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International Orthopaedics

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01-05-2013 | Original Paper

Balloon reduction and cement fixation in calcaneal articular fractures: a five-year experience

Authors: Frederic Jacquot, Thomas Letellier, Arthur Atchabahian, Levon Doursounian, Jean-Marc Feron

Published in: International Orthopaedics | Issue 5/2013

Abstract

Purpose

Balloon reduction and cement fixation of displaced articular fractures of the calcaneus have been described elsewhere but support for it lacks clinical evidence. We have been performing the technique since October 2006 and describe here our clinical experience including three to five-year follow up of our first ten cases with no patient lost to follow up.

Methods

From September 2006 to September 2009, ten patients were admitted with a calcaneus fracture, six were female and four male, one case was bilateral (11 fractures). Patients were operated upon in the prone position according to the technique we have described. Reduction was obtained in all cases. Patients were discharged after an average of four days postoperatively and were allowed weight bearing after two to three months. All patients were followed up regularly and were examined by an independent observer at the latest follow up. The clinical results were assessed using the AOFAS ankle score, the Babin score and the RAND-36 physical components score. A CT scan was obtained in all patients before, after the operation and at the latest follow up.

Results

After a minimal follow up of 36 months (three to five years), no patient was lost to follow up and none required further surgery. The AOFAS clinical results were rated good or excellent in 81.8 % of cases (nine fractures, eight patients), and the physical component of the RAND-36 was 74.6. One patient only (one fracture) had a bad clinical result and evidence of subtalar arthritis on the CT scan and was offered a subtalar fusion; she refused. All patients had returned to their former professional activities at the same level as before the fracture except one who had retired but had resumed leisure walking.

Conclusion

Balloon reduction and cement fixation of fresh calcaneal fractures (“balloon calcaneoplasty”) appears a safe and effective procedure in a variety of calcaneal fractures with lasting and excellent clinical results. More studies are needed to further refine the indications and the limits of the procedure.

Bano A, Pasku D, Karantanas A, Alpantaki K, Souvatzis X, Katonis P (2009) Intra-articular calcaneal fracture: closed reduction and balloon-assisted augmentation with calcium phosphate cement: a case report. Cases J 2:9290. doi:10.1186/1757-1626-2-9290 PubMedCrossRef

Broome B, Mauffrey C, Statton J, Voor M, Seligson D (2012) Inflation osteoplasty: In vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius. J Orthop Traumatol 13(2):89–95. doi:10.1007/s10195-012-0185-z PubMedCrossRef

Gupta AK, Gluck GS, Parekh SG (2011) Balloon reduction of displaced calcaneus fractures: surgical technique and case series. Foot Ankle Int 32(2):205–210. doi:10.3113/FAI.2011.0205 PubMedCrossRef

Heiney JP, O’Connor JA (2010) Balloon reduction and minimally invasive fixation (bramif) for extremity fractures with the application of fast-setting calcium phosphate. J Orthop 7(2):e8

Jacquot F, Atchabahian A (2011) Balloon reduction and cement fixation in intra-articular calcaneal fractures: a percutaneous approach to intra-articular calcaneal fractures. Int Orthop 35(7):1007–1014. doi:10.1007/s00264-011-1249-z PubMedCrossRef

Jacquot F, Atchabahian A, Letellier T (2011) Comment to the paper “balloon reduction and cement fixation in intra-articular calcaneal fractures: a percutaneous approach to intra-articular calcaneal fractures” by Jacquot et al. Int Orthop 35(11):1741–1742. doi:10.1007/s00264-011-1319-2 PubMedCrossRef

Jacquot F, Mokhtar MA, Sautet A, Feron J-M (2011) Balloon percutaneous reduction and cementoplasty of thalamic fractures of the calcaneum: four cases with two years follow-up. J Bone Joint Surg Br 93-B(Suppl IV):539

Mauffrey C, Bailey JR, Hak DJ, Hammerberg ME (2012) Percutaneous reduction and fixation of an intra-articular calcaneal fracture using an inflatable bone tamp: description of a novel and safe technique. Patient Saf Surg 6(1):6. doi:10.1186/1754-9493-6-6

Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353PubMedCrossRef

10.

