A novel minimally invasive percutaneous treatment for Essex-Lopresti joint depression-type DIACFs by ligamentotaxis

作者全名："Chen, Zhiguo; Fan, Chongyin; Zhang, Jinsong; Zhao, Chen; Du, Xin; Huang, Wei; Ni, Weidong; Luo, Gang"

作者地址："[Chen, Zhiguo; Fan, Chongyin; Zhang, Jinsong; Zhao, Chen; Du, Xin; Huang, Wei; Ni, Weidong; Luo, Gang] Chongqing Med Univ, Affiliated Hosp 1, Dept Orthoped, Orthoped Lab, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Luo, G (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Orthoped, Orthoped Lab, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：BMC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000899965400001

JCR分区：Q2

影响因子：1.9

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Calcaneus; Intra-articular fracture; Minimally invasive; Percutaneous fixation

摘要："Objective: To compare the clinical efficacy of minimally invasive percutaneous treatment by ligamentotaxis with traditional open reduction and internal fixation in the treatment of Essex-Lopresti joint depression-type displaced intra-articular calcaneal fractures (DIACFs).Methods: The medical records of patients with calcaneal fractures admitted to our department from January 2016 to December 2020 were retrospectively analyzed, and patients who met the inclusion criteria were finally included for analysis. Twenty-one patients underwent minimally invasive percutaneous treatment by ligamentotaxis (Group A), while eighteen patients were treated by traditional open reduction and internal fixation through an extended lateral approach (Group B). The preoperative waiting time, operative time, hospital stay, radiologic parameters (calcaneal height, width, length, Bohler angle and Gissane angle), American Foot and Ankle Surgery Association (AOFAS) hind-foot scores, Maryland Foot Score (MFS), visual analogue scale (VAS), and incidence of complications of the included patients were all recorded and analysed.Results: Thirty-nine patients with Essex-Lopresti joint depression type DIACFs were finally included. According to the Sanders classification, 22 were type II, 12 were type III and 5 were type IV. The preoperative waiting time and the hospital stay of Group A were 3.7 +/- 1.6 d and 7.2 +/- 1.7 d, respectively, which were significantly shorter than those of Group B (6.9 +/- 2.0 d and 12.4 +/- 1.5 d) (P < 0.05). There was no significant difference in the operative time between the two groups (88.8 +/- 9.8 min vs. 91.3 +/- 12.1 min; P > 0.05). No significant differences were shown in the radiological parameters (calcaneal height, width, length, Bohler angle and Gissane angle) or the satisfactory rate of joint surface reduction (SRJSR) of the two groups immediately postoperatively. All patients were followed up for 14 to 56 months [(30.2 +/- 10.4) months]. All fractures healed. At the final follow-up, there were no significant differences in the radiological parameters or the SRJSR between the two groups (P > 0.05). No significant differences were shown in the AOFAS scores, MFS or VAS scores between the two groups [(89.5 +/- 8.2) vs. (89.4 +/- 9.0), P > 0.05; (87.5 +/- 8.3) vs. (86.3 +/- 8.9), P > 0.05; and (2.1 +/- 1.2) vs. (2.2 +/- 1.2), P > 0.05]. The excellent and good rates of the AOFAS scores and MFS were 90.5% and 85.7%, respectively, in Group A and 88.9% and 88.9%, respectively, in Group B (P > 0.05). Four patients experienced wound complications, including 1 superficial incision infection, 2 skin necrosis around the incision edge and 1 deep infection in Group B, while there were no wound complications in Group A (P < 0.05). One patient in each group suffered traumatic arthritis (P > 0.05).Conclusions: In the assessment of Essex-Lopresti joint depression type DIACFs, minimally invasive percutaneous treatment by ligamentotaxis has similar clinical outcomes to traditional open reduction and internal fixation through an extended lateral approach. However, the former has the advantages of shorter preoperative waiting time and hospital stay, and lower incidence of incision complications."

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