Does Treatment Modality Affect Clinical Results of Calcaneal Fractures: A Retrospective Comparative Study

Year 2017, Volume: 1 Issue: 2, 77 - 82, 15.07.2017

Mehmet Nuri Konya , Serdar Sargın

https://doi.org/10.30565/medalanya.313876

Abstract

Aim: To determine if there is any
difference in functional results between surgical and conservative treatments
in displaced intra-articular fractures of the calcaneum.

Methods: 27 patients (22 males, 5
females, who were treated with surgical or conservative modalities (13
conservative and 14 surgical) due to displaced calcaneal fractures in different
hospitals, were evaluated in this study between the years of 2012 and 2014. All
patients were followed up at least for 2 years. All patients were compared
using the AOFAS questionnaire.

Results: There was no significant
difference in terms of ages and sexes of the patients. (p>0, 05) The mean
AOFAS score was 69, 15 (56-82) in conservative group, and 84, 3 (56-96) in
surgical group. When these AOFAS scores were compared (Mann Whitney-U Test),
the functional scores were significantly higher in surgical group (p<0, 05).

Conclusion: Our study showed – as the
existing literature also supports– that surgical treatment of intraarticular
calcaneal fractures is functionally and clinically more effective than
conservative treatment.

Keywords

Calcaneus, Surgery, conservative

Kalkaneus Kırıklarında Tedavi Yöntemi Klinik Sonuçları Etkiler Mi? Retrospektif Karşılaştırmalı Çalışma.

Abstract

Amaç: Deplase intraartiküler
kalkaneus kırıklarında konservatif ve cerrahi tedaviler arasında fonksiyonel
sonuçlar açısından herhangi bir fark olup olmadığını belirlemek.

Yöntemler: Çalışmamızda 2012-2014 yılları
arasında farklı merkezlerde konservatif ve cerrahi olarak tedavi edilmiş ve en
az 2 yıl takibi olan 27 (13 konservatif ve 14 cerrahi tedavi) kalkaneus kırıklı
hasta (22 erkek, 5 kadın) geriye dönük olarak incelendi. Hastaların fonksiyonel
sonuçları AOFAS skorlarına göre karşılaştırıldı.

Bulgular: Yaş ve cinsiyet açısından
gruplar arasında anlamlı fark olmadığını bulduk.(p>0,05). AOFAS skorları
konservatif tedavi uygulanan hastalarda 69,15 (56-82) ve cerrahi tedavi
uygulanan hastalarda 84,3 (56-96) puan idi. Her iki tedavi grubunun AOFAS
skorları karşılaştırıldığında (Mann Whitney-U Test) cerrahi tedavi uygulanan
grupta fonksiyonel sonuçların istatistiksel anlamlı olarak daha iyi olduğunu
bulduk. (p<0,05).

Sonuç: Çalışmamızdan literatürdeki
mevcut bilgileri destekleyecek şekilde çıkan sonuç,  cerrahi tedavilerin sonuçlarının özellikle
eklem içi kalkaneus kırıklarının tedavisinde, klinik ve fonksiyonel sonuçlar
açısından konservatif tedaviden daha etkin olduğudur.

Keywords

Kalkaneus, Cerrahi, Konservatif

References

• 1. Seyahi A, Uludag S, Koyuncu LO, Atalar AC, Demirhan M. [The calcaneal angles in the Turkish population]. Acta Orthop Traumatol Turc. 2009;43(5):406-11.
• 2. Asik M, Sen C. Surgical management of intraarticular fractures of the calcaneus. Arch Orthop Trauma Surg. 2002;122(6):354-9.
• 3. Clare MP, Sanders, R.W. Calcaneal Fractures. Fuss Sprungg 2007(5):58–73. 4. Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;(290):87-95.
• 5. Swanson SA, Clare MP, Sanders RW. Management of intra-articular fractures of the calcaneus. Foot Ankle Clin. 2008;13(4):659-78.
• 6. Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma. 1992;6(2):252-65.
• 7. Sanders R. Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 2000;82(2):225-50.
• 8. Kundel K, Funk E, Brutscher M, Bickel R. Calcaneal fractures: operative versus nonoperative treatment. J Trauma. 1996;41(5):839-45.
• 9. Kennedy JG, Jan WM, McGuinness AJ, Barry K, Curtin J, Cashman WF, Mullan GB. An outcomes assessment of intra-articular calcaneal fractures, using patient and physician's assessment profiles. Injury. 2003;34(12):932-6.
• 10. Buckley RE, Meek RN. Comparison of open versus closed reduction of intraarticular calcaneal fractures: a matched cohort in workmen. J Orthop Trauma. 1992;6(2):216-22.
• 11. Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, Galpin R. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84-A(10):1733-44.
• 12. Kitaoka HB, Schaap EJ, Chao EY, An KN. Displaced intra-articular fractures of the calcaneus treated non-operatively. Clinical results and analysis of motion and ground-reaction and temporal forces. J Bone Joint Surg Am. 1994;76(10):1531-40.
• 13. Randle JA, Kreder HJ, Stephen D, Williams J, Jaglal S, Hu R. Should calcaneal fractures be treated surgically? A meta-analysis. Clin Orthop Relat Res. 2000;(377):217-27.
• 14. Macey LR, Benirschke SK, Sangeorzan BJ, Hansen ST. Acute Calcaneal Fractures: Treatment Options and Results. J Am Acad Orthop Surg. 1994;2(1):36-43.
• 15. Clare MP, Lee WE, 3rd, Sanders RW. Intermediate to long-term results of a treatment protocol for calcaneal fracture malunions. J Bone Joint Surg Am. 2005;87(5):963-73.
• 16. Tennent TD, Calder PR, Salisbury RD, Allen PW, Eastwood DM. The operative management of displaced intra-articular fractures of the calcaneum: a two-centre study using a defined protocol. Injury. 2001;32(6):491-6.
• 17. O'Farrell DA, O'Byrne JM, McCabe JP, Stephens MM. Fractures of the os calcis: improved results with internal fixation. Injury 1993;24(4):263-5.
• 18. Thordarson DB, Krieger LE. Operative vs. nonoperative treatment of intra-articular fractures of the calcaneus: a prospective randomized trial. Foot Ankle Int. 1996;17(1):2-9.
• 19. Leung KS, Yuen KM, Chan WS. Operative treatment of displaced intra-articular fractures of the calcaneum. Medium-term results. J Bone Joint Surg Br.1993;75(2):196-201.
• 20. Melcher G, Degonda F, Leutenegger A, Ruedi T. Ten-year follow-up after operative treatment for intra-articular fractures of the calcaneus. J Trauma. 1995;38(5):713-6.
• 21. Myerson M, Quill GE, Jr. Late complications of fractures of the calcaneus. J Bone Joint Surg Am. 1993;75(3):331-41.
• 22. Aslan A, Atay T, Baykal YB, Baydar ML, Uysal E. Traumatic Posterior Tibial Tendon Rupture After Bimalleolar Fracture: Case Report and Review of the Literature. JEMCR 2011; 2(3): 23-25.
• 23. Atay T, Aksoy O, Aslan A. Kauda equina sendromlu çocukta kronik kalkaneal aktinomiçes osteomyeliti. Olgu sunumu. SDÜ Tıp Fak. Derg. 2008;15(3):34-37.