A Comparison of the Essex-Lopresti Technique and Conservative Treatment for Displaced Tongue-Type Calcaneus Fractures

Abstract

Aims: This study aimed to evaluate the mid-term clinical and radiological results of conservative treatment and surgical treatment made with the Essex-Lopresti technique in tongue-type calcaneus fractures. Study Design: A comparison of two treatment options (the Essex-Lopresti Technique and conservatively). Radiological comparison, Functional comparison and isokinetic dynamometer were used to evaluate. Place and Duration of Study: 3 separate centers between November 2005 and April 2013 were examined. Methodology: A retrospective evaluation was made of 19 patients (Group 1) who were operated on with the Essex-Lopresti Technique and 27 patients (Group 2) who were treated conservatively. Radiological comparison was based on correction in Bohler’s angle. Functional comparison was made using the Maryland Foot Score (MFS). In the comparison of the gastrosoleus muscle complex strength, an isokinetic dynamometer was used. To determine the distribution of all the variables in the comparisons of the groups, the Kolmogorov-Smirnov test was used. For variables showing normal distribution, Student’s t-test (Independent Sample T Test) was applied. Results: The Maryland Foot Score was determined as 96.2 in Group 1 and 85.6 in Group 2 (p=0.002). While findings of subtalar arthrosis were determined in 2 (10.5%) patients of Group1, subtalar arthrosis was seen to have developed in 7 (25.9%) patients of Group 2 (p=0.014). In the isokinetic muscle strength measurements, the mean plantar flexion muscle strength was 106.2 (85-122.4) Nm in Group 1 and 96.4 (73.3-124) Nm in Group 2 and this difference was statistically significant (p=0.034). Conclusion: The Essex-Lopresti Technique is an effective method in the treatment of tongue-type calcaneus fractures.