Acta Chir Orthop Traumatol Cech. 2022; 89(5):349-352 | DOI: 10.55095/achot2022/056

Locking Nail versus Plate Fixation in Calcaneal Fractures: Brief report on a Retrospective Analysis of Treatment Characteristics and Radiographic Correction PotentialOriginal papers

N. STACHEL1, B. J. BRAUN2,*, M. ORTH3, S. C. HERATH2, M. F. R. ROLLMANN2, M. M. MENGER2, T. HISTING2, T. POHLEMANN3
1 Saarland University Hospital; Department of Orthopaedics and Orthopaedic Surgery, Homburg, Germany
2 Department of Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, Germany
3 Saarland University Hospital; Department of Trauma, Hand and Reconstructive Surgery, Homburg, Germany

PURPOSE OF THE STUDY:
Minimal and limited access techniques are gaining increasing interest for the treatment of displaced intra-articular calcaneal fractures. The ideal treatment method is however still debated and largely based on individual case factors and surgeon experience. Aim of this study was thus to compare the treatment characteristics and radiographic correction potential of a locking nail system with a sinus tarsi approach to plate fixation via an extended lateral approach.

MATERIAL AND METHODS:
We retrospectively reviewed 39 cases of patients with calcaneal fractures that received primary fracture treatment for displaced intra-articular calcaneal fractures between July 2017 and March 2020. Patient characteristics, time to surgery, time to discharge, OR time and the correction achieved were analyzed and comparative statistics performed.

RESULTS:
In total 19 patients treated with the locking nail and 20 patients treated with plate fixation were analyzed. Patient age and fracture severity according to the Sanders classification were comparable between the groups. Overall surgical time, as well as the achieved reduction was equal between both groups. Time to surgery, as well as time from surgery to discharge was significantly shorter in the locking nail group. 2 additional soft tissue procedures were necessary in the extended lateral approach group.

DISCUSSION: AND CONCLUSIONS
The results with the locking calcaneus nail and sinus tarsi approach suggest, that similar treatment results can be achieved as with plate osteosynthesis and an extended lateral approach. Soft tissue management, as well as pre- and post-operative timing and discharge management can be improved with the nail. Further controlled trials comparing the long-term outcome between the treatment options are needed.

Keywords: calcaneus fracture, sinus tarsi approach, calcaneal nail, C-Nail

Published: October 15, 2022  Show citation

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STACHEL N, BRAUN BJ, ORTH M, HERATH SC, ROLLMANN MFR, MENGER MM, et al.. Locking Nail versus Plate Fixation in Calcaneal Fractures: Brief report on a Retrospective Analysis of Treatment Characteristics and Radiographic Correction Potential. Acta Chir Orthop Traumatol Cech. 2022;89(5):349-352. doi: 10.55095/achot2022/056. PubMed PMID: 36322035.
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    References

