Analysis of Demographic Characteristics in a Series of 94 Patients with Articular Calcaneal Fractures
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Published:
Feb 17, 2023
Keywords:
Calcaneal fractures, intra-articular, demographic features, epidemiology
Main Article Content
Abstract
Objective: To analyze the demographic characteristics of patients with articular calcaneal fractures in connection with trauma mechanisms and fracture patterns, according to the Sanders and Essex-Lopresti classifications.
Materials and Methods: 94 patients and 111 articular calcaneal fractures were evaluated retrospectively, analyzing the following variables: age, gender, fractured side, mechanism of trauma, and associated injuries. The patients were initially evaluated through foot radiographs (anteroposterior and lateral) and axial computerized tomography with multiplanar reconstruction. Demographic data were analyzed combined withthe types of fracture.
Results: 94 patients (78 men and 16 women) who presented 105 intra-articular calcaneal fractures (11.7% were bilateral) were evaluated. The average age was 40.1±12.5 years. 9.8% of the fractures were caused by high-level falls and 20.1% by traffic accidents. 9.5% had associated injuries. The patients with bilateral fractures presented more associated injuries (p = 0.0123) and the same fracture pattern and Sanders type in both feet. The Sanders classification and Essex Lopresti patterns were unrelated to age, gender, and trauma mechanism.
Conclusion: Calcaneal fractures are more frequent in male and young patients, and the most common trauma mechanism is a high-level fall. Patients with bilateral fractures present a higher rate of associated injuries and the same Sanders type fracture and Essex-Lopresti pattern in both feet.
Materials and Methods: 94 patients and 111 articular calcaneal fractures were evaluated retrospectively, analyzing the following variables: age, gender, fractured side, mechanism of trauma, and associated injuries. The patients were initially evaluated through foot radiographs (anteroposterior and lateral) and axial computerized tomography with multiplanar reconstruction. Demographic data were analyzed combined withthe types of fracture.
Results: 94 patients (78 men and 16 women) who presented 105 intra-articular calcaneal fractures (11.7% were bilateral) were evaluated. The average age was 40.1±12.5 years. 9.8% of the fractures were caused by high-level falls and 20.1% by traffic accidents. 9.5% had associated injuries. The patients with bilateral fractures presented more associated injuries (p = 0.0123) and the same fracture pattern and Sanders type in both feet. The Sanders classification and Essex Lopresti patterns were unrelated to age, gender, and trauma mechanism.
Conclusion: Calcaneal fractures are more frequent in male and young patients, and the most common trauma mechanism is a high-level fall. Patients with bilateral fractures present a higher rate of associated injuries and the same Sanders type fracture and Essex-Lopresti pattern in both feet.
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How to Cite
Seletti, M., Pendino, A., & Lombardo, E. (2023). Analysis of Demographic Characteristics in a Series of 94 Patients with Articular Calcaneal Fractures. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(1), 59-65. https://doi.org/10.15417/issn.1852-7434.2023.88.1.1662
Section
Clinical Research
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References
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intra-articular calcaneal fractures: results of a nationwide survey. Int Orthop 2008;32:711-5.
