Displaced intra-articular calcaneal fractures: is there a consensus on treatment in Germany?
Introduction: Open reduction in displaced intra-articular calcaneal fractures entails a high rate of wound healing deficits and infections as well as an uncertain outcome, which leads to remaining ambiguity in treatment preferences.Methods: Between January and July 2011, we emailed 575 German chairp...
| Publicado en: | International Orthopaedics Vol. 40; no. 10; pp. 2181 - 2191 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Oct2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118509111&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118509111 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03412695 NQZ jtl: International Orthopaedics issn: 03412695 maglogo: N pubinfo: dt: Oct2016 vid: 40 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 118509111 118509111 NLM26899483 10.1007/s00264-016-3134-2 NLM26899483 118509111 ppf: 2181 ppct: 10 formats: tig: atl: Displaced intra-articular calcaneal fractures: is there a consensus on treatment in Germany? aug: au: Pastor, Tatjana Gradl, Gertraud Klos, Kajetan Ganse, Bergita Horst, Klemens Andruszkow, Hagen Hildebrand, Frank Pape, Hans-Christoph Knobe, Matthias affil: Department of Orthopaedic Trauma , University of Aachen Medical Center, RWTH Aachen University , 30 Pauwelsstreet 52074 Aachen Germany sug: subj: Fractures Surgery Fracture Fixation Methods Calcaneus Injuries Female Consensus Germany Internet Adult Surveys Orthopedic Fixation Devices Male Questionnaires Adult: 19-44 years Female Male ab: Introduction: Open reduction in displaced intra-articular calcaneal fractures entails a high rate of wound healing deficits and infections as well as an uncertain outcome, which leads to remaining ambiguity in treatment preferences.Methods: Between January and July 2011, we emailed 575 German chairpersons of trauma and/or orthopaedic departments, asking them to complete a 31-question web-based survey regarding three broad domains: fracture classification, surgical treatment algorithms and risk factors for wound healing deficits.Results: The response rate was 47 %. With an incidence of 77 %, open reduction via an extended lateral approach and plate fixation was the main treatment option for displaced intra-articular fractures of the joint-depression-type (Sanders II or III). Percutaneous techniques were only preferred in individual cases, with mainly precarious wound situations (59 %) as well as in patients with a reduced general health condition (ASA 3 and 4; 41 %). The re-operation rate due to infections and wound healing deficits after an extended lateral approach was reported with a percentage of 0-5 % by 88 % of the respondents. Participants stated that especially a poor microcirculation of the foot, disregard of soft tissue conserving techniques, overall condition of the patient, smoking, long time-to-surgery and operation time are the main reasons for wound healing deficits.Conclusion: Given the extended lateral approach as the preferred treatment option, we found minimally invasive techniques and primary arthrodesis of the lower ankle joint play a minor role in treating intra-articular calcaneal fractures in Germany. Ninety percent of our respondents stated less than 5 % of patients required re-operations due to infections and wound healing deficits. Level of Evidence Level V, expert opinion. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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