[This retracts the article DOI: 10.7759/cureus.19681.].
Open reduction and internal fixation of displaced intraarticular calcaneal fractures remain the gold standard of treatment, but the traditional extensile approach has been associated with relatively frequent complications. The current study aims to evaluate the less invasive sinus tarsi approach and to elaborate on the associated complications, risk factors, and outcome predictors. A retrospective observational study was carried out among 39 patients diagnosed with calcaneal fractures that were operatively treated between January 2019 and January 2020 at a level-one trauma center in Riyadh, Saudi Arabia. Patients were assessed regarding the complications, pre- and postoperative Bohler's angle, Gissane's angle, calcaneal height, and return to baseline function. Patients older than 60 years show significantly more complications compared to younger patients (p < 0.05). Type IV calcaneal fracture, according to Sander's classification, showed significantly more complications than other types (p < 0.05). There were significant variations in pre- and postoperative Bohler's angle and calcaneal height (p < 0.05). These variations apply to the Gissane's angle but do not rise to significant results (p > 0.05). Furthermore, the current study reports a significant moderate direct correlation between delay time and complication incidence (p < 0.05). In conclusion, the minimally invasive sinus tarsi approach has relatively low complications and excellent clinical and radiological outcomes. Older patients and those who are diagnosed with type IV calcaneal factures, besides those presented with more delay, are more associated with unfavorable complications.
Small intestinal obstruction is a common indication for hospitalization and emergency surgeries. The most frequent etiologies are adhesions, hernia, and benign or malignant neoplasms. Abdominal imaging plays an important role in making the diagnosis and evaluating the complications of the obstruction. We report a case of a young woman who presented with sudden abdominal pain and vomiting. She had a relevant past medical history of sickle cell disease and multiple episodes of biliary colic for which she underwent laparoscopic cholecystectomy two months before her current presentation. Laboratory findings indicated mild inflammation in the form of elevated C-reactive protein and erythrocyte sedimentation rate with the leukocytes count in the upper normal limits. Abdominal computed tomography demonstrated a knuckle of small bowel incarcerated in the port location of the previous laparoscopy. The bowel was reduced and the defect was repaired. The patient had complete resolution of her symptoms following the surgery. The case highlighted the importance of considering port-site hernia as an etiology of bowel obstruction in the relevant clinical settings since laparoscopic operations are being increasingly performed.
