5
Calcaneal fractures
Obsah
Foreword . . . . . . . . . . . . . . . . . . . . . . . . .
7
1 INTRODUCTION
9
2 FUNCTIONAL ANATOMY . . . . . . . . . . . . . . . . . . . .
11
3 BIOMECHANICS OF THE SUBTALAR JOINT . . . . . . . . . . . .
17
4 INCIDENCE AND MECHANISM OF INJURY
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4.1 Incidence . . . . . . . . . . . . . . . . . . . . . . . .
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4.2 Mechanism of injury . . . . . . . . . . . . . . . . . . . .
19
Analysis of mechanism of injury in patients operated on in the period of 2007–2014,
at the Department of Trauma Surgery of the Slovak Medical University (KÚCH SZU)
in Bratislava, Slovakia . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
5 Pathoanatomy of fractures
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5.1 Fracture patterns and the course of fracture lines
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5.2 Factors influencing the course and number of fracture lines . . . . .
23
5.3 Primary and secondary fracture lines
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5.4 Major fragments
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6 Diagnosis
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6.1 Patient´s medical history
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6.2 Clinical examination . . . . . . . . . . . . . . . . . . . .
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6.3 Radiographic diagnosis . . . . . . . . . . . . . . . . . .
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6.3.1 Standard radiographic projections . . . . . . . . . . . . . . . . . . . . .
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6.3.2 Other radiographic views
31
6.4 Computed tomography, 3D reconstruction . . . . . . . . . . .
32
7 Classifications
35
7.1 Radiography based classifications
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7.2 CT based classifications . . . . . . . . . . . . . . . . . .
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8 Scoring systems
41
9 Therapy . . . . . . . . . . . . . . . . . . . . . . . . . .
45
9.1 Non-operative treatment
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9.1.1 Historical review . . . . . . . . . . . . . . . . . . . . . . . . . . .
45
9.1.2 Indications for non-operative treatment
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9.1.3 Non-operative treatment used at our institution . . . . . . . . . . . . . . .
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9.2 Operative treatment . . . . . . . . . . . . . . . . . . . .
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9.2.1 Historical review . . . . . . . . . . . . . . . . . . . . . . . . . . .
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9.2.2 Non-operative versus operative treatment . . . . . . . . . . . . . . . . .
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9.2.3 Factors influencing the choice of operative technique . . . . . . . . . . . . .
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9.2.4 Timing of surgery . . . . . . . . . . . . . . . . . . . . . . . . . . .
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9.3 Open reduction and internal fixation (ORIF) . . . . . . . . . . .
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9.3.1 ORIF indications . . . . . . . . . . . . . . . . . . . . . . . . . . .
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9.3.2 ORIF indication criteria used at our institution
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9.3.3 ORIF contraindications used at our institution . . . . . . . . . . . . . . . .
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9.3.4 ORIF – surgical approaches
53
9.4 MIO (minimally invasive osteosynthesis) . . . . . . . . . . . .
69
9.4.1 MIO in tongue type fractures
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9.4.2 MIO in joint-depression type fractures
71
9.5 External fixation
73
9.6 MIO versus ORIF . . . . . . . . . . . . . . . . . . . . .
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10 Intraoperative control . . . . . . . . . . . . . . . . . .
77
10.1 Two-dimensional intraoperative control
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10.2 ISO-C-3D image intensifier . . . . . . . . . . . . . . . . .
78
