TITLE

Comparison of Surgical Outcomes of Intra-Articular Calcaneal Fractures by Age

AUTHOR(S)
Gaskill, Trevor; Schweitzer, Karl; Nunley, James
PUB. DATE
December 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;12/15/2010, Vol. 92-A Issue 18, p2884
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Internal fixation is an accepted treatment for displaced fractures of the calcaneus. Operative intervention in older patients, however, is traditionally discouraged in the literature. The purpose of this study was to compare the outcomes of internal fixation of intra-articular fractures of the calcaneus on the basis of patient age. Methods: One hundred and seventy-five patients (191 fractures) who underwent internal fixation between 1992 and 2007 for a displaced, intra-articular calcaneal fracture were identified. The American Society of Anesthesiologists score, the fracture pattern, and the mechanism of injury were recorded. Each patient was contacted to complete a follow-up survey from which clinical outcome scores were calculated. One hundred and forty-six patients with 158 fractures were available for follow-up and were divided into two groups for comparison. Group I consisted of 108 fractures in patients who were less than fifty years old. Group II was composed of fractures in fifty patients who were fifty years of age or older. Results: The mean duration of follow-up was 8.98 years. The average patient age was thirty-six years for Group I and fifty- eight years for Group II. The average adjusted American Orthopaedic Foot & Ankle Society score was 64 for Group I and 75 for Group II. The mean calcaneal fracture scoring system score was 66 for Group I, and 76 for Group II. Similarly, the average Foot Function Index was 24 and 15 for Groups I and II, respectively. Each clinical outcome measure suggests significantly better outcomes for Group II as compared with Group I (all p < 0.05). Overall, the complication rates were similar between groups. Conversion to subtalar fusion was 15% for Group I and 8% for Group II. Conclusions: In this series, outcomes of older patients are at least equivalent to those of younger patients undergoing internal fixation for an intra-articular calcaneal fracture. Operative intervention appears to be a reasonable option for displaced calcaneal fractures in older patients. Physiologic age should be considered when evaluating older patients, and individualized treatment plans remain critical because patients with low physical demands or who have medical complications may be better candidates for nonoperative treatment. Prospective studies are needed in this area.
ACCESSION #
57048929

 

Related Articles

  • Concomitant Ipsilateral Pertrochanteric and Subcapital Fracture of the Proximal Femur. Sayegh, Fares E.; Karataglis, Dimitris; Trapotsis, Stergios J.; Christoforides, John E.; Pournaras, John D. // European Journal of Trauma;Feb2005, Vol. 31 Issue 1, p64 

    Background: Concomitant pertrochanteric and subcapital fracture on the same side of the hip is rare. There have been only a few documented cases of combined intertrochanteric and subcapital fracture of the hip. Case Study: This is an unusual case of combined ipsilateral pertrochanteric and...

  • Anatomical study of axis for odontoid screw thickness, length, and angle. Tun, Kagan; Kaptanoglu, Erkan; Cemil, Berker; Yorubulut, Mehmet; Karahan, S. Tuna; Tekdemir, Ibrahim // European Spine Journal;Mar2009, Vol. 18 Issue 2, p271 

    Anterior odontoid screw fixation is a safe and effective method for treatment of odontoid fractures. The screw treads should fit into the odontoid medulla, should pass the fracture line, and should pull fractured odontoid tip against body of axis in order to achieve optimum screw placement and...

  • Placement of C2 laminar screws using three-dimensional fluoroscopy-based image guidance. Nottmeier, Eric; Foy, Andrew // European Spine Journal;Apr2008, Vol. 17 Issue 4, p610 

    The use of C2 laminar screws in posterior cervical fusion is a relatively new technique that provides rigid fixation of the axis with minimal risk to the vertebral artery. The techniques of C2 laminar screw placement described in the literature rely solely on anatomical landmarks to guide screw...

  • Failure of osteosynthesis and prosthetic joint infection due to Mycobacterium tuberculosis following a subtrochanteric fracture: a case report and review of the literature. Krappel, F. A.; Harland, U. // Archives of Orthopaedic & Trauma Surgery;Jul2000, Vol. 120 Issue 7/8, p470 

    We report a patient with a subtrochanteric fracture, for whom internal fixation failed and a prosthetic joint replacement was complicated by a local reactivation of a Mycobacterium tuberculosis infection. After hip replacement with revision and adequate medical therapy, a full recovery was...

  • Use of leg positioning holders. Richardson, Caroline // British Journal of Perioperative Nursing;Mar2004, Vol. 14 Issue 3, p127 

    Provides information about Direct Placement Leg Holders, used in lower limb internal fixation for fractures. Brief history of how and why their potential use in orthopedic trauma; Benefits for patient care and how they can improve patient positioning; Benefits for practitioners acting as...

  • A retrospective analysis of bilateral fractures over sixteen years: localisation and variation in treatment of second hip fractures. Kok, Laura; Steenhoven, Tim; Nelissen, Rob // International Orthopaedics;Oct2011, Vol. 35 Issue 10, p1545 

    The aim of this study was the evaluation of contralateral hip fractures after a previous hip fracture. For this retrospective analysis patients were selected from the database of the LUMC, a teaching hospital in the south-west of the Netherlands. We analyzed all patients with a second fracture...

  • Preliminary experience with biodegradable implants for fracture fixation. Dhillon, Mandeep S.; Prabhakar, Sharad; Prasanna, Chandiralingam // Indian Journal of Orthopaedics;Jul-Sep2008, Vol. 42 Issue 3, p319 

    Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence...

  • Effects of Lag Screw Design and Lubrication on Sliding in Trochanteric Nails. Kummer, Frederick J. // Bulletin of the NYU Hospital for Joint Diseases;2010, Vol. 68 Issue 1, p29 

    This study compared the sliding characteristics of three lag screw designs used with trochanteric nails and determined the effects of lubrication on sliding. They were tested by an established method to measure initiation and ease of lag screw sliding. These tests were then repeated with calf...

  • Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage. Martetschläger, Frank; Kraus, Tobias; Schiele, Clara; Sandmann, Gunther; Siebenlist, Sebastian; Braun, Karl; Stöckle, Ulrich; Freude, Thomas; Neumaier, Markus // Knee Surgery, Sports Traumatology, Arthroscopy;May2013, Vol. 21 Issue 5, p1189 

    Purpose: The purpose of the current study was to assess the clinical and radiological results after locking T-plate osteosynthesis with coracoclavicular augmentation of unstable and displaced distal clavicle fractures (Neer type 2). Methods: Thirty patients, treated between January 2007 and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics