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- Talk
- 29/09/2024
- UK
Calcaneum Fracture Management - An Experience from a Large Major Trauma Centre
Description
In this presentation, Ben Gabbott provides an overview of calcaneal fractures, highlighting their severity and the challenges associated with surgical management. The talk begins with a definition of calcaneal fractures as serious injuries typically caused by high-energy axial loads, leading to joint depression, widening, and shortening of the calcaneus. Mr Gabbott discusses the surgical objective of restoring the natural anatomy, even though it carries a significant risk of complications, thus posing difficulties for foot and ankle trauma surgeons.
He explains a retrospective cohort study aimed at identifying radiological characteristics linked to operative management and the potential predictors of complications. The study involved analyzing routine NHS data from outpatient records over three years, focusing on adult patients with calcaneal fractures.
Findings reveal that of 170 fractures analyzed, 64 were surgically managed, with a demographic predominance among males at a mean age of 50. The speaker points out notable associated injuries, particularly ipsilateral foot fractures, indicating a need for comprehensive imaging in clinical evaluations.
The study assessed Bohler's angle and the Sanders classification as radiological markers, concluding that no single marker reliably predicts the need for surgery or the complication risk. Furthermore, open injuries and smoking status were highlighted as significant risk factors. The overall complication rate for treated fractures was reported at 18.5%, aligning with existing literature.
Concluding remarks emphasize the higher incidence of mid- and forefoot fractures discovered incidentally during the study, leading to recommendations for routine CT scans in calcaneal fractures workups. The presentation summarizes the limitations of the study, notably underpowering, and suggests future directions focusing on other radiological markers and long-term patient outcomes.