. - p. 23-30
Titre : | Outcome evaluation of minimally invasive surgery versus extensile lateral approach in management of displaced intra-articular calcaneal fractures : a randomised control trial |
Type de document : | article de périodique |
Auteurs : | Rakesh John, Auteur ; [et al.], Auteur |
Année de publication : | 2017 |
Article en page(s) : | p. 23-30 |
Langues : | Anglais (eng) |
Descripteurs (mots clés) : | [Thésaurus Mesh]Interventions chirurgicales mini-invasives
|
Mots-clés : | Displaced intra-articular calcaneal fractures DIACFs Calcaneum fracture American Orthopaedic Foot and Ankle Score AOFAS Minimally invasive surgery MIS Extensile lateral approach |
Résumé : | Background: Minimally invasive surgery has a significant and evolving role in the treatment of DIACFs, but there is limited literature on this topic. Objectives: To compare the clinico-radiological outcomes of DIACFs fixed with MIS technique with ORIF. Methods: This randomised control trial (RCT) included 21 closed Sanders type 2 and 3 DIACFs which were selected from 70 who presented. Extensile lateral approach was used in the ORIF group; while MIS techniques included either percutaneous reduction or small incisions with indirect fragment manipulation. Main Outcome Measurement: AOFAS hindfoot score, pre-operative and postoperative radiology. Results: There were 9 fractures in the Extensile group and 12 in the MIS group, with both groups having comparable demography, fracture classification, surgery delay & initial radiology. Bohler s angle improved after surgery by an average of 18.44 with ORIF and 14.67 with MIS (p = 0.28). Mean AOFAS in the MIS group was 82.58 (66.67% good and 33.33% fair) and was 89.56 (44.44% excellent, 55.56% good, 0 fair/poor) with ORIF (p = 0.034). Two patients who underwent ORIF had a major complication (one deep infection and Sural nerve injury each) while none in the MIS group. Conclusions: MIS methods minimized soft tissue complications and achieved comparable radiological reductions but clinical outcomes were poorer, with percutaneous methods having the worst outcomes. |
Permalink : | https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= |