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Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey.

Schepers T, van Lieshout EM, van Ginhoven TM, Heetveld MJ, Patka P - Int Orthop (2007)

Bottom Line: An outcome score, mainly AOFAS, was documented by 7%.The socio-economic cost was estimated to be euro21.5-30.7 million.Better insight into treatment modalities currently employed and costs in the Netherlands was obtained.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, CA Rotterdam, The Netherlands. t.schepers@erasmusmc.nl

ABSTRACT
The treatment of intra-articular calcaneal fractures is controversial and randomised clinical trials are scarce. Moreover, the socio-economic cost remains unclear. The aim of this study was to estimate the incidence, treatment preferences and socio-economic cost of this complex fracture in the Netherlands. This data may aid in planning future clinical trials and support education. The method of study was of a cross-sectional survey design. A written survey was sent to one representative of both the traumatology and the orthopaedic staff in each hospital in the Netherlands. Data on incidence, treatment modalities, complications and follow-up strategies were recorded. The socio-economic cost was calculated. The average response rate was 70%. Fracture classifications, mostly by Sanders and Essex-Lopresti, were applied by 29%. Annually, 920 intra-articular calcaneal fractures (0.4% incidence rate) were treated, mainly with ORIF (46%), conservative (39%) and percutaneous (10%) treatment. The average non-weight-bearing mobilisation was 9 weeks (SD 2 weeks). An outcome score, mainly AOFAS, was documented by 7%. A secondary arthrodesis was performed in 21% of patients. The socio-economic cost was estimated to be euro21.5-30.7 million. Dutch intra-articular calcaneal fracture incidence is at least 0.4% of all fractures presenting to hospitals. Better insight into treatment modalities currently employed and costs in the Netherlands was obtained.

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Response rates and the number of patients treated using the three most frequently applied modalities per province in the Netherlands. R=response rate in percentage; C=absolute number of patients treated conservatively; O=absolute number of patients treated using ORIF; P=absolute number of patients treated percutaneously, as described by Forgon and Zadravecz
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Fig1: Response rates and the number of patients treated using the three most frequently applied modalities per province in the Netherlands. R=response rate in percentage; C=absolute number of patients treated conservatively; O=absolute number of patients treated using ORIF; P=absolute number of patients treated percutaneously, as described by Forgon and Zadravecz

Mentions: The majority of patients were treated with ORIF (46%), conservatively (39%) or percutaneously according to Forgon and Zadravecz (10%), as shown in Table 3. Large differences exist in the number of patients treated using these three most used techniques per province (Fig. 1). The definite use of bone grafts in the ORIF group was reported by 20% of respondents, a total of 42% used grafting when deemed necessary and 38% did not use bone grafts at all. Five different types of calcaneal plates were used in the Netherlands in the ORIF group (Synthes AO Plate, Biomet, AO cervical H-plate, New Deal and Stryker) and two different types of fixation in the percutaneous group (cannulated screws and Kirschner wires).Table 3


Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey.

Schepers T, van Lieshout EM, van Ginhoven TM, Heetveld MJ, Patka P - Int Orthop (2007)

Response rates and the number of patients treated using the three most frequently applied modalities per province in the Netherlands. R=response rate in percentage; C=absolute number of patients treated conservatively; O=absolute number of patients treated using ORIF; P=absolute number of patients treated percutaneously, as described by Forgon and Zadravecz
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2551728&req=5

Fig1: Response rates and the number of patients treated using the three most frequently applied modalities per province in the Netherlands. R=response rate in percentage; C=absolute number of patients treated conservatively; O=absolute number of patients treated using ORIF; P=absolute number of patients treated percutaneously, as described by Forgon and Zadravecz
Mentions: The majority of patients were treated with ORIF (46%), conservatively (39%) or percutaneously according to Forgon and Zadravecz (10%), as shown in Table 3. Large differences exist in the number of patients treated using these three most used techniques per province (Fig. 1). The definite use of bone grafts in the ORIF group was reported by 20% of respondents, a total of 42% used grafting when deemed necessary and 38% did not use bone grafts at all. Five different types of calcaneal plates were used in the Netherlands in the ORIF group (Synthes AO Plate, Biomet, AO cervical H-plate, New Deal and Stryker) and two different types of fixation in the percutaneous group (cannulated screws and Kirschner wires).Table 3

Bottom Line: An outcome score, mainly AOFAS, was documented by 7%.The socio-economic cost was estimated to be euro21.5-30.7 million.Better insight into treatment modalities currently employed and costs in the Netherlands was obtained.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, CA Rotterdam, The Netherlands. t.schepers@erasmusmc.nl

ABSTRACT
The treatment of intra-articular calcaneal fractures is controversial and randomised clinical trials are scarce. Moreover, the socio-economic cost remains unclear. The aim of this study was to estimate the incidence, treatment preferences and socio-economic cost of this complex fracture in the Netherlands. This data may aid in planning future clinical trials and support education. The method of study was of a cross-sectional survey design. A written survey was sent to one representative of both the traumatology and the orthopaedic staff in each hospital in the Netherlands. Data on incidence, treatment modalities, complications and follow-up strategies were recorded. The socio-economic cost was calculated. The average response rate was 70%. Fracture classifications, mostly by Sanders and Essex-Lopresti, were applied by 29%. Annually, 920 intra-articular calcaneal fractures (0.4% incidence rate) were treated, mainly with ORIF (46%), conservative (39%) and percutaneous (10%) treatment. The average non-weight-bearing mobilisation was 9 weeks (SD 2 weeks). An outcome score, mainly AOFAS, was documented by 7%. A secondary arthrodesis was performed in 21% of patients. The socio-economic cost was estimated to be euro21.5-30.7 million. Dutch intra-articular calcaneal fracture incidence is at least 0.4% of all fractures presenting to hospitals. Better insight into treatment modalities currently employed and costs in the Netherlands was obtained.

Show MeSH
Related in: MedlinePlus