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- Talk
- 15/09/2021
- Canada
Calcaneus Fracture Fixation: Soft Tissue Complications With Minimally Invasive Versus Extensile Lateral Approaches
Description
This is a presentation given by Nebojsa Kuljic, a PGY 2 resident at the University of Saskatchewan, focusing on a study investigating calcaneus fracture fixation using the sinus tarsi approach. The introduction highlights that calcaneus fractures are the most frequently fractured tarsal bones, which can have significant detrimental effects on patients' lives. The presentation discusses the historical debates regarding treatment methods and compares traditional large incisions, which often result in soft tissue complications, to newer, less invasive approaches designed to minimize dissections and complications while ensuring effective joint reductions.
The limited sinus tarsi approach is presented as an innovative method under evaluation for its effectiveness in reducing calcaneus fractures. The study aimed to assess radiographic outcomes, particularly focusing on joint reduction, along with secondary clinical measures. Through hospital billing codes, cases from approximately three years were analyzed, with strict inclusion criteria emphasizing the availability of pre and post-operative imaging.
Findings from examining 50 patient charts showed that while some patients were excluded due to insufficient imaging data, the demographic details revealed an average age of 49 years with 80% being males, predominantly injured from falls. The presentation mentions the complexity of these fractures and how timely intervention at the center helps in achieving lower fixation complications compared to literature.
Radiographic evaluation indicated competency in restoring Bohler's angle and joint step deformities, highlighting the effectiveness of the sinus tarsi approach in surgical outcomes. The study found that although improvements were made in the measurements of fractures, the angle of Gissane showed less significant changes. Complications were primarily superficial infections, and reoperations were mostly for hardware removal rather than for addressing more complex issues such as arthritis.
The conclusion emphasizes the clinical relevance of the sinus tarsi approach as an effective treatment strategy with fewer complications, suggesting it as a suitable option for managing calcaneus fractures while noting the potential for post-traumatic arthritis as an inevitable long-term concern regardless of initial treatment. The presentation ends with thoughts on the benefits of avoiding additional morbidity through minimally invasive techniques.