Validity of percutaneous external fixator for calcaneal fractures to allow early weight bearing

Marimuthu Sivagnanam, Surendhar Rathinasamy, R. Selvaraj, Anbuvigneshwaran Balakumaran
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Abstract

Calcaneum, the most common tarsal bone to fracture affecting manual labourers who were sole breadwinners of the family. Generally treated with below knee pop and ORIF, commonly associated with complications and delayed weight bearing. This study analyses functional outcome of early weight bearing with minimally invasive skeletal stabilisation of calcaneal fractures.This study was conducted at Institute of orthopaedics and traumatology, Coimbatore medical college and Meenakshi medical college hospital and research institute, Kanchipuram between July 2019 to October 2021. 15 patients in age group 20-65 years with 19 calcaneal fractures less than 4 weeks duration are included in study.Surgery averaged 1.6 days after injury. Full weight-bearing was achieved in 11.7 days for unilateral calcaneal fractures (range 9 to 15 days) and 43.5 days for bilateral fractures (40 to 49 days). Patients returned to work in 35.6 days on average (range 24 to 52 days). All 19 calcaneal fractures healed in 52.63 days. External fixator removal averaged 56.57 days. Two patients had postoperative pin site infections. No bones were infected. Six-month AOFAS scores averaged 86.15.In our study calcaneal fractures are fixed with mini external fixator percutaneously and it can be used in presence of compound fractures and with skin blisters. Though anatomical reduction cannot be attained completely weight bearing is possible from 2nd day after surgery and full weight bearing was possible in 2nd week. The limitations of our study include a smaller number of cases. A large multi-centric study may be necessary to confirm our results.
经皮外固定架治疗跟骨骨折早期负重的有效性
跟骨,最常见的跗骨骨折影响体力劳动者谁是唯一的经济支柱的家庭。通常采用膝下穿刺和ORIF治疗,通常伴有并发症和延迟负重。本研究分析了早期负重与微创骨稳定治疗跟骨骨折的功能结果。该研究于2019年7月至2021年10月在哥印拜陀医学院和米纳克什医学院医院和坎奇普兰研究所的骨科和创伤学研究所进行。研究对象为15例年龄在20 ~ 65岁的患者,其中19例跟骨骨折持续时间小于4周。手术后平均1.6天。单侧跟骨骨折(9 - 15天)11.7天达到完全负重,双侧骨折(40 - 49天)43.5天达到完全负重。患者平均在35.6天(24 ~ 52天)恢复工作。19例跟骨骨折均在52.63 d内愈合。取出外固定架平均56.57天。2例患者术后发生针部感染。没有骨头被感染。六个月AOFAS平均得分为86.15分。在我们的研究中,微型外固定架经皮固定跟骨骨折,它可以用于存在复合骨折和皮肤水泡。虽然解剖复位不能达到完全负重,但术后第2天可以完全负重,第2周可以完全负重。本研究的局限性包括病例数量较少。可能需要一项大型多中心研究来证实我们的结果。
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