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Fractures of the Calcaneus
Mandeep S Dhillon
CHAPTER 1:
Historical Aspects of Calcaneus Injury
CHAPTER 2:
Clinical Anatomy and Injury Mechanics
INTRODUCTION
TOPOGRAPHICAL ANATOMY
FUNCTIONAL ANATOMY
VASCULAR ANATOMY
ANATOMY AND PATHOMECHANICS OF OS CALCIS FRACTURE
CHAPTER 3:
Imaging Techniques and Image Interpretation
INTRODUCTION
COMPRESSIVE TRABECULAE
TENSILE TRABECULAE
RADIOLOGICAL GOALS
PLAIN RADIOGRAPHY
LATERAL VIEW OF HINDFOOT
ANTEROPOSTERIOR AND OBLIQUE VIEW OF FOOT
HARRIS AXIAL VIEW7–9
COMPARATIVE X-RAYS
BRODEN'S VIEWS7–9
MORTISE VIEW
IMAGING OF UNCOMMON EXTRA-ARTICULAR FRACTURES
TOMOGRAMS
CT SCAN
RADIOLOGY INTERPRETATION
Angles
Fracture Lines
Joints
Shape and Size
Heel Position
Bony Walls
Sustantaculum Tali
Fragments
Bone Quality and Degree of Communition
Classification
RADIOLOGY INTERPRETATION AND ITS ROLE IN MANAGEMENT
CHAPTER 4:
Fracture Classification
INTRODUCTION
EXTRA-ARTICULAR FRACTURES
THE BOHLER CLASSIFICATION
THE ESSEX-LOPRESTI CLASSIFICATION
THE ZWIPP CLASSIFICATION
THE CROSBY CLASSIFICATION
THE SANDERS CLASSIFICATION
THE AO/OTA CLASSIFICATION
DISCUSSION
SUMMARY
CHAPTER 5:
Nonoperative Management of Calcaneal Fractures
INTRODUCTION
HISTORICAL PERSPECTIVE REGARDING NONOPERATIVE MANAGEMENT OF CALCANEAL FRACTURES
Indications for Nonoperative Treatment14
How to Give Nonoperative Treatment
Nonoperative Treatment for Pediatric Calcaneal Fractures
Nonoperative Treatment for Geriatric Calcaneal Fractures
Special Situations
Operative vs Nonoperative Management for Calcaneal fractures
SUMMARY
CHAPTER 6:
Operative Management: Surgical Approaches
THE PALMER APPROACH
SINUS TARSI APPROACH
SMALL LATERAL APPROACH
EXTENSILE SINUS TARSI APPROACH
GEEL AND FLEMISTER APPROACH
POSTERO-PLANTAR APPROACH11
STRAIGHT LATERAL SUBTALAR APPROACH
EXTENDED LATERAL TRANSCALCANEAL APPROACH
SUSTENTACULAR APPROACH14
MEDIAL APPROACH14
CARR'S MODIFICATION OF THE MEDIAL APPROACH
GALLIE'S APPROACH15
CINCINNATI UNIVERSITY APPROACH
COMBINED MEDIAL AND LATERAL APPROACHES17
OLLIER APPROACH
CHAPTER 7:
Percutaneous Reduction and Fixation of Calcaneal Fractures
INTRODUCTION
PRINCIPLES OF MANAGEMENT
METHODS OF PERCUTANEOUS REDUCTION: ESSEX-LOPRESTI MANEUVER
FRACTURE FIXATION
MINIMALLY INVASIVE SURGERY TECHNIQUE FOR JOINT DEPRESSION FRACTURES
POSTOPERATIVE REGIMEN
COMPLICATIONS
RESULTS FOLLOWING PERCUTANEOUS FIXATION
TIPS
CHAPTER 8:
Fixation by Extensile Lateral Approach
INDICATIONS
TIMING OF SURGERY
POSITIONING
APPROACH AND SURGICAL TECHNIQUE
POSTOPERATIVE MANAGEMENT
CHAPTER 9:
Evolution of Implant Use and Rationale for Locking Compression Plates (LCP)
SCREW FIXATION
WIRE FIXATION
EXTERNAL FIXATORS
PLATE AND SCREW FIXATION
LOCKING PLATES
FUTURE DIRECTIONS AND INNOVATIONS
BIOABSORBABLE IMPLANTS AND SCREWS
CHAPTER 10:
Management of Open Calcaneal Fractures
INCIDENCE
Soft Tissue Envelope Over the Calcaneus
MECHANISMS
Diagnosis and Evaluation of the Open Fracture
TREATMENT GOALS
Initial Management
SURGICAL MANAGEMENT
LITERATURE REVIEW
Recommendations for Treatment
CHAPTER 11:
Primary Reconstructive Subtalar Arthrodesis
INTRODUCTION
INDICATIONS
SURGICAL TECHNIQUE
VIRA® SYSTEM
TECHNIQUE AND TREATMENT PROTOCOL
Surgical Technique
RESULTS OF PRIMARY FUSION
Biomechanical Consequences of Subtalar Fusion After Calcaneus Fracture
CHAPTER 12:
Role of Bone Graft and Bone Substitutes
INTRODUCTION/BACKGROUND
BONE GRAFT AND SUBSTITUTE CHARACTERISTICS
BONE GRAFT AND SUBSTITUTE OPTIONS
No Graft or Substitute
Bone Grafts (Biologic)
Autograft
Allograft/Demineralized Bone Matrix
Synthetic Bone Substitutes
Polymethylmethacrylate (PMMA) Cement
Ceramic Cements
Hydroxyapatite
Calcium Sulfate
Calcium Phosphate
Composite Bone Substitutes
RECOMMENDATIONS
CHAPTER 13:
