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Malunited calcaneal fracture: the role and technique of osteotomy—a systematic review

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Abstract

Purpose

The research is aimed to introduce various corrective osteotomies utilized in treating calcaneal malunions in published papers, to further analyze the results, and to summarize recommended indications.

Methods

The relevant research screening was conducted on the following search engines: the Cochrane Library, Web of Science, PubMed, Embase, Medline, and Academic Search Premier. Key words input included “calcaneal/calcaneus”, “malunion,” and “malunited fracture(s)” with Boolean operators “AND” and “OR.” The inclusion criteria were researches containing surgical procedures treating calcaneal malunion with corrective osteotomy and published in the English language. For included research article, such information was extracted and analyzed: the type of calcaneal malunion, the time from initial injury to corrective surgery, the method of osteotomy, outcomes of each osteotomy (score systems, Bohler angle, talocalcaneal height and width of calcaneus, etc.), the function of the affected limb, post-operative complications, and patients’ satisfaction. For included review, descriptive, commentary, or indicative sentences about corrective osteotomy were highlighted, analyzed, and summarized.

Results

Ten research articles (170 patients with 184 feet) and nine reviews were included in this review, presenting seven types of corrective osteotomies (lateral wall exostectomy, Dwyer osteotomy, lateral wedge opening osteotomy, Romash osteotomy, tongue osteotomy, sagittal resection osteotomy, and modified Dwyer osteotomy).

Conclusion

A different corrective osteotomy with/without arthrodesis is recommended to be utilized based on the classification of the malunion and the condition of the cartilage in treating malunited calcaneal fractures. With adequate postoperative care and rehabilitation, the results of treatment could be associated with patients’ satisfaction and good function.

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Data availability

All data used during the study are available from the corresponding author by request.

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Acknowledgements

The authors would like to thank Dr. P. V. Giannoudis for his selfless help, of which the constructive suggestions and detailed advice provided indispensable contribution for improving this paper. The authors also would like to thank Miss Luo, Huan for the fabulous illustrations visualizing the complex procedures of various surgeries, and making this paper more vivid.

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Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Xin Guan & Bin Yu

  2. Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Dayong Xiang, Yanjun Hu, Guiyong Jiang, Bin Yu & Bowei Wang

Authors
  1. Xin Guan
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  2. Dayong Xiang
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  3. Yanjun Hu
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  4. Guiyong Jiang
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  5. Bin Yu
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  6. Bowei Wang
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Contributions

B Wang and B Yu designed the research; X Guan, D Xiang, Y Hu, and G Jiang collected and analyzed data; X Guan wrote the paper; B Wang and B Yu supervised the research and revised the manuscript.

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Correspondence to Bin Yu or Bowei Wang.

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Guan, X., Xiang, D., Hu, Y. et al. Malunited calcaneal fracture: the role and technique of osteotomy—a systematic review. International Orthopaedics (SICOT) 45, 2663–2678 (2021). https://doi.org/10.1007/s00264-021-05130-1

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