Radiographic Analysis of Intra-articular Fractures of the Calcaneus in patients undergoing Minimally Invasive Surgical Treatment in a Tertiary Hospital

Félix, Glauter Carlos; Matias, Marcelo Silveira; Lira, Réjelos Charles Aguiar; Matias, Nelson Silveira; Sousa, Clodoaldo José Duarte de; Pinto Neto, Luiz Holanda

doi:10.1055/s-0039-1700824

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Original Articles, Foot • Rev. bras. ortop. 55 (2) • Mar-Apr 2020 • https://doi.org/10.1055/s-0039-1700824 copy

Radiographic Analysis of Intra-articular Fractures of the Calcaneus in patients undergoing Minimally Invasive Surgical Treatment in a Tertiary Hospital^* * Study performed at the Orthopedics and Traumatology Service, Instituto Doutor José Frota, Fortaleza, Ceará, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

This paper aims to evaluate patients with articular calcaneal fractures treated with a minimally invasive surgical technique between January 2015 and August 2016, with emphasis on radiographic results.

Methods

Retrospective study of 49 patients with 64 displaced calcaneal fractures treated with open reduction by minimal lateral access to the subtalar joint and minimal fixation. Pre- and postoperative radiographic studies were performed to measure the angles of Böhler and Gissane.

Results

The average angle of Böhler before surgery was 2.5º, increasing to an average value of 25.3º after the minimally invasive surgical treatment. The average angle of Gissane before surgery was 136.3º, decreasing to an average value of 114.3º after the procedure.

Conclusion

The minimally invasive surgical technique improves the radiographic parameters of intra-articular calcaneal fractures, with appropriate anatomical restoration of anatomical shape.

