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Lateral bone flap approach for displaced intra‐articular calcaneus fractures
Author(s) -
Wang Shouli,
Zhou Xiaobo,
Liang Junbo,
Liu Fucun,
Wang Bin
Publication year - 2019
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15133
Subject(s) - medicine , calcaneus , soft tissue , surgery , reduction (mathematics) , heel , sural nerve , dissection (medical) , radiological weapon , fixation (population genetics) , calcaneal fracture , anatomy , population , geometry , mathematics , environmental health
Background The traditional extended lateral approach for calcaneus fractures can provide sufficient exposure for reduction, but complications are frequent. The minimally invasive approach does limited damage to the soft tissue and its complication rate is low, but provides limited surgical exposure for complicated fracture. Thus, an approach that could provide wide exposure with less soft tissue injury is important. Methods The lateral bone flap approach, we proposed, involved the same incision as the extended lateral approach. After incision, osteotomy was performed around the lateral bulged wall of the calcaneus without dissection of soft tissue. The lateral wall was free from calcaneus and connected with the soft tissue, and the lateral bone flap was developed. The reduction of fracture and the fixation of plate were performed as usual. Next, the bone flap was reduced and sutured. This retrospective study of lateral bone flap approach included 63 cases of 58 patients with displaced intra‐articular calcaneus fractures from January 2011 to January 2015. Clinical and radiological outcomes and complications were all recorded. Results Radiological outcome was significantly improved at 3 months and 2 years post‐operatively compared with that of pre‐operatively ( P < 0.01). The Maryland Foot Score at the last follow up was 87.2 ± 7.0. The excellent/good rate was 90.5%. One case of delayed wound healing occurred. No infection or sural nerve injury occurred. Conclusion The lateral bone flap approach is simple, safe and effective for displaced intra‐articular calcaneus.