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Surgical treatment of thalamic fractures treated by anatomic plate with survevent

MOJ Orthopedics & Rheumatology
Lahrach K,1 Soumare B,1 Sidibe S,1 Diarra S,2 Saeed AR,1 Boutayeb F1

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Introduction: Calcaneus fractures are frequent and serious injuries. They represent 65% of tarsal trauma and 2% of all fractures. The thalamic fractures constitute a particular entity by their mechanism of occurrence, by their treatment and by their prognosis much less favorable than the extra-articular fractures.1

Materials and methods: Our series spanning a period of 7 years from January 2011 to November 2018 focused on 12 patients with a thalamic fracture of the calcaneus treated by anatomical plate with bearing, collected in the Orthopedic Trauma Department A of the Hassan II Fez University Hospital. All adult patients with a thalamic calcaneal fracture who had undergone an osteosynthesis using an anatomical plate were included and extra-thalamic fractures and thalamic fractures treated by other therapeutic means or other types of screw plates were excluded. All patients underwent an urgent general systematic examination and a regional examination. On the neurological level, the majority of patients were admitted with a GCS at 15.

Results: Our focused on 12 operated patients between the ages of 17 and 53 with an average of 35 years. Our series includes 12 patients including 17 calacneum fractures which are divided into 10 men and 2 women; the male sex represents 83.3%. The preoperative delay was on average 9.25 days with extremes between 03 and 20 days. No thromboembolic complications or algodystrophy were noted in our series. According to Kitaoka's rating, the average score was 73.5%. The functional results were excellent in 47.06% of the cases, good in 23.53% of the cases, average in 23.53% of the cases and poor in 5.88% of the cases. In post-operative the average Bohler angle was 26.5° (15° to 35°) against a pre-operative Bohler angle varying between -7° to 15°. On revision, the average recoil from Bohler's angle finds it to be 21.5°.

Conclusion: In the light of all those preceding the surgical treatment of articular fractures of the calcaneus displaced by anatomical plate, despite the risks associated with this technique provides a certain superiority if you are sure you can get a perfect reduction.


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