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At least 811 records · Page 45Linked to original sources
PubMed1976

Reappraisal of the treatment of fractures of the calcaneus involving the subtalar joint.

From our findings it appears that no one method of treatment is infallible and that functional and anatomical restitutio ad integrum of the fractured heel cannot be obtained. Each method has its advantages and disadvantages and these are not only inherent in the method itself, but also depend on how it is applied. The treatment must be chosen according to the lesion and cannot be standardised because of the variable and complex nature of these fractures. Other factors to be considered are whether it is bilateral, whether there are multiple injuries, and the general condition of the patient etc. In fractures with depressions of the mixed horizontal type the Stulz method of treatment seems to be the best.

Arthrodesis↗
PubMed1999

[Comparative biomechanical study of 3 types of osteosynthesis of the Duparc grade IV fractures of the calcaneus: value of triangular internal fixation].

PURPOSE OF THE STUDY: We present an in vitro biomechanical study performed to evaluate and compare, for an experimentally produced fracture of the calcaneum (Duparc grade IV), the reaction of 3 standard models of internal fixation commonly used in these fractures and which occupy different volumes. MATERIALS AND METHODS: We compared different methods of fixation using fresh human calcanei. In two experimental series, we compared triangular internal fixation (3 1/4 tube AO plates Saragaglia), Y internal fixation (2 1/3 tube AO plates Bezes), isolated screw technique (three 3.5 diameter screws, two 4.5 diameter screws). The plates and screws were made of identical material (316L). Both series used 8 pairs of bone (talo-calcaneum system) with the same fracture submitted to a 200N to 1000N load. Stiffness and movement were analyzed using 8 references on the calcaneum. RESULTS: The stiffness and movement analysis with 8 references points demonstrated the superior resistance to bending with the triangular internal fixation. Fixation stability was significantly better than with the Y or screw technique. DISCUSSION: This study underlined the importance of triangular trabecular organization of cancellous bone on calcaneum biomechanics. We showed that the 3 (anterior, posterior and inferior) trabeculae must be repaired in calcaneum fractures to achieve horizontal and vertical stability of the talar joint. CONCLUSION: In our hands, restoration of the triangular architecture of calcaneum fractures, to resemble a roof truss, where the talus is fixed to the triangle vertex, is fundamental to obtain a rigid and stable internal fixation.

Biomechanical Phenomena↗
PubMed2000

[Progress in measurement of the calcaneus using ultrasonic methods in children and adolescents].

At present, Dual Energy X-ray Absorptiometry (DEXA) method is a reference method to diagnose osteoporosis. This method allows to measure bone density and bone mass, however bone quality can not be estimated. Quantitative ultrasound (QUS) method provides information about bone structure. The aim of our work was the evaluation of QUS method in healthy children, establishing reference values in cross-sectional study of healthy children aged 7-18 yrs and to examine the annual change of ultrasound parameters in prospective study at pubertal. Group of 530 girls and 369 boys was recruited from Warsaw schools, and right heel was measured with Achilles Plus apparatus. Measurements were repeated after 1 year, in a subgroup of 153 children aged 9-13 yrs. The method was adapted for paediatric measurements by using limiter of ultrasonic wave and pads for positioning foot in water chamber. Speed of sound (SOS) and broadband ultrasound attenuation (BUA) were measured and Stiffness index was calculated. Width of heel, at the same location as QUS measurement, was also measured using calipers. SOS, BUA and Stiffness values increased by age in boys and girls. BUA and Stiffness values were significantly higher in 15, 16 and 17 year old boys than in age-matched girls (in 18 yrs--only Stiffness). However, there were no significant sex differences in annual increase of SOS, BUA and Stiffness, although the biggest increase was observed between the age of 13-14 yrs for boys and 11-12 yrs for girls. That may reflect pubertal spurt of body growth but that relationship was not confirmed by annual increases calculated from cross-sectional data. Statistically significant correlation of SOS, BUA and Stiffness with body mass, height, body mass index (BMI) and heel width was observed. Normalization of SOS, BUA and Stiffness on heel width decreased force of that correlation but it was still statistically significant. Dynamics of SOS, BUA and Stiffness increase by age was higher in boys than in girls. This phenomenon is probably related to higher peak bone mass in men than in women, and lower risk of fracture in men, especially concerning hip. Increase of speed of sound, broadband ultrasound attenuation and stiffness index by age, and their correlations with body mass, height and body mass index reflects bone growth in children and adolescents. Broadband ultrasound attenuation and Stiffness index show sex differences in bone development in adolescence. Higher dynamics of the increase of speed of sound, broadband ultrasound attenuation and Stiffness index by age in boys confirms faster bone mass accumulation in boys than in girls.

Absorptiometry, Photon↗
PubMed2000

Shortening of the calcaneus treated with Ilizarov's method.

The author reports the case of a sixteen year old young lady with heel shortening, due to a growth arrest of the calcaneal epiphysis, secondary to its septic involvement by a heel puncture. At the age of sixteen a lengthening according to Ilizarov's method was performed, using progressive distraction of an osteotomy of the calcaneal tuberosity. The result was satisfying with a cosmetical improvement, a painless function and a more comfortable shoe fitting.

Adolescent↗
PubMed2001

[Diagnostic image (42). Solitary bone cyst of the left calcaneus].

A 9-year-old boy presented with a painful left heel. A plain radiograph showed a lytic lesion with a benign appearance, with a simple bone cyst or an intraosseous lipoma as the most likely differential diagnostic possibilities. MRI demonstrated a simple bone cyst.

Bone Cysts↗
PubMed2001

[Fractures of the calcaneus].

The authors present the results of another investigation of a group of casualties with fractures of the calcaneum treated by open reposition and stabilization with a splint and screws in 1994 to 1996, followed up after an interval of 57-74 months after the injury, on average after 66 months. Sixteen patients (20 calcanea) could be followed up, 7 patients were lost (8 calcanea). Again two evaluation patterns were compared. According to the authors the results were evaluated 12x as excellent, 6x as good and 2x as poor. On subjective evaluation 13 patients were satisfied, another three satisfied with reservations. During the subsequent follow up no complications developed. In all patients the osteosynthetic material was extracted and in one also ossificates in the planta. In two patients spontaneous talocalcaneal fusion occurred. Since 1997 in the Casualty Hospital as the basic method for treatment of dislocated intraarticular fractures of the calcaneum ligamentotaxis by exterior fixation is used (the authors give an account of all therapeutic methods used between 1994 and 2000). The authors evaluated a group of 28 casualties (36 fractures of the calcaneum) treated by external fixation, 18-81 months after injury, on average after 34.3 months. The evaluation proceeded in the same way. According to the authors' pattern the result was excellent 8x, good 13x and poor 15x. Spontaneous talocalcaneal fusion occurred 9x, 2x desis was performed and 1 desis is planned. As to subjective evaluation, 11 patients were satisfied, 15 were satisfied with reservations and two were not satisfied. According to the authors' opinion to achieve reposition of fragments of a fractured calcaneum in addition to other possibilities open reposition and synthesis using screws (possibly plate and screws) remains the basic method.

Adult↗