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nailing utilises small 1–2 cm incisions and avoids s.c. implants, with the nail being embedded in the medullary canal of the bone and locked proximally and distally. Nevertheless, increased post-operative wound care is still needed for diabetics who
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radiologically and a very low complication rate. 54 For further evaluation, more comparative long-term studies are needed. Post-operative care Our post-operative protocol consists of full weight-bearing mobilisation in a post-operative shoe for six
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, anterior tibial and Achilles tendon sheaths, and named the technique ‘tendoscopy’. 2 Tendoscopy is usually followed by a functional post-operative treatment and has the advantages of less post-operative pain, fewer complications and being performed as
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. This approach can be easily extended both proximally and distally, and implant removal may be performed with little operative morbidity. However, if a second posteromedial or lateral incision is planned, care must be taken not to create an island of
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incidence of malpositioning in post-operative CT scans. 33 Direct lag screw fixation of the posterior fragment is more reliable than indirect fixation from anterior. In osteoporotic bone, a dorsal anti-glide plate ( Fig. 5 ) will provide even more
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of the RCTs assessed the outcomes of calcaneal fractures specifically in relation to smoking or diabetes, which are considered two of the important risk factors for potential post-operative complications. 19 , 36 Discussion Various
Department of Orthopaedics and Trauma Surgery, Klinik Gut, St. Moritz, Switzerland
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AO Research Institute Davos, Davos Switzerland
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patients requires an individual concept. The attendant surgeon has to take the soft tissue conditions, bone quality and compliance into account. Stabil fractures and patients with absolute contraindications for operative care should be treated
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photograph: (A) Modified scarf osteotomy cut. (B) Modified scarf osteotomy fixation. Figure 9 Post-operative radiograph of the foot: (A) Dorso-plantar view. (B) Lateral view. (ii) Length discrepancy of 5–7 mm Lesser metatarsal
Orthopaedic Surgery Working Group, Society of Junior Doctors, Athens, Greece
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University of Patras, School of Medicine, Patras, Greece
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NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK
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-establishment of the medullary cavity. In case the patient is an operative candidate, an intramedullary screw fixation is our usual standard of care as described above. Post-operatively, the patient is placed in a non-weight-bearing splint after 1 week and
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through a lateral approach, as described above, may be carried out and the tendons explored accordingly. Post-operative care and rehabilitation We generally advise a non-weight-bearing back slab until a two-week wound check. A cast, walking boot