Babin SR, Copin G, Simon P, Kempf JF, Vidal P (1985) Statistical study of a series of 355 subtalar fractures of the calcaneus. Therapeutic conclusions. Int Orthop 9(3):171–179PubMedCrossRef

11.

Loutzenhiser L, Lawrence SJ, Donegan RP (2008) Treatment of select open calcaneus fractures with reduction and internal fixation: an intermediate-term review. Foot Ankle Int 29(8):825–830. doi:10.3113/FAI.2008.0825 PubMedCrossRef

12.

Hahnhaussen JHD, Weckbach S, Heiney JP, Stahel PF (2012) Percutaneous inflation osteoplasty for indirect reduction of depressed tibial plateau fractures. Orthopedics 35(9):768–772. doi:10.3928/01477447-20120822-04 PubMedCrossRef

13.

Iida KSA, Ishiguro S (2010) Clinical and radiological results of calcium phosphate cement-assisted balloon osteoplasty for Colles’ fractures in osteoporotic senile female patients. J Orthop Sci 15(2):204–209. doi:10.1007/s00776-009-1449-1 PubMedCrossRef

14.

Ishiguro SOY, Sudo A, Uchida A (2007) Calcium phosphate cement-assisted balloon osteoplasty for a Colles’ fracture on arteriovenous fistula forearm of a maintenance hemodialysis patient. J Hand Surg Am 32(6):821–826PubMedCrossRef

15.

Pizanis AGP, Pohlemann T, Burkhardt M (2012) Balloon tibioplasty: a useful tool for reduction of tibial plateau depression fractures. J Orthop Trauma 26(7):e88–e93. doi:10.1097/BOT.0b013e31823a8dc8 PubMedCrossRef

16.

Epstein N, Chandran S, Chou L (2012) Current concepts review: intra-articular fractures of the calcaneus. Foot Ankle Int 33(1):79–86. doi:10.3113/FAI.2012.0079

17.

Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, Galpin R (2002) Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am 84-A(10):1733–1744PubMed

18.

Rammelt S, Amlang M, Barthel S, Zwipp H (2004) Minimally-invasive treatment of calcaneal fractures. Injury 35(Suppl 2):SB55–SB63. doi:10.1016/j.injury.2004.07.012 PubMed

19.

Rammelt S, Gavlik JM, Barthel S, Zwipp H (2002) The value of subtalar arthroscopy in the management of intra-articular calcaneus fractures. Foot Ankle Int 23(10):906–916PubMed

20.

Wee AT, Wong YS (2009) Percutaneous reduction and injection of Norian bone cement for the treatment of displaced intra-articular calcaneal fractures. Foot Ankle Spec 2(2):98–106. doi:10.1177/1938640009334153 PubMedCrossRef

21.

Bajammal SSZM, Lelwica A, Tornetta P 3rd, Einhorn TA, Buckley R, Leighton R, Russell TA, Larsson S, Bhandari M (2008) The use of calcium phosphate bone cement in fracture treatment. A meta-analysis of randomized trials. J Bone Joint Surg Am 90(6):1186–1196PubMedCrossRef

22.

Kissel CG, Husain ZS, Cottom JM, Scott RT, Vest J (2011) Early clinical and radiographic outcomes after treatment of displaced intra-articular calcaneal fractures using delta-frame external fixator construct. J Foot Ankle Surg 50(2):135–140. doi:10.1053/j.jfas.2010.12.026

Title: Balloon reduction and cement fixation in calcaneal articular fractures: a five-year experience
Authors: Frederic Jacquot
Thomas Letellier
Arthur Atchabahian
Levon Doursounian
Jean-Marc Feron
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 5/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-1865-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Balloon reduction and cement fixation in calcaneal articular fractures: a five-year experience

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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