The Effect Of The Primary Wound Closure Technique In The Surgical Treatment Of Closed Intra-Articular Calcaneal Fractures

Περίληψη

Aim: To assess the impact of the primary wound closure method in the surgical management of closed intra-articular calcaneal fractures, with the aim of improving postoperative wound healing, reducing complications, minimizing expenses, enhancing overall functional outcomes, and restoring foot function and patients' quality of life. Design: Our study, a prospective and retrospective cohort clinical study, was conducted in our hospitals. Patients and Methods: Twenty-eight patients with thirty-one intra-articular calcaneal fractures were enrolled, following stringent inclusion and exclusion criteria for patient selection. These patients underwent open reduction using an extensile lateral approach and internal fixation with plates and screws at our institution between November 2020 and August 2023. Sixteen fractures were closed using the modified Allgöwer-Donati technique, while the remaining fifteen fractures were closed using the conventional vertical mattress suturing technique. Results: The overall incidence of post-operative wound complications in the operated fractures in our series was 32.26% (10 out of 31 operated fractures). Two cases (12.5%) from the first group, which used the modified Allgöwer-Donati suturing technique, compared to eight cases (53.33%) from the second group, which used the traditional vertical mattress suturing technique, showed post-operative wound complications in our series. Conclusion: The use of the modified Allgöwer-Donati technique for surgical wound closure following open reduction and internal fixation (ORIF) of fresh closed intra-articular calcaneal fractures in adult patients resulted in improved wound healing and reduced post-operative wound complications compared to the standard technique. This improvement is attributed to the technique's ability to relieve tension on wound edges, which enhances skin vascularity and perfusion.