PMID- 22448049
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20120823
LR  - 20220321
IS  - 1998-3727 (Electronic)
IS  - 0019-5413 (Print)
IS  - 0019-5413 (Linking)
VI  - 46
IP  - 2
DP  - 2012 Mar
TI  - Treatment of displaced intraarticular calcaneal fractures with or without bone 
      grafts: A systematic review of the literature.
PG  - 130-7
LID - 10.4103/0019-5413.93672 [doi]
AB  - BACKGROUND: The necessity of bone grafts in the treatment of intraarticular 
      calcaneal fractures continues to be one of the most debated topics in foot and 
      ankle surgery. The purpose of this study was to determine whether there are 
      sufficient objective cumulative data in the literature to compare the two methods 
      and if the bone graft was needed in surgical treatment of intraarticular 
      calcaneal fractures. MATERIALS AND METHODS: A comprehensive search of all 
      relevant articles from 1990 to 2010 was conducted. Two reviewers evaluated each 
      study to determine its suitability for inclusion and collected the data of 
      interest. Meta-analytic pooling of group results across studies was performed for 
      the two treatment methods. RESULTS: The systematic review identified 32 primary 
      studies with 1281 fractures, which contained 4 comparative studies, 13 with bone 
      grafts, and 15 without bone grafts in treatment methods. The infection rate in 
      bone graft group was higher through statistically insignificant than in non-graft 
      group (8.3% vs. 6.3%) No significant difference was found between good reduction 
      rate, postoperative osteoarthritis rate, and subtalar fusion rate. The average 
      full weight-bearing time in bone graft group was significantly lower (5.4 months) 
      than in non-graft group (10.5 months). The mean postoperative Bohler's angle was 
      significantly higher in bone graft group (lose due to collapse was significancy 
      less). For the efficacy outcomes, the bone graft group had a lower American 
      Orthopaedic Foot and Ankle Society Score (AOFAS) (71.4 points vs. 80.5 points) 
      but a higher Creighton score (89.9 points vs. 81.0 points) compared with 
      non-graft group. Pooled mean results showed 35% of the patients in bone graft 
      group had an excellent result, 40% had a good result, 21% had a fair result, and 
      4% had a poor result. In the non-graft group, the corresponding values were 34, 
      42, 14, and 10%, respectively. CONCLUSIONS: The operative treatment of 
      intraarticular calcaneal fractures with bone grafts could restore the Bohler's 
      angle better and the patients could return to full weight bearing earlier. 
      However, the functional and efficacy outcomes appear to be similar between the 
      two treatment groups. There were more joint depression and comminuted fractures 
      in the bone graft group, and the mean followup time was shorter. Large sample 
      comparative studies are still needed.
FAU - Yang, Yunfeng
AU  - Yang Y
AD  - Department of Orthopaedic Surgery, Tongji Hospital of Tongji University, 
      Shanghai, China.
FAU - Zhao, Hongmou
AU  - Zhao H
FAU - Zhou, Jiaqian
AU  - Zhou J
FAU - Yu, Guangrong
AU  - Yu G
LA  - eng
PT  - Journal Article
PL  - Switzerland
TA  - Indian J Orthop
JT  - Indian journal of orthopaedics
JID - 0137736
PMC - PMC3308652
OTO - NOTNLM
OT  - Bone graft
OT  - calcaneal fracture
OT  - operative treatment
COIS- Conflict of Interest: None.
EDAT- 2012/03/27 06:00
MHDA- 2012/03/27 06:01
PMCR- 2012/03/01
CRDT- 2012/03/27 06:00
PHST- 2012/03/27 06:00 [entrez]
PHST- 2012/03/27 06:00 [pubmed]
PHST- 2012/03/27 06:01 [medline]
PHST- 2012/03/01 00:00 [pmc-release]
AID - IJOrtho-46-130 [pii]
AID - 10.4103/0019-5413.93672 [doi]
PST - ppublish
SO  - Indian J Orthop. 2012 Mar;46(2):130-7. doi: 10.4103/0019-5413.93672.