The value of Gissane's angle in the population of central Serbia

Background / Aim. Determining the value of Gissane?s angle (GA) plays a role in diagnosis and prognosis of heel fractures, determining treatment methods and assessing the outcome of surgical treatment. Normal values of the GA vary in relation to ethnicity, age and gender of the examined group, which indicates its anthropometric significance. The aim of this study was to determine the range of normal GA values in the population of Central Serbia. Methods. GA was determined on lateral radiography of the foot of 145 subjects, both sexes (67 women and 78 men), with subjects divided into 6 age groups. The patients included in the study did not have a calcaneus fracture. The obtained results were processed in the Graph Pad program. Results: The average value of GA in Serbia was 110.8? ? 8.1, ranging from 93? to 132.9?. The mean value of GA decreased with age, and no difference was observed between women and men, except in the youngest age group were women had higher GA values than men. Conclusion. The results of the study showed a wide range of normal GA values, as well as the existence of a difference in subjects of different age and sex.

Functional and radiological outcomes in displaced heel fractures: Open reduction and internal fixation versus external fixation

Management of intra-articular heel fractures is controversial. The main goals of surgical treatment are restoring subtalar articular congruence and width, height, form and alignment of the heel. The gold standard is considered Open Reduction and Internal Fixation (ORIF), a complex technique with a high rate of complications. External Fixation (EF) could be a good alternative. In this study were identified 37 fractures in 35 patients (24 patients underwent ORIF and EF was performed in 13 cases) and the outcomes of the two techniques were compared. The mean surgical time for ORIF was 107.8 minutes, while for EF was 88.61 minutes and the ORIF group presented a higher rate of complications, despite of similar results in the mean postoperative AOFAS Ankle and Hindfoot Scale scores (73.31/100 points in the ORIF group and 75.40/100 points in the EF group). Fast learning curve, short surgery time and low complications rate make EF an alternative to ORIF in treating intraarticular heel fractures.

Biomechanics – Elastic Foundation Applied in Modelling of Calcaneal Nails

This paper presents a strength analysis of a calcaneal nail (material Ti6Al4V and stainless steel) which is used to treat complex heel fractures. The application focuses on a unique calcaneal nail, the C-NAIL, produced by Medin a.s. (Nové Město na Moravě, Czech Republic). The paper first presents an analysis of fracture types, treatment methods and loading of the calcaneus. It then presents an analysis of limit conditions and loading. Calculations (displacement and stress) are performed for 6 and 7 fixing screws using FEM (Ansys Workbench 14 software). The calculation involves a new, original application of an elastic foundation, which effectively replaces the complex interaction of the calcaneal nail and the heel bone.