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Complications in operative fixation of calcaneal fractures

View Article: PubMed Central - PubMed

ABSTRACT

Objective:: The purpose of this study focused on a number of factors that have been implicated in calcaneal complications and find the incidence of wound complications.

Methods:: This was a retrospective study. A total of 162 patients (176 feet) who underwent calcaneal fractures between 2007 and 2012 were included. The patient’s personal details, age, time from injury to surgery, cause of injury, type of fracture, operative details, operating and tourniquet times were collected from hospital computers and paper records. Evidence of complications including wound infection, wound necrosis, pain, malunion, nonunion, impingement, loss of fixation, ect were studied.

Results:: Forty-seven of one hundred and seventy-six fractures (26.704%) had complications, wound infection was noted in seven fractures (3.977%), twelve fractures developed necrosis (6.818%), 14 fractures (7.955%) developed pain. Malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). Three neurologic injury was also seen in our study (1.705%). Operating time, time from injury to surgery and type of fracture had some association with complications in operative fixation of calcaneal fractures, which showed a statistically significant improvement (P=0.000, 0.031, 0.020, respectively), but there were no evidence that age and tourniquet time affect the incidence of complication after calcaneal fracture surgery (P=0.119, 0.682, respectively).

Conclusions:: Despite developments in the surgical treatment of calcaneal fracture, wound complications still remain inevitable. Advanced imaging techniques, less invasive surgical procedures, wealth of anatomical knowledge, surgical experience and better postoperative care should be ensured.

No MeSH data available.


Related in: MedlinePlus

Nail broken in operative fixation of calcaneal fracture.
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Figure 3: Nail broken in operative fixation of calcaneal fracture.

Mentions: One hundred and seventy-six closed intra-articular calcaneal fractures were retrospectively assessed. Complication rate in operative fixation of calcaneal fractures is shown in Table-I. Forty-seven of one hundred and seventy-six fractures (26.704%) had complications. Wound infection was noted in seven fractures (3.977%), there were three (1.704%) deep infections and four (2.273%) superficial infections. All of these twelve fractures developed necrosis (6.818%). Pain was reported the most common in 176 fractures, 14 fractures (7.955%) developed pain that included arthritis pain (3 fractures), heel pad pain (5 fractures) and diffuse pain (6 fractures). In the other complications, malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). three neurologic injury was also seen in our study (1.705%). Although compartment syndrome is a recognized complication, it was not documented in any of our patient’s notes (Fig. 1-3).


Complications in operative fixation of calcaneal fractures
Nail broken in operative fixation of calcaneal fracture.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5017091&req=5

Figure 3: Nail broken in operative fixation of calcaneal fracture.
Mentions: One hundred and seventy-six closed intra-articular calcaneal fractures were retrospectively assessed. Complication rate in operative fixation of calcaneal fractures is shown in Table-I. Forty-seven of one hundred and seventy-six fractures (26.704%) had complications. Wound infection was noted in seven fractures (3.977%), there were three (1.704%) deep infections and four (2.273%) superficial infections. All of these twelve fractures developed necrosis (6.818%). Pain was reported the most common in 176 fractures, 14 fractures (7.955%) developed pain that included arthritis pain (3 fractures), heel pad pain (5 fractures) and diffuse pain (6 fractures). In the other complications, malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). three neurologic injury was also seen in our study (1.705%). Although compartment syndrome is a recognized complication, it was not documented in any of our patient’s notes (Fig. 1-3).

View Article: PubMed Central - PubMed

ABSTRACT

Objective:: The purpose of this study focused on a number of factors that have been implicated in calcaneal complications and find the incidence of wound complications.

Methods:: This was a retrospective study. A total of 162 patients (176 feet) who underwent calcaneal fractures between 2007 and 2012 were included. The patient’s personal details, age, time from injury to surgery, cause of injury, type of fracture, operative details, operating and tourniquet times were collected from hospital computers and paper records. Evidence of complications including wound infection, wound necrosis, pain, malunion, nonunion, impingement, loss of fixation, ect were studied.

Results:: Forty-seven of one hundred and seventy-six fractures (26.704%) had complications, wound infection was noted in seven fractures (3.977%), twelve fractures developed necrosis (6.818%), 14 fractures (7.955%) developed pain. Malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). Three neurologic injury was also seen in our study (1.705%). Operating time, time from injury to surgery and type of fracture had some association with complications in operative fixation of calcaneal fractures, which showed a statistically significant improvement (P=0.000, 0.031, 0.020, respectively), but there were no evidence that age and tourniquet time affect the incidence of complication after calcaneal fracture surgery (P=0.119, 0.682, respectively).

Conclusions:: Despite developments in the surgical treatment of calcaneal fracture, wound complications still remain inevitable. Advanced imaging techniques, less invasive surgical procedures, wealth of anatomical knowledge, surgical experience and better postoperative care should be ensured.

No MeSH data available.


Related in: MedlinePlus