Complications of Calcaneus Fracture other than Malunion
COMPARTMENT SYNDROME
Mechanism and Pathophysiology
Clinical Presentation
Treatment
Indications for Fasciotomy
Fasciotomy Incisions of Foot
NONUNION
Risk Factor
Pathoanatomy
Clinical Presentation
Management
Surgical Approach
Basic Surgical Steps are Enumerated Below
TARSAL TUNNEL SYNDROME
REFLEX SYMPATHETIC DYSTROPHY
INFECTION AND WOUND COMPLICATIONS
Review of Gold Standard Evidences
Clinical Presentation and Management
CHAPTER 14:
Malunion Calcaneus: Understanding it, Classification and Treatment Planning
SURGICAL ANATOMY AND ANATOMY OF THE MALUNION
MALUNION—CLINICAL EVALUATION
MALUNION—RADIOLOGICAL EVALUATION
CLASSIFICATION
Shortcomings of Classification
PLANNING OF THE TREATMENT FOR CALCANEAL MALUNION
Case Studies
Case 1: (Figs 14.22 and 14.23)
Case 2: (Figs 14.24 and 14.25)
Case 3: (Figs 14.26 and 14.27)
CHAPTER 15:
Surgical Treatment of Calcaneal Malunion
PATHOANATOMY
SURGICAL INDICATIONS AND CONTRAINDICATIONS
General Principles of Surgical Treatment
LATERAL WALL DECOMPRESSION
POSTERIOR EXOSTECTOMY
Case Example 1
Technique
IN SITU SUBTALAR ARTHRODESIS
SUBTALAR DISTRACTION BONE BLOCK ARTHRODESIS
Case Example 2
Technique
Outcomes
CORRECTIVE OSTEOTOMY AND ARTHRODESIS
Vertical Sliding Calcaneal Osteotomy and Arthrodesis
Technique
Outcomes
Osteotomies and Arthrodesis to Correct Varus or Valgus Deformity
Technique
Outcomes
ROMASH OSTEOTOMY
SUMMARY
CHAPTER 16:
Malunion Calcaneus Minimally Invasive Surgery
INTRODUCTION
ARTHROSCOPIC SURGERY
Calcaneofibular Impingement
POSTERIOR ANKLE IMPINGEMENT SYNDROME CAUSED BY MALUNION OF JOINT DEPRESSED TYPE CALCANEAL FRACTURE
Impingement to the Achilles Tendon by Malunited Tongue type Calcaneal Process
CALCANEOCUBOID IMPINGEMENT
Anterosuperior Impingement
SUBTALAR AND/OR CALCANEOCUBOID ARTHROSIS
SUBTALAR ARTHROFIBROSIS
Synovitis
PERONEAL TENDON PATHOLOGIES
TAKE HOME MESSAGES
CHAPTER 17:
Outcome Evaluations of Calcaneal Fractures
INTRODUCTION/BACKGROUND
Global Update
OUTCOME MEASURES FOR EVALUATION OF CALCANEAL FRACTURES MANAGEMENT
Demographic Data
Fracture Characteristics and Classification
Radiographic Parameters
Foot Function Assessment
Unspecified Pain Scores
Range of Movement
Walking Ability
Return to Work
Shoe Wear
VAS (Visual Analog Scale) Scores
Foot Function Scores
American Orthopaedic Foot Ankle Society (AOFAS) Ankle-Hindfoot Score18
FOOT FUNCTION INDEX
Foot Function Index
Calcaneal Fracture Scoring System
Maryland Foot Score
Modified Rowe score
“Calgary” Score
“Hannover” Calcaneal Fracture Score
Quality of Life Measuring Scores
Short Form Health Survey (SF-36)
Short SF-36 Questionnaire
EQ-5D
Complications
Need for Unplanned Operations
Conclusions/Take Home Messages
CHAPTER 18:
Rehabilitation Protocols after Calcaneal Fractures
OBSERVATION AND PHYSICAL EXAMINATION
AIMS OF REHABILITATION AND PROGNOSIS
NONOPERATIVE TREATMENT
Surgical Procedure
PREOPERATIVE REHABILITATION
Postoperative Details
REHABILITATION PROTOCOL FOR CALCANEAL FRACTURE (NONOPERATIVE AND POSTOPERATIVE)16
CALCANEUS FRACTURE POSTOPERATIVE PROTOCOL17
REHABILITATION PROTOCOL FOR CALCANEAL FRACTURE18
REHABILITATION FOR A CALCANEAL STRESS FRACTURE
Physiotherapy Techniques for a Calcaneus Stress Fracture
CHAPTER 19:
Evidence Based Orthopedics: What is Optimal for Calcaneus Fracture Today
INTRODUCTION
NONOPERATIVE MANAGEMENT
OPERATIVE VERSUS NONOPERATIVE MANAGEMENT
Case-Control Studies
Observational Cohort Studies
Randomized Controlled Trials
Systematic Reviews
OPERATIVE MANAGEMENT: TECHNIQUES AND PARAMETERS
Observational Cohort Studies
EVIDENCE FOR BONE GRAFTS AND SUBSTITUTES
EVIDENCE FOR COMPLICATIONS
INSTITUTIONAL FACTORS
RECOMMENDATIONS FOR FUTURE RESEARCH
INDEX
TOC
Index
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