Keywords
calcaneus; minor surgical procedures; radiography

Patient	Foot	Age	Gender	Trauma mechanism	Height (m)	Work-related accident	Fracture	Preoperative Böhler angle (degrees)	Postoperative Böhler angle (degrees)	Preoperative Gissane angle (degrees)	Postoperative Gissane angle (degrees)
1	R	29	m	Traffic accident		No	Closed	-10	26	120	120
*1^ * contralateral fracture at the same patient.**	L						Closed	2	28	118	116
2	L	35	m	Fall	6	No	Closed	22	24	146	140
*2^ * contralateral fracture at the same patient.**	R						Closed	10	20	140	129
3	L	52	m	Fall	4	No	Closed	-10	5	116	114
4	R	35	m	Fall	2.5	No	Closed	-5	26	150	118
*4^ * contralateral fracture at the same patient.**	L						Closed	8	22	142	126
5	R	16	m	Fall	5	No	Closed	10	46	146	116
*5^ * contralateral fracture at the same patient.**	L						Closed	20	35	138	122
6	R	45	m	Fall	4	No	Closed	0	20	146	124
7	R	36	m	Fall	4	Yes	Closed	0	26	140	110
*7^ * contralateral fracture at the same patient.**	L						Closed	5	20	145	112
8	R	40	m	Fall	3	Yes	Closed	0	18	144	100
9	L	26	m	Fall	16	Yes	Closed	0	22	152	124
10	R	55	m	Fall	3	Yes	Closed	0	20	140	112
11	L	65	m	Fall	4	No	Closed	-12	22	140	108
*11^ * contralateral fracture at the same patient.**	R						Closed	4	30	138	118
12	L	31	m	Fall	5	Yes	Closed	0	24	150	114
13	L	47	m	Fall	7	Yes	Closed	2	28	142	124
*13^ * contralateral fracture at the same patient.**	R						Closed	5	24	132	115
14	L	54	m	Fall	2	Yes	Closed	12	20	56	110
15	R	19	m	Fall	14	No	Closed	0	22	146	122
*15^ * contralateral fracture at the same patient.**	L						Closed	10	29	132	115
16	R	30	m	Traffic accident		No	Open	0	24	148	110
17	R	40	m	Fall	3	Yes	Closed	10	28	128	106
18	R	35	m	Fall	3.5	Yes	Closed	12	38	140	135
*18^ * contralateral fracture at the same patient.**	L					No	Closed	14	54	138	115
19	R	30	m	Traffic accident		No	Closed	0	24	100	110
20	R	52	m	Fall	2	No	Closed	16	24	138	104
21	R	58	m	Fall	15	Yes	Closed	8	26	136	124
*21^ * contralateral fracture at the same patient.**	L						Closed	10	29	140	126
22	R	35	f	Traffic accident		No	Open	-6	20	128	114
23	R	45	m	Gunshot wound		No	Open	-12	2	120	118
24	L	44	m	Fall	3	No	Closed	-10	12	130	120
25	R	26	m	Fall	2	Yes	Closed	30	30	158	118
26	R	33	m	Fall	2	Yes	Closed	-10	30	140	124
27	L	37	m	Fall	3	Yes	Closed	-12	28	44	108
28	L	48	f	Gunshot wound		No	Open	6	20	128	114
29	L	35	m	Fall	2	Yes	Closed	-8	34	138	110
30	R	57	m	Fall	3	No	Closed	12	22	156	120
31	L	37	m	Fall	3	No	Closed	0	26	158	106
32	L	44	m	Fall	4	Yes	Closed	-2	26	138	112
*32^ * contralateral fracture at the same patient.**	R						Closed	5	24	132	114
33	L	37	f	Traffic accident		No	Closed	0	22	148	122
34	R	13	m	Fall	3	No	Closed	-2	20	156	130
35	R	34	m	Fall	4	No	Closed	4	22	148	116
36	R	32	m	Traffic accident		No	Closed	6	24	142	128
*36^ * contralateral fracture at the same patient.**	L						Closed	14	30	124	108
37	L	67	m	Fall	3	No	Closed	10	28	156	120
38	R	24	m	Fall	4	No	Closed	2	22	154	130
39	L	70	m	Traffic accident		No	Closed	12	22	130	118
40	R	52	m	Fall	4	No	Closed	0	20	112	108
*40^ * contralateral fracture at the same patient.**	L						Closed	-22	12	152	118
41	R	59	f	Fall	3	No	Closed	-8	32	170	116
42	L	49	m	Fall	3	No	Closed	14	38	146	108
43	L	58	f	Fall	4	No	Closed	6	14	152	122
44	R	26	m	Fall	4	Yes	Closed	6	30	140	108
*44^ * contralateral fracture at the same patient.**	L							0	26	148	112
45	R	16	m	Gunshot wound		No	Open	10	36	120	120
46	L		m	Traffic accident		No	Open	4	30	110	118
47	R	26	m	Traffic accident		No	Closed	-2	42	142	108
48	R	29	m	Traffic accident		No	Closed	0	20	138	102
49	R	29	m	Fall	4	No	Closed	0	24	140	102
*49^ * contralateral fracture at the same patient.**	L						Closed	4	22	138	112

	Preoperative (standard deviation)	Postoperative (standard deviation)	p-value^* * t-test.
Böhler angle, average value	2.5º (9.5)	25.3º (8.6)	< 0.001
Gissane angle, average value	136.3º (21.3)	114.3º (8.2)	< 0.001

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Réjelos Charles Aguiar Lira, MD, Instituto Dr José Frota, Rua Barão do Rio Branco, 1816, Centro, Fortaleza, CE, 60025-061, Brasil (e-mail: rejeloscharles@hotmail.com).

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Radiographic Analysis of Intra-articular Fractures of the Calcaneus in patients undergoing Minimally Invasive Surgical Treatment in a Tertiary Hospital* * Study performed at the Orthopedics and Traumatology Service, Instituto Doutor José Frota, Fortaleza, Ceará, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Radiographic Analysis of Intra-articular Fractures of the Calcaneus in patients undergoing Minimally Invasive Surgical Treatment in a Tertiary Hospital^* * Study performed at the Orthopedics and Traumatology Service, Instituto Doutor José Frota, Fortaleza, Ceará, Brazil.