    1. Arastu M, Sheehan B, Buckley R. Minimally invasive reduction and fixation of displaced calcaneal fractures: surgical technique and radiographic analysis. Int Orthop. 2014;38:539-545. Go to original source... Go to PubMed...
    2. Bartoníček J, Rammelt S. Carl Gussenbauer and the history of nailing for calcaneal fractures. Fuss Sprung. 2020:18:239-243. Go to original source...
    3. Ceccarini P, Manfreda F, Petruccelli R, Talesa G, Rinonapoli G, Caraffa A. Minimally invasive sinus tarsi approach in Sanders II-III calcaneal fractures in high-demand patients. Med Glas (Zenica). 2021;18:322-327. Go to original source...
    4. Fascione F, Di Mauro M, Guelfi M, Malagelada F, Pantalone A, Salini V. Surgical treatment of displaced intraarticular calcaneal fractures by a minimally invasive technique using a locking nail: a preliminary study. Foot Ankle Surg. 2019;25:679-683. Go to original source... Go to PubMed...
    5. Goldzak M, Mittlmeier T, Simon P. Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail®. Eur J Orthop Surg Traumatol. 2012;22:345-349. Go to original source... Go to PubMed...
    6. Goldzak M, Simon P, Mittlmeier T, Chaussemier M, Chiergatti R. Primary stability of an intramedullary calcaneal nail and an angular stable calcaneal plate in a biomechanical testing model of intraarticular calcaneal fracture. Injury. 2014;45:49-53. Go to original source... Go to PubMed...
    7. Herlyn A, Brakelmann A, Herlyn PK, Gradl G, Mittlmeier T. Calcaneal fracture fixation using a new interlocking nail reduces complications compared to standard locking plates-preliminary results after 1.6 years. Injury. 2019;50:63-68. Go to original source... Go to PubMed...
    8. van Hoeve S, Poeze M. Outcome of minimally invasive open and percutaneous techniques for repair of calcaneal fractures: a systematic review. J Foot Ankle Surg. 2016;55:1256-1263. Go to original source... Go to PubMed...
    9. Jandová S, Pazour J. Limited versus extended lateral approach for osteosynthesis of calcaneal fractures-comparison of temporal and dynamic parameters of the gait cycle. Acta Chir Orthop Traumatol Cech. 2018;85:57-61. Go to original source... Go to PubMed...
    10. Jin C, Weng D, Yang W, He W, Liang W, Qian Y. Minimally invasive percutaneous osteosynthesis versus ORIF for Sanders type II and III calcaneal fractures: a prospective, randomized intervention trial. J Orthop Surg Res. 2017;12:1-9. Go to original source... Go to PubMed...
    11. Kline AJ, Anderson RB, Davis WH, Jones CP, Cohen BE. Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures. Foot Ankle Int. 2013;34:773-780. Go to original source... Go to PubMed...
    12. Levine DS, Helfet DL. An introduction to the minimally invasive osteosynthesis of intra-articular calcaneal fractures. Injury. 2001;32:51-54. Go to original source... Go to PubMed...
    13. Majeed H, Barrie J, Munro W, McBride D. Minimally invasive reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular calcaneal fractures: a systematic review of the literature. EFORT Open Rev. 2018;3:418-425. Go to original source... Go to PubMed...
    14. Pastides PS, Milnes L, Rosenfeld PF. Percutaneous arthroscopic calcaneal osteosynthesis: a minimally invasive technique for displaced intra-articular calcaneal fractures. J Foot Ankle Surg. 2015;54:798-804. Go to original source... Go to PubMed...
    15. Peng Y, Liu J, Zhang G, Ji X, Zhang W, Zhang L, Tang P. Reduction and functional outcome of open reduction plate fixation versus minimally invasive reduction with percutaneous screw fixation for displaced calcaneus fracture: a retrospective study. J Orthop Surg Res. 2019;14:1-9. Go to original source... Go to PubMed...
    16. Pompach M, Carda M, Amlang M, Zwipp H. Treatment of calcaneal fractures with a locking nail (C-Nail). Oper Orthop Traumatol. 2016;28:218-230. Go to original source... Go to PubMed...
    17. Rammelt S, Amlang M, Barthel S, Zwipp H. Minimally-invasive treatment of calcaneal fractures. Injury. 2004;35:55-63. Go to original source... Go to PubMed...
    18. Reinhardt S, Martin H, Ulmar B, Döbele S, Zwipp H, Rammelt S, Richter M, Pompach M, Mittlmeier T. Interlocking nailing versus interlocking plating in intra-articular calcaneal fractures: a biomechanical study. Foot Ankle Int. 2016;37:891-897. Go to original source... Go to PubMed...
    19. Saß M, Rotter R, Mittlmeier T. Minimally invasive internal fixation of calcaneal fractures or subtalar joint arthrodesis using the Calcanail®. Oper Orthop Traumatol. 2019;31:149-164. Go to original source... Go to PubMed...
    20. Sharr PJ, Mangupli MM, Winson IG, Buckley RE. Current management options for displaced intra-articular calcaneal fractures: non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. A contemporary review. Foot Ankle Surg. 2016;22:1-8. Go to original source... Go to PubMed...
    21. Simon P, Goldzak M, Eschler A, Mittlmeier T. Reduction and internal fixation of displaced intra-articular calcaneal fractures with a locking nail: a prospective study of sixty nine cases. Int Orthop. 2015;39:2061-2067. Go to original source... Go to PubMed...
    22. Veliceasa B, Filip A, Pinzaru R, Pertea M, Ciuntu B, Alexa O. Treatment of displaced intra-articular calcaneal fractures with an interlocking nail (C-Nail). J Orthop Trauma. 2020;34:414-419. Go to original source... Go to PubMed...
    23. Wilkinson BG, Marsh JL. Minimally Invasive Treatment of Displaced Intra-Articular Calcaneal Fractures. Orthop Clin North Am. 2020;51:325-338. Go to original source... Go to PubMed...
    24. Wu Z, Su Y, Chen W, Zhang Q, Liu Y, Li M, Wang H, Zhang Y. Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts. J Trauma Acute Care Surg. 2012;73:743-751. Go to original source... Go to PubMed...
    25. Zeng Z, Yuan L, Zheng S, Sun Y, Huang F. Minimally invasive versus extensile lateral approach for sanders type II and III calcaneal fractures: a meta-analysis of randomized controlled trials. Int J Surg. 2018;50:146-153. Go to original source... Go to PubMed...
    26. Zhang T, Su Y, Chen W, Zhang Q, Wu Z, Zhang Y. Displaced intra-articular calcaneal fractures treated in a minimally invasive fashion: longitudinal approach versus sinus tarsi approach. J Bone Joint Surg. 2014;96:302-309. Go to original source... Go to PubMed...
    27. Zwipp H, Paša L, Žilka L, Amlang M, Rammelt S, Pompach M. Introduction of a new locking nail for treatment of intraarticular calcaneal fractures. J Orthop Trauma. 2016;30:88-92. Go to original source... Go to PubMed...

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