014
M3 - Article
C2 - 23870395
SN - 0020-1383
VL - 44
SP - 1596
EP - 1600
JO - Injury
JF - Injury
IS - 11
ER -