$Complications following the extended lateral approach for calcaneal fractures do not influence mid- to long-term outcome$
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Complications following the extended lateral approach for calcaneal fractures do not influence mid- to long-term outcome

Abstract Background and aim 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 t...

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Bibliographic Details
Published in:	Injury Vol. 44; no. 11; pp. 1596 - 1600
Main Authors:	De Groot, R, Frima, A.J, Schepers, T, Roerdink, W.H
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-11-2013
Subjects:	Adult Aged Calcaneal Calcaneus Calcaneus - diagnostic imaging Calcaneus - injuries Calcaneus - surgery Female Follow-Up Studies Fracture Fixation, Internal Fracture Healing Fractures, Bone - complications Fractures, Bone - diagnostic imaging Fractures, Bone - physiopathology Humans Intra-articular fracture Intra-Articular Fractures - complications Intra-Articular Fractures - diagnostic imaging Intra-Articular Fractures - physiopathology Male Middle Aged Open reduction internal fixation Orthopedics Os calcis Patient Satisfaction Postoperative Complications - diagnostic imaging Postoperative Complications - physiopathology Range of Motion, Articular Recovery of Function Retrospective Studies Time Factors Tomography, X-Ray Computed Treatment Outcome Visual Analog Scale Weight-Bearing Calcaneal Open reduction internal fixation Intra-articular fracture Os calcis Calcaneus
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Summary:	Abstract Background and aim 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. Methods 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. Results 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). Conclusion 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0020-1383 1879-0267
DOI:	10.1016/j.injury.2013.06.014