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nonoperative management of displaced intra-articular calcaneal fractures. J Bone Joint Surg Am 2005;8(12):2741-9. https://doi.org/10.2106/JBJS.E.00166
3. Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res1993;(290):87-95. PMID: 8472475
4. Backes M, Schepers T, Beerekamp MSH, Luitse JSK, Goslings JC, Schep NWL. Wound infections following open
reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop 2014;38(4):767-73. https://doi.org/10.1007/s00264-013-2181-1
5. Atkins RM, Allen PE, Livingstone JA. Demographic features of intra-articular fractures of the calcaneum. Foot
Ankle Surg 2001;7(2):77-84. https://doi.org/10.1046/j.1460-9584.2001.00242.x
6. Mitchell MJ, McKinley JC, Robinson CM. The epidemiology of calcaneal fractures. Foot (Edinb) 2009;19(4):197-
200. https://doi.org/10.1016/j.foot.2009.05.001
7. Benson E, Conroy C, Hoyt DB, Eastman AB, Pacyna S, Smith J, et al. Calcaneal fractures in occupants involved in
severe frontal motor vehicle crashes. Accid Anal Prev 2007;39(4):794-9. https://doi.org/10.1016/j.aap.2006.11.010
8. Bohl DD, Ondeck NT, Samuel AM, Diaz-Collado PJ. Demographics, mechanisms of injury, and concurrent injuries associated with calcaneus fractures: A study of 14 516 patients in the American College of Surgeons National Trauma Data Bank. Foot Ankle Spec 2017;10(5):402-10. https://doi.org/10.1177/1938640016679703
9. Essex-Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. Br J Surg
1952;39(157):395-419. https://doi.org/10.1002/bjs.18003915704
10. Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, et al. Operative compared with nonoperative
treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am 2002;84(10):1733-44. https;//doi.org/10.2106/00004623-200210000-00001
11. Thorogood M, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, et al. Operative versus nonoperative treatment for closed, displaced, intraarticular fractures of the calcaneus: Randomised controlled trial. BMJ 2014;349:g4483. https://doi.org/10.1136/bmj.g4483
12. Dooley P, Buckley R, Tough S, McCormack B, Pate G, Leighton R, et al. Bilateral calcaneal fractures: operative
versus nonoperative treatment. Foot Ankle Int 2004;25(2):47-52. https://doi.org/10.1177/107110070402500202
intra-articular calcaneal fractures: results of a nationwide survey. Int Orthop 2008;32:711-5.
https://doi.org/10.1007/s00264-007-0385-y
2. Brauer CA, Manns BJ, Ko M, Donaldson C, Buckley R. An economic evaluation of operative compared with
nonoperative management of displaced intra-articular calcaneal fractures. J Bone Joint Surg Am 2005;8(12):2741-9. https://doi.org/10.2106/JBJS.E.00166
3. Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res1993;(290):87-95. PMID: 8472475
4. Backes M, Schepers T, Beerekamp MSH, Luitse JSK, Goslings JC, Schep NWL. Wound infections following open
reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop 2014;38(4):767-73. https://doi.org/10.1007/s00264-013-2181-1
5. Atkins RM, Allen PE, Livingstone JA. Demographic features of intra-articular fractures of the calcaneum. Foot
Ankle Surg 2001;7(2):77-84. https://doi.org/10.1046/j.1460-9584.2001.00242.x
6. Mitchell MJ, McKinley JC, Robinson CM. The epidemiology of calcaneal fractures. Foot (Edinb) 2009;19(4):197-
200. https://doi.org/10.1016/j.foot.2009.05.001
7. Benson E, Conroy C, Hoyt DB, Eastman AB, Pacyna S, Smith J, et al. Calcaneal fractures in occupants involved in
severe frontal motor vehicle crashes. Accid Anal Prev 2007;39(4):794-9. https://doi.org/10.1016/j.aap.2006.11.010
8. Bohl DD, Ondeck NT, Samuel AM, Diaz-Collado PJ. Demographics, mechanisms of injury, and concurrent injuries associated with calcaneus fractures: A study of 14 516 patients in the American College of Surgeons National Trauma Data Bank. Foot Ankle Spec 2017;10(5):402-10. https://doi.org/10.1177/1938640016679703
9. Essex-Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. Br J Surg
1952;39(157):395-419. https://doi.org/10.1002/bjs.18003915704
10. Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, et al. Operative compared with nonoperative
treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am 2002;84(10):1733-44. https;//doi.org/10.2106/00004623-200210000-00001
11. Thorogood M, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, et al. Operative versus nonoperative treatment for closed, displaced, intraarticular fractures of the calcaneus: Randomised controlled trial. BMJ 2014;349:g4483. https://doi.org/10.1136/bmj.g4483
12. Dooley P, Buckley R, Tough S, McCormack B, Pate G, Leighton R, et al. Bilateral calcaneal fractures: operative
versus nonoperative treatment. Foot Ankle Int 2004;25(2):47-52. https://doi.org/10.1177/107110070402500202