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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia del Piede 2013 April;37(1):1-8
Open osteosynthesis of calcaneus fractures: which are the means?
Daghino W. 1, Testa D. 2, Matteotti R. 2, Guidi P. 1, Cerlon R. 3, Battiston B. 1
1 U.O.C. Traumatologia, Dipartimento di Ortopedia e Traumatologia, ASO CTO-Maria Adelaide, Torino, Italia;
2 Scuola di Specializzazione in Ortopedia e Traumatologia, Università degli Studi di Torino, Torino, Italia;
3 U.O.C. Clinica Ortopedica II, Dipartimento di Ortopedia e Traumatologia, ASO CTO-Maria Adelaide, Torino, Italia
Aim: The internal osteosynthesis of calcaneus fractures is implemented by pursuing the principle of anatomic reduction and stable synthesis, in order to obtain a cure with restoration morphological and biomechanical structures damaged while enabling early mobilization of articular structures. Aim of the work was to assess the resources currently available to the surgeon in light of their claims, the advantages and disadvantages in the use and its economic cost.
Methods: The implants and materials used in the surgical synthesis of 85 calcaneus fractures between January 2003 and December 2010 at UOC of Traumatology, Department of Orthopedics and Traumatology of the ASO CTO/ Maria Adelaide in Turin have been assessed and a systematic analysis of the results obtained by entering key words as “rearfoot”, “surgery”, “calcaneus” and “osteosynthesis” by the Internet search engines “PubMed” and “Google” was conducted.
Results: Implants and materials now available are Kirschner wires, free screws, systems of plates and screws, rods and screws in PLLA and injectable bone substitutes.
Conclusion: A stable osteosynthesis is the most important condition for avoiding to employ bone grafts, thus reducing the time for surgery and consequently the risk of infection. Plate and screws, especially most recent locking plate, is the golden standard to obtain a good stability in ORIF of articular fractures. Other implants have to be used in well-encoded cases, and the choice of the implant is based not only on the type of lesion but also on the inherent technical characteristics.