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German Congress of Orthopaedics and Traumatology (DKOU 2019)

22. - 25.10.2019, Berlin

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Calcaneal fracture fixation using a minimum-invasive interlocking nailing technique provides superior function and reduced infection complications when compared with standard locking plate fixation

Meeting Abstract

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  • presenting/speaker Anica Herlyn - Universität Rostock, Chirurgische Klinik, Abteilung für Unfall, Hand- und Wiederherstellungschirurgie, Rostock, Germany
  • Anna Brakelmann - Universität Rostock, Chirurgische Klinik, Abteilung für Unfall, Hand- und Wiederherstellungschirurgie, Rostock, Germany
  • Philipp Herlyn - Universitätsmedizin Rostock, Chirurgische Klinik, Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Rostock, Germany
  • Georg Gradl - Klinikum München Harlachingen, Abt. für Unfallchirurgie, Orthopädie und Wiederherstellungschirurgie, München, Germany
  • Thomas Mittlmeier - Universitätsmedizin Rostock, Chirurgische Klinik, Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Rostock, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019). Berlin, 22.-25.10.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocAB53-1024

doi: 10.3205/19dkou507, urn:nbn:de:0183-19dkou5071

Published: October 22, 2019

© 2019 Herlyn et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives: Plate fixation of displaced calcaneal fractures using a standard lateral extended approach is complicated by infections and wound healing complications. This matched-pairs analysis prospectively evaluates the new minimally-invasive calcaneal interlocking nail in terms of complication rates, reduction capacities and functional outcome compared to standard locking plate fixation.

Methods: 40 feet (20 feet/group; mean patient age 53 years, range 27-78) with displaced intraarticular calcaneal fractures were either treated with a calcaneal locking nail (LN) or locking plate (LP) and observed clinically and radiologically after 1.6 years. Follow-up included CT-based radiological assessment of reduction and reduction retention as well as functional evaluation including the AOFAS Ankle-Hindfoot-Score and Foot Function Index (FFI).

Results: Time for surgery did not differ between both techniques (LN 93 min vs. LP 96 min). Inpatient treatment time was significantly reduced in the LN group (7.6 days vs. LP 11 days). Postoperative and follow-up radiographs revealed adequate restoration of the calcaneal body in both groups. The remaining defect of the posterior facet was significantly smaller in the LN group (0.7 mm vs. LP 1.6 mm). The results for the AOFAS Score (LN 71.6 points vs. LP 66.1 points) and FFI Score (LN 27.3 points vs. LP 30.8 points) were both better for the LN group. No intraoperative complications but two postoperative infections with wound healing complications were observed in the LP group.

Conclusion: The minimum-invasive interlocking nailing technique shows promising results in terms of reduction capacities and safety. Infection complications were reduced whilst superior function was found applying the interlocking nail compared with standard locking plate fixation via a lateral extended approach.