Early Experience in the Management of Fractures of the Calcaneus by Ilizarov External Fixation
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- Category: Vol. 77, June 2009
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Early Experience in the Management of Fractures of the Calcaneus by Ilizarov External Fixation, SHERIF ABDELLATIF OSMAN
Abstract
Aim: The aim of this prospective clinical trial is to evaluate an alternative method for the treatment of intraarticular fractures of the calcaneus by open reduction and external fixation using Ilizarov external fixator.
Materials and Methods: In this study 15 cases (10 males and 5 females) of severely comminuted intraarticular calcaneal fractures were treated by open reduction and external fixation using Ilizarov external fixator. The age of the patients ranged between 14 and 38 years. Fall from a height was the causative trauma in all cases. Lateral approach was used for open reduction of the subtalar joint, image intensifier was used to evaluate the accuracy of reduction in lateral, antero-posterior and axial calcaneal views. A construct of 2 rings and a foot piece was applied. The duration of application of the fixator ranged from 8-12 weeks with a mean duration of 9.1 weeks.
Results: Union was achieved in all patients with congruent subtalar joint, length and height of the calcaneus maintained; following removal of the fixator 11 patients were able to bear weight without pain, 2 with mild pain that improved gradually within 3-4 weeks and 2 with moderate pain.
Conclusion: The versatility of the Ilizarov external fixator offers a rigid construct specially tailored for the fracture fragments that made fixation of severely comminuted intraar-ticular fractures of the calcaneus possible with better chances to reconstitute length, height and width of the calcaneus with congruent subtalar joint compared with standard techniques of ORIF and with fewer complications.