The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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The aim of the present study was to investigate the outcomes of surgical treatment of calcaneal fractures of Sanders type II and III using a minimally invasive technique and a locking plate. We reviewed 33 feet in 33 consecutive patients with Sanders type II and III calcaneal fractures who had undergone a minimally invasive technique using percutaneous reduction and locking plates. All operations were performed by the same surgeons. ⋯ Postoperative superficial infections occurred in 2 patients, subtalar arthritis developed in 2, and no soft tissue necrosis was observed. For Sanders type II and III fractures of the calcaneus bone, treatment with a minimally invasive technique combining percutaneous reduction and locking plate fixation provided satisfactory clinical results, with a lower incidence of complications. However, longer term studies with a larger sample size and more randomized controlled trials are required to define the superiority of our minimally invasive technique compared with conventional surgical treatment of calcaneal fractures.
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The present case report demonstrates a rare finding associated with irreducible ankle fracture dislocations. To our knowledge, posterior tibial tendon entrapment with an intact ankle mortise has not yet been documented in published studies. In the case of our patient, a high-energy, 12-ft fall resulted in a comminuted intra-articular fracture of the medial malleolus, confirmed by the initial radiographs. ⋯ The tendon was returned back to its anatomic position, and the tendon sheath was reapproximated. Although uncommon, it is important that entrapment of the posterior tibial tendon be considered in cases of irreducible ankle fracture. This injury type can be addressed during open reduction internal fixation to achieve reduction.
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Calcaneus fractures in children differ from those in adults. Most calcaneus fractures in children can be managed nonoperatively, with good long-term results expected. The width and height of the calcaneus can remodel with time in children. ⋯ Anatomic joint alignment was restored. The children were followed up until they had both resumed their full activities with no complications. We recommend this approach for operative treatment of displaced intra-articular fractures of the calcaneus, because it addresses the intra-articular displacement, which is the most important element of the deformity in children.
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The Minimally Invasive Reduction and Osteosynthesis System(®) (MIROS) is a percutaneous angle stable device for the treatment of fractures. The aim of the present study was to evaluate the clinical and radiographic results of an early minimally invasive osteosynthesis with the MIROS device. A total of 40 consecutive patients were treated for an intra-articular fracture of the calcaneus. ⋯ The MIROS device for early treatment of intra-articular calcaneus fractures resulted in excellent clinic and radiologic results. The standardized technique we have reported, with the elastic wires acting as a girder for the fractured and displace subtalar joint and the collapsed lateral calcaneal wall, has permitted early weightbearing with positive stimuli for the bone healing. The drainage effect of the percutaneous wires likely prevented compartment syndrome when applied within the first hours after the trauma.
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The talar neck is deviated medially with reference to the long axis of the body of the talus. In addition, it deviates plantarward. The talar neck fracture line is sometimes observed to be oriented obliquely (not perpendicular to the long axis of the talar neck). ⋯ Both screw heads should be countersunk. A series of 8 patients underwent this form of internal fixation for talar neck fracture repair, with satisfactory functional outcomes. In conclusion, the use of antegrade-retrograde opposing lag screws is a reasonable method of internal fixation for simple displaced talar neck fractures.