Compressed Fixation Combined with Vacuum-Assisted Closure for Treating Acute Injury of the Heel Fat Pad
Wanzhong Chu, Shidong Liu, Yeben Wang, Jianmin Li, Huashui Liu
(Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland))
Med Sci Monit 2018; 24:9466-9472
Treating acute injury of the heel fat pad is different from treating common soft tissue damage. Due to the paucity of literature on the topic, we described our initial experience treating acute injury of the heel fat pad to determine the ideal treatment method.
MATERIAL AND METHODS: A total of 53 patients with acute injury of the heel fat pad admitted to our hospital were selected for the study and were randomly divided into 2 groups: the compressed fixation combined with vacuum-assisted closure group and the only reimplanted and sewn group. Twenty-seven of the heel fat pads were compressed and fixed using a flat, hard piece of plastic and hollow screws; then, they were covered with a vacuum-assisted closure device. The other 27 were only sewn without tension. The clinical results were evaluated according to the American Orthopedic Foot and Ankle Society hindfoot score and the British Medical Research Council function evaluation criteria
RESULTS: In the compressed fixation combined with vacuum-assisted closure group, flaps of 12 feet with retrograde avulsion injury survived successfully. Partial flap necrosis occurred in 8 feet. Seven feet underwent repair using the neurocutaneous vascular resupinated island flap. Results were excellent or good for 74% of patients according to the AOFS. However, in the only reimplanted and sewn group, results were excellent or good for 44% of patients according to the AOFS.
CONCLUSIONS: Compressed fixation with vacuum-assisted closure is effective for treating acute injury of the heel fat pad, with high success rates and good utility.
Keywords: External Fixators, Heel, Negative-Pressure Wound Therapy, Replantation