Early Weight Bearing of Calcaneal XXXX Treated by Intraoperative 3D-Fluoroscopy and Locked-Screw Plate Fixation.

@entity1 @entity174 @entity4040 @entity170 @entity7334 @entity2270
Operative therapy of @entity7334 of the calcaneus is an established surgical standard. The aim is an accurate reduction of the @entity174 with reconstruction of Boehler's angle, length, @entity2270 and subtalar joint surface. Intraoperative 3D-fluoroscopy with the Siremobil Iso-C 3D(R) mobile C-arm system is a valuable assistant for accurate reconstruction of these anatomical structures. Remaining incongruities can be recognized and corrected intraoperatively. The achieved reduction can be fixed by the advantages of an internal fixator (locked-screw plate interface). In the period of October 2002 until April 2007 we operated 136 @entity1 with @entity7334 of the calcaneus by means of anatomical reduction, and internal plate fixator under intraoperative control of 3D-fluoroscopy. All @entity1 were supplied with an orthesis after the operation which allowed weight bearing of 10 kg for 12 weeks for the @entity1 operated between October 2002 and October 2004 (Group A). Transient @entity170 was observed in all X-Rays at follow-up after an average of 8,6 months. Therefore we changed our postoperative treatment plan for the @entity1 operated between November 2004 and April 2007 (Group B). Weight bearing started with 20 KG after 6 weeks, was increased to 40 KG after 8 weeks and full weight bearing was allowed after 10 weeks for these @entity1 . In no case a secondary dislocation of the @entity174 was seen. No bone graft was used. At follow up the average American Foot and Ankle Society Score (AOFAS) were 81 for Group_A, compared to 84 for Group B, treated with earlier weight bearing. Autologous bone graft was not necessary even if weight bearing was started after a period of six weeks postoperatively. The combination of 3D-fluoroscopy with locked internal fixation showed promising results. If the rate of @entity1 developing @entity4040 will decrease by this management will have to be shown in long term follow up.
