[Intra-articular fracture of the calcaneus. Classification, assessment and surgical procedures].
Our experience with open reduction of calcaneus fractures and internal stabilization without joint transfixation (n = 83) has shown us that the following features are mandatory in order to obtain normal postoperative foot statics and dynamics, normal joint mobility, and normal foot function: (1) restoration of the normal height, length and width of the calcaneus; (2) reduction of all joint surfaces and (3) stable screw- or H-plate osteosynthesis, allowing functional treatment later. Our own fracture classification (X-fragment/Y-joint fracture) allowed us to determine the type of fracture, its severity, and the prognosis, as well as the choice of operative treatment. A detailed +/- 200-point follow-up scoring system assured operative quality control and comparability of results. The complications were: 9 cases of superficial wound-edge necrosis (8%), 2 hematomas requiring revision, and 1 deep bone infection (1.2%). During our first operative period (1983-1985, mostly unilateral medial approach and trans-articular K-wire fixation), we had only 50% good-to-excellent results. During the second period (1986-1988, bilateral, extended lateral approach and stable screw/H-plate osteosynthesis), 76.5% (29 of 51 patients) had good-to-excellent results. Our experience thus indicates that our operative treatment principles can be recommended for patients who are either professionally active or active in sports.
Zwipp
H
H
Tscherne
H
H
Wülker
N
N
Grote
R
R
D016512:Ankle Injuries; D002111:Calcaneus / Q000293:injuries*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology
Der intraartikuläre Fersebeinbruch. Klassifikation, Bewertung und Operationstaktik.