J 2016

Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures

ZWIPP, Hans, Libor PAŠA, Luboš ŽILKA, Michael AMLANG, Stefan RAMMELT et. al.

Basic information

Original name

Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures

Authors

ZWIPP, Hans (276 Germany), Libor PAŠA (203 Czech Republic, guarantor, belonging to the institution), Luboš ŽILKA (203 Czech Republic), Michael AMLANG (203 Czech Republic), Stefan RAMMELT (276 Germany) and Martin POMPACH (203 Czech Republic)

Edition

Journal of Orthopaedic Trauma, Philadelphia, Lippincott Williams & Wilkins, 2016, 0890-5339

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30211 Orthopaedics

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.251

RIV identification code

RIV/00216224:14110/16:00090096

Organization unit

Faculty of Medicine

DOI

UT WoS

000371385200003

Keywords in English

sinus tarsi approach; arthroscopy; fluoroscopy; calcaneal fracture; locking calcaneal nail

Tags

Tags

International impact, Reviewed
Změněno: 4/8/2016 08:53, Ing. Mgr. Věra Pospíšilíková

Abstract

V originále

Objectives: To reduce the complication rate associated with open reduction and internal fixation of displaced intraarticular calcaneal fractures through extensile approaches, a locking nail system (C-Nail) was developed for internal fixation. Design: Prospective case–control study. Setting: Two level I trauma centers (university hospital) and 1 large regional hospital in the Czech Republic and Germany. Patients: One hundred three patients (89 male and 14 female; mean age, 45.6 years) with 106 calcaneal fractures were treated between February 2011 and October 2013. Intervention: In all 106 cases, the stainless steel C-Nail with a length of 65 mm, a diameter of 8 mm, and 7 locking options was used for internal fixation. Previous reduction of the posterior facet was performed in 15 cases percutaneously, assisted by arthroscopy and fluoroscopy, and in 91 cases by a sinus tarsi approach. The reduced joint surface was fixed by 1 or 2 compression screws. All other fragments were fixed after reduction and temporary K-wire fixation with the C-Nail introduced percutaneously through the tuberosity and 5 to 6 interlocking screws. The latter were introduced into the sustentacular, the tuberosity, and the anterior process fragments with an aiming device consisting of 3 arms. Main Outcome Measures: Patients were assessed for complications, restoration of Böhler angle, posterior facet reduction with postoperative computed tomography, and weight-bearing radiographs at 6 months. Functional outcome was assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot scale after 6 and 12 months for all patients. Results: Wound edge necrosis was seen in 2 cases (1.9%), and soft tissue infection was observed in 1 case (0.9%). Böhler angle improved from 7.3 degree preoperatively to 28.7 degree at 6 months. The posterior facet step-off was reduced from 5.3 mm preoperatively to 0.7 mm postoperatively. The average AOFAS score averaged 89.5 at 6-month and 92.6 at 12-month follow-up. Conclusions: The C-Nail is a new locking system for treatment of displaced intraarticular calcaneal fractures combining a primary stability with reduced soft tissue complications.