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      Percutaneous Cannulated Screw Fixation vs. Plating With Minimally Invasive Longitudinal Approach After Closed Reduction for Intra-Articular Tongue-Type Calcaneal Fractures: A Retrospective Cohort Study

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          Abstract

          Objective

          Displaced intra-articular tongue-type fractures are often treated with surgical interventions, and there is a lack of consensus regarding the surgical approach. This retrospective cohort study aimed to compare percutaneous cannulated screw (PCS) fixation and plating with a minimally invasive longitudinal approach (MILA) after closed reduction for the treatment of tongue-type calcaneal fractures.

          Materials and Methods

          A total of 77 patients with intra-articular tongue-type calcaneal fractures between September 2015 and July 2019 were included in this study. They were randomly allocated into two groups: PCS fixation ( n = 32) and MILA ( n = 45). The outcome measures included demographic variables, operation time (OT), preoperative time (POT), hospital stay time (HST), blood loss, visual analog scale (VAS) scores, American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores, postoperative complications, and imaging parameters. The patients were clinically examined at 1, 3, 6, and 12 months, with a final follow-up period of 27 months.

          Results

          No significant differences were observed during the follow-up in calcaneal length, height, Gissane's and Böhler's angles, VAS scores, AOFAS hindfoot scores, or complication rates between the two groups. However, the postoperative VAS scores in the PCS group were significantly lower than those in the MILA group ( p < 0.05). Furthermore, the OT, POT, and HST in the PCS group were significantly shorter than those in the MILA group ( p < 0.05). Blood loss was lower in the PCS group than those in the other group ( p = 0.044). However, postoperative calcaneal widening was significantly smaller in the MILA group than that in the PCS group ( p < 0.001).

          Conclusions

          After closed reduction for the treatment of tongue-type calcaneal fractures, PCS fixation was superior to MILA in terms of OT, POT, HST, blood loss, pain, and degree of comfort. Meanwhile, MILA has the advantage of restoring the calcaneal width. Under the same rehabilitation program, the two approaches showed similar abilities in maintaining the closed reduction.

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          The mechanism, reduction technique, and results in fractures of the os calcis.

          P ESSEX-LOPRESTI (1952)
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            Displaced intra-articular calcaneal fractures treated in a minimally invasive fashion: longitudinal approach versus sinus tarsi approach.

            Tao Zhang, Yanling Su, Wei-Wei Chen … (2014)
            The optimal treatment for displaced intra-articular fractures of the calcaneus remains controversial. This study aims to assess the clinical outcomes of a minimally invasive longitudinal approach compared with the sinus tarsi approach in the surgical treatment of these fractures.
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              Open reduction and internal fixation with conventional plate via L-shaped lateral approach versus internal fixation with percutaneous plate via a sinus tarsi approach for calcaneal fractures - a randomized controlled trial.

              Shengli Xia, Yaogang Lu, Huizhong Wang … (2014)
              We aimed to compare the clinical outcomes of intra-articular calcaneus fractures treated with open reduction and internal fixation with conventional plate via L-shaped lateral approach (routine treatment) versus those with percutaneous plate via a sinus tarsi approach (minimally invasive treatment).
              Article 0 comments Cited 24 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Surg
                Journal ID (iso-abbrev): Front Surg
                Journal ID (publisher-id): Front. Surg.
                Title: Frontiers in Surgery
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-875X
                Publication date (Electronic): 04 April 2022
                Publication date Collection: 2022
                Volume: 9
                Electronic Location Identifier: 854210
                Affiliations
                [1] 1Department of Orthopaedics, Peking University Third Hospital , Beijing, China
                [2] 2Engineering Research Center of Bone and Joint Precision Medicine , Beijing, China
                [3] 3School of Basic Medical Sciences, Peking University Health Science Center , Beijing, China
                Author notes

                Edited by: Yuan Xiong, Huazhong University of Science and Technology, China

                Reviewed by: Junlin Zhou, Capital Medical University, China; Jingfeng Li, Wuhan University, China

                *Correspondence: Yang Lv lvyang42@ 123456126.com

                This article was submitted to Orthopedic Surgery, a section of the journal Frontiers in Surgery

                †These authors have contributed equally to this work and share first authorship

                ‡These authors share last authorship

                Article
                DOI: 10.3389/fsurg.2022.854210
                PMC ID: 9013838
                PubMed ID: 35445076
                SO-VID: 5779715f-1e75-4bfa-b5bf-b2f4761f1427
                Copyright © Copyright © 2022 Cao, Xu, Guo, Cui, Zhao, Gao, Tian, Lv and Zhou.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 13 January 2022
                Date accepted : 01 March 2022
                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 25, Pages: 8, Words: 5924
                Categories
                Subject: Surgery
                Subject: Original Research

                Keywords: calcaneus,tongue-type fracture,joint depression type,closed reduction,percutaneous cannulated screw fixation,minimally invasive longitudinal approach
                Data availability:
                Keywords: calcaneus, tongue-type fracture, joint depression type, closed reduction, percutaneous cannulated screw fixation, minimally invasive longitudinal approach

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