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Comparison of Minimally Invasive Percutaneous Osteosynthesis Versus ORIF for Sanders type II and III Calcaneal Fractures: at Bhuj, Kutch: A Randomized Trial

Dipak Suthar, Assistant Professor, Department of Orthopedics, Government Medical College, Surat, Gujarat 395001, India. , Tushar Vegad1 , Dipak Suthar2

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Journal of Orthopedic Education 3(2):p 156-162, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/joe.2454.7956.3217.5

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Abstract

Background and Aim: Fractures of the calcaneum constitute approximately 60% of all tarsal injuries, and are usually the result of a fall from a height. This randomized controlled trial compared the clinical outcomes and complications of a novel minimally invasive percutaneous osteosynthesis (MIPO) with those of conventional treatment via an extended L-shaped lateral approach for calcaneal fractures. Methods: Present study was performed at Department of orthopedics, Gujarat Adani institute of medical science, Bhuj, Kutch, Gujarat. Sixty-four patients with displaced intraarticular calcaneal fractures were enrolled. The patients were randomly allocated to receive either MIPO (29 patients) or open reduction and internal fixation via an extended Lshaped lateral approach (35 patients). The same calcaneal plate was used in both groups. Preoperative and postoperative calcaneal height, width, and length, Bohler’s angle, and Gissane’s angle were compared. Results: The operative time in the MIPO group was 52.5 ± 11.1 min, which was significantly shorter than 82.8 ± 16. 2 min in the conventional treatment group (P < 0.001). One week postoperatively, the VAS value was 3.2 ± 1.4 in the MIPO group, which was lower than that in the conventional treatment group, 3.9 ± 1.3 (P = 0.038). In the conventional treatment group, 13 of 35 fractures (37.1%) had wound healing problems, whereas this issue occurred in only 2 of 29 fractures (6.7%) in the MIPO group (P = 0.004). At the last follow-up, the SF- 36 scores and AOFAS scores in the two groups were comparable (P > 0.05). Conclusion: Compared with conventional ORIF, the advantages of MIPO are a considerably shortened operating time and hospital stay, decreased postoperative pain, and reduced risk of wound healing complications.

Keywords: Bhuj; Calcaneum; Fracture; Minimally Invasive; Randomized Controlled Trial. 

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DOI: http://dx.doi.org/10.21088/joe.2454.7956.3217.5

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