Issue: July 2011
July 01, 2011
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Most patients report good or excellent results with MIS for calcaneal fractures

Tomesen T, et al. J Bone Joint Surg Am. 2011. doi:10.2106/JBJS.H.01834

Issue: July 2011
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The minimally invasive Forgon and Zadravecz technique may be a viable option for the treatment of intra-articular calcaneal fractures, according to Dutch researchers.

Tomesen and his team performed a retrospective study of 39 displaced intra-articular calcaneal fractures treated with the Forgon and Zadravecz technique, finding the technique to be an “excellent option for the treatment … despite the frequent need for screw removal following fracture healing.”

Five patients (13%) developed infection, 17 patients (46%) required a second procedure to remove the screw due to pain, and two patients had pain because of subtalar arthritis. Additionally, one patient developed type 1 complex regional pain syndrome, four patients had transient neurological disorders, and two patients developed hammertoe deformities.

The Bohler angle of the lateral radiographs improved from a mean of 3.4° preoperatively to a mean of 21.8° postoperatively, and a mean of 20.1° was measured at the final follow-up of 66 months. Furthermore, the calcaneal height increased to 49.9 mm and length increases were both 102% of the normal.

Functional outcome assessments were filled out by patients to measure their satisfaction, pain, disability and need to wear orthotic devices. Seventy-three percent of patients reported good or excellent results on the American Orthopaedic Foot and Ankle Society questionnaire. Twenty-two (59%) of the patients reported no pain, while three patients (8%) had severe pain with limitations to daily tasks. Twenty-six patients (70%) were able to return to their normal level of work. Twenty-nine patients (78%) were able to wear normal shoes after the surgery, while six patients (16%) used shoes with orthotic devices, and two had custom-made orthopedic shoes.