Bone Grafting in Surgical Management of Intraarticular Impressional Calcaneal Fractures
DOI: 10.22138/2500-0918-2017-14-2-123-130
M. V. Gilev, E. A. Volokitina, Y. V. Antoniadi, S. M. Kutepov
Ural State Medical University, Yekaterinburg, Russian Federation
Abstract: up to 92% of calcaneus fractures are accompanied by impressive elegance of bone tissue, leading to a structural defect. Surgical treatment is to open reduction and bone grafting; stabilization is achieved by plates. The aim of the study was to analyze the results of surgical treatment of intraarticular impression fractures of the calcaneus with the use of autostylicity and b-tricalcium phosphate. Materials and methods. Retrospective analysis of surgical treatment of 41 patients for the period 2010–2014 years was done. Inclusion criteria were: bone grafting with autologous iliac crest or b-threecalcium phosphate (bTCP); postoperative monitoring period up to 36 months. To assess the effectiveness of the proposed bone grafting two groups were created: basic, N = 20 and control, N = 21. In the basic bTCP was applied. In the control group the IC was applied. The x-ray, clinical and statistical methods of research were used. To evaluate fracture reduction dynamic the difference of posterior calcaneus articular facet’s angle (?Gissane angle, ?G) after surgery and at the desired timing was monitored. Results. In overall performance, in the 36 post operation ?G in the range from 1 to 5 degrees was observed at 71.4 % in control group; main — 70 %. The unsatisfactory results equally often were observed in the two groups. Bone grafting of intraarticular calcaneal impressional fractures with bTCP, along with IC transplant, is an effective way in the surgical treatment of intraarticular fractures. Application of synthetic composite materials in bone surgery eliminates the problem of donor lodge and reduces the operating time
Keywords: calcaneal bone fracture, impressional fracture, bone grafting, b-threecalcium phosphate
Received 17.01.2017
For citation:Gilev M.V., Volokitina E.A., Antoniadi Y.V., Kutepov S.M. Bone grafting in surgical management of intraarticular impressional calcaneal fractures. Vestn. Ural. Med. Akad. Nauki = Jour. Ural Med. Acad. Science. 2017, no. 2, pp. 123–130. DOI: 10.22138/2500-0918-2017-14-2-123-130 (In Russ.)
REFERENCES
1. Ardashev I.P., Kalashnikov V.V., Stacenko O.A., Afonin E.A., Voronkin R.G. Diagnostika i hirurgicheskoe lechenie oskol'chatyh chressustavnyh perelomov pjatochnoj kosti [Diagnostic and surgical treatment of intraarticular calcaneal fractures]. Travmatologija i ortopedija Rossii. 2009. No. 4 (54). pp. 31-36 [in Russ]
2. Kalenskij V.O., Kononova K.Ju., Gluhov D.A., Ivanov P.A., Berdjugin K.A., Chelnokov A.N. Vnutrikostnyj osteosintez kak novaja opcija v lechenii perelomov pjatochnoj kosti [Internal osteosynthesis as a new option in treatment of calcaneus fractures]. Travmatologija i ortopedija Rossii. 2015. No. 4 (78). pp. 79-86 [in Russ]
3. Gusic N. Operative treatment of intraarticular calcaneal fractures: Anatomical and functional outcome of three different operative techniques. N. Gusic, I. Fedel, N. Darabos, Z. Lovric, N. Bukvic, B. Bakota, D. Lemac. Injury. 2015 Nov; 46 Suppl 6: pp. 130-133. DOI: 10.1016/j.injury.2015.10.061.
4. Kupitman M.E. Atmanskij M.K., Chernikov M.K., Maminov D.V., Gashev A.A., Zubkov M.A., Semenov A.A. Rezul'taty i perspektivy razvitija sposobov operativnogo lechenija perelomov pjatochnoj kosti [Results and prospects for development of operative treatment calcaneal fractures]. Genij ortopedii. 2013. No. 2. pp. 22-26 [in Russ]
5. Kulkarni H.G. Plating for intra-articular calcaneal fractures…. Is it an overkill? V.S. Mane, K.L. Gaonkar, P.P. Patil, M.S. Shaha, N.S. Patel, N.R. Desai. J Clin Orthop Trauma. 2015 Sep; 6 (3):153-9. doi: 10.1016/j.jcot.2015.03.011.
6. Kumar S. Evaluation of functional outcome and complications of locking calcaneum plate for fracture calcaneum. S. Kumar, L.G. Krishna, D. Singh, P. Kumar, S. Arora, S. Dhaka. J Clin Orthop Trauma. 2015 Sep; 6 (3). pp. 147-152. doi: 10.1016/j.jcot.2015.05.006.
7. Pillai A., Basappa P., Ehrendorfer S.: Modified Essex-Lopresti. Westheus reduction for displaced intra-articular fractures of the calcaneus. Description of surgical technique and early outcomes ActaOrthopBelg, 2007; 73. pp. 83–87
8. Tomesen T. Treatment of Displaced Intra-Articular Calcaneal Fractures with Open Reduction and Internal Fixation. T. Tomesen, J. Biert, J.M. Frolke. J Bone Joint Surg Am, 2011; 93: 920–28
9. Volokitina, E.A. Antoniadi Ju.V, Gilev M.V., Chernicyn D.N. Surgical treatment of intraarticular fractures with b-threecalcium phosphate. Ural'skij medicinskij zhurnal. 2014. no. 1. pp. 75-79 [in Russ]
10. Dimitriou R. G., Giannoudis P. V. Bone graft substitutes: What are the options? Surgeon. 2012 Aug; 10(4). pp. 230-9. doi: 10.1016/j.surge.2012.04.001.
Authors
Mikhail V. Gilev
Cand. Sci. (Med.), Associate Professor, Department of Operative Surgery and Topographic Anatomy
Elena A. Volokitina
Dr. Sci. (Med.), Professor, Department of Traumatology and Orthopedics
Yuri V. Antoniadi
Cand. Sci. (Med.), Associate Professor, Department of Traumatology and Orthopedics
Sergej M. Kutepov
Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Rector of Ural State Medical University
Ural State Medical University
Repin Str. 3, Yekaterinburg, Russian Federation, 620028
usma@usma.ru
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