Therapeutic Advantages of Internal Fixation with Kirschner Wire and Bone Grafting via Limited Tarsal Sinus Incision Approach for Displaced Intra-Articular Calcaneal Fractures of Children
Jin Wan, Jing Feng, Fan Li, Jian Xu, Ming-Jing Li, Tao Hu
Department of Pediatric Orthopedics, Wuhan Fourth Hospital (Puai Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
Med Sci Monit 2018; 24:7862-7868
Displaced intra-articular calcaneal fractures (DIACF) are a serious injury and are clinically considered to be an important source of disability. This study investigated therapeutic effects of internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision in pediatric DIACF.
MATERIAL AND METHODS: This retrospective study included pediatric DIACF patients admitted to our department from June 2010 to February 2014. Patients were divided into Sanders II, Sanders III, and Sanders IV groups. Patients were also divided into pre-operation and post-operation groups. All patients underwent the internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision operation. Bohler angles, Gissane angles, and modified American Orthopedic Foot and Ankle Society Score (AOFAS) were evaluated.
RESULTS: Four weeks after surgery, all patients had clinical healing and no complications appeared. According to CT and X-ray results, the operation had satisfactory reduction effects for pediatric DIACF of childhood and adolescence. The operation significantly enhanced the Bohler angle of patients in Sanders II, III, and IV patients in the post-operation group compared to the pre-operation group (p<0.05). The operation significantly increased Gissane angle in the post-operation group compared to the pre-operation group in Sanders II, III, and IV patients (p<0.05). The operation significantly improved AOFAS scores of patients in the Sanders II, III, and IV groups (p<0.05).
CONCLUSIONS: Internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision approach is safe and effective for pediatric DIACF. This approach exhibited advantages of satisfactory reduction for articular surface, solid fixation, and no complications due to infection or tissue necrosis.
Keywords: Bone Wires, Internal Fixators, intra-articular fractures