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- Talk
- 15/09/2021
- Canada
Soft Tissue Complications: Extensile Lateral vs MIS Calcaneus ORIF
Description
In this presentation, Gabriel Larose discusses the complications associated with soft tissue following two different surgical techniques for calcaneus fractures: the extensile lateral approach and minimally invasive surgery (MIS). He begins by thanking his co-authors and clarifying that there are no significant disclosures related to their work. Larose shares findings from multiple RCTs which indicate that while open reduction and internal fixation (ORIF) shows no short-term benefits, it does lead to improved long-term outcomes. However, it also comes with a higher risk of surgical complications, particularly soft tissue issues, with rates as high as 25% noted with the extensile lateral approach as opposed to lower rates with MIS, though the latter findings come from smaller studies.
This research is touted as the largest comparative study between these techniques, utilizing a prospective trauma database to collect patient demographics, comorbidities, and the nature of any soft tissue complications requiring treatment. The surgical approach was left to the discretion of the surgeons, leading to descriptive and statistical analyses of the data collected.
Key results revealed statistically significant differences in complication rates at both two and six weeks post-surgery, with the extensile lateral approach showing higher incidences of complications necessitating medical and surgical intervention. Logistic regression analyses confirmed that the extensile lateral approach and open fractures significantly predict increased risks of soft tissue complications. Larose emphasizes the longer time to surgery and operative time associated with the extensile approach as well.
The presentation concludes with a call for further research to better assess the functional outcomes between these surgical techniques, highlighting the extensile lateral approach and open fractures as the primary predictors of soft tissue complications.