Evaluation of the functional outcome of displaced intraarticular calcaneal fractures Management surgically with locking plate fixation

2025-01-15T12:11:45+0530

Introduction: Intra-articular fractures account for 70% of all calcaneal fractures. They are the most challenging and outcomes are unpredictable. There is no consensus between surgical and conservative treatment in terms of outcomes. Due to difficult terrain and frequent motor vehicle accidents in this area, the calcaneal fracture is the most common tarsal bone fracture managed at our center. We are managing these injuries by both operative and non-operative methods. To evaluate the functional and radiological outcome of intraarticular calcaneal fractures managed surgically with a plate in terms of bohler’s and gissane’s angle, rate of radiological union and AOFAS score.

Methods: The Prospective study was conducted for the period of two years and a total of 100 patients with intra-articular calcaneal fractures who met the inclusion criteria were admitted, underwent necessary examinations, and were assessed for surgical suitability. Swelling was reduced by using a below knee slab with cotton padding, elevating the leg, and using an ice pack. Pre-operative x-rays of the lateral and axial views of the calcaneum, together with a CT scan of the calcaneum, were taken for pre-operative planning. Bohler’s and Gissane’s angles were measured pre-operatively.

Results: Patients aged 18–60 with a mean age of 34.38 years were included in our research. The research included 88% male patients. This research found 64% right side engagement and 36% left side involvement. Falling from height caused the greatest injuries in the research group, followed by RTA. Our investigation found Sander's type II fractures most prevalent, followed by type IV. Type III was rarest. In all research participants, surgery was postponed until skin wrinkles appeared to prevent wound dehiscence and ensure proper wound closure. From injury until surgery, it took 4–14 days, averaging 7.8. Radiological union averaged 13.64 weeks in the research group. Difference between pre- and post-op mean Gissane's angle was significant (p< 0.01).

Conclusion: Proper pre-operative planning, scheduling of surgery, surgeon's skill during the operation, and post-operative care are crucial factors for achieving successful surgical treatment of intra-articular fractures with a locking plate, resulting in improved outcomes and fewer problems.

Treatment in proximal tibial fractures is to obtain early union of Minimally invasive percutaneous plate osteosynthesis technique

2025-01-15T12:08:59+0530

Introduction: Treatment options in proximal tibia fractures vary from closed reduction, cast immobilization, nailing to open reduction and internal fixation with plating. We conducted a study on management of these fractures by using minimally invasive plate osteosynthesis (MIPO) technique. Methods: This study was conducted in the Department of Orthopaedic Surgery BSMMU from January 2023 to February 2024. This was study a prospective study where 60 patients with proximal tibia fractures were enrolled. Results: Mean age of patients was 47.23 years (range 20-70 years). The enrolled patients were evaluated from the emergency department. The mean operative time was 49.57 minutes. Mean time for radiological union was 15.6 weeks. Superficial wound infection was found in 10 (16.67%) patients, which resolved with daily dressings and antibiotics. Delayed union occurred in 6 (10%) of patients and nonunion in 2 (3.33%) patients. Wound necrosis found in 4 (4%) patients. Conclusion: Minimally invasive plate osteosynthesis (MIPO) technique in the treatment of proximal tibia fractures gives stable as well as optimal internal fixation and complete recovery of limb function at an early stage with minimal risk of complications.

Surgical Review: International Journal of Surgery, Trauma and Orthopedics

Evaluation of the functional outcome of displaced intraarticular calcaneal fractures Management surgically with locking plate fixation

Treatment in proximal tibial fractures is to obtain early union of Minimally invasive percutaneous plate osteosynthesis technique