What did the study look at?
Tongue-type fractures are one kind of heel bone (calcaneus) fracture, and they can be treated with or without surgery (conservatively). The Essex-Lopresti technique is one of the surgical methods used for these fractures. The study aimed to compare the mid-term clinical and radiological results of surgery with the Essex-Lopresti technique and of non-surgical treatment in displaced tongue-type heel fractures.
How was it done?
Patients treated at three separate centres between November 2005 and April 2013 were reviewed retrospectively:
- Group 1: 19 patients operated on with the Essex-Lopresti technique.
- Group 2: 27 patients treated without surgery.
Three types of comparison were used:
- Radiological: correction of Böhler's angle, an X-ray measurement of the heel bone's shape.
- Functional: the Maryland Foot Score.
- Muscle strength: the strength of the calf muscle group (gastrosoleus complex), measured with a device called an isokinetic dynamometer.
The distribution of the data was checked with the Kolmogorov-Smirnov test, and normally distributed variables were compared with the independent-samples Student's t-test.
What did it find?
- The Maryland Foot Score was 96.2 in the operated group and 85.6 in the non-operated group (p = 0.002).
- Signs of arthritis in the joint below the ankle (subtalar arthrosis) were found in 2 patients (10.5%) in the operated group and 7 patients (25.9%) in the non-operated group (p = 0.014).
- Mean strength for pointing the foot downwards (plantar flexion) was 106.2 Nm (85-122.4) in the operated group and 96.4 Nm (73.3-124) in the non-operated group, a statistically significant difference (p = 0.034).
The authors' conclusion
The authors concluded that the Essex-Lopresti technique is an effective method for treating tongue-type heel bone fractures.
These results come from a retrospective review of 46 patients treated at three centres; patients were not randomly assigned to the treatment groups.
Reference
Isik C, Tahta M, Cay N, Akmese R, Gürsoy S, Bozkurt M. 2015. A Comparison of the Essex-Lopresti Technique and Conservative Treatment for Displaced Tongue-Type Calcaneus Fractures. British Journal of Medicine and Medical Research (now Journal of Advances in Medicine and Medical Research) 6(9):918-925.
Free full text: Journal of Advances in Medicine and Medical Research
This summary is based on the article's abstract.
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
