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Prospective randomized trial comparing open reduction and internal fixation with minimally invasive reduction and percutaneous fixation in managing displaced intra-articular calcaneal fractures

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Abstract

Purpose

Managing displaced intra-articular calcaneal fractures remains controversial. A prospective randomised trial was undertaken to compare open reduction and internal fixation (ORIF) with minimally invasive reduction and percutaneous fixation (MIRPF).

Methods

Forty-five displaced intra-articular calcaneal fractures were randomised to undergo either ORIF (n = 23) or MIRPF (n = 22). Patients were followed up clinically and radiologically for a minimum of one year postoperatively. The primary outcome measure was wound-healing complication. Functional outcome was assessed using Creighton Nebraska Health Foundation (CNF) scale, and radiological outcome was assessed using plain radiographs and computed tomography (CT) scans.

Results

Of the 23 heels in the ORIF group, seven (30%) had wound-healing problems, compared with none in the MIRPF group (p = 0.005). There was no statistically significant difference in radiological outcomes between groups, as measured by Böhler’s angle, Gissane’s angle and Score Analysis of Verona (SAVE). Median time to return to work was two weeks earlier (p = 0.004), and the functional outcome score (CNF scale) at one year of follow-up was better (p = 0.013) following MIRPF compared with ORIF.

Conclusion

MIRPF is associated with fewer wound-healing problems, better functional outcome and earlier return to work compared with ORIF.

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Authors and Affiliations

  1. All India Institute of Medical Sciences, Orthopaedics, New Delhi, India

    Venkatesan Sampath Kumar, Vijay Sharma & Prakash Kotwal

  2. Parvathy Hospital, Tamil Nadu, India

    Kanniraj Marimuthu

  3. Ganga Medical Centre and Hospitals, Tamil Nadu, India

    Suresh Subramani

  4. RAK Hospital, Ras Al Khaimah, UAE

    John Bera

Authors
  1. Venkatesan Sampath Kumar
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  2. Kanniraj Marimuthu
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  3. Suresh Subramani
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  4. Vijay Sharma
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  5. John Bera
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  6. Prakash Kotwal
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Correspondence to Venkatesan Sampath Kumar.

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Sampath Kumar, V., Marimuthu, K., Subramani, S. et al. Prospective randomized trial comparing open reduction and internal fixation with minimally invasive reduction and percutaneous fixation in managing displaced intra-articular calcaneal fractures. International Orthopaedics (SICOT) 38, 2505–2512 (2014). https://doi.org/10.1007/s00264-014-2501-0

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  • DOI: https://doi.org/10.1007/s00264-014-2501-0

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