Modified percutaneous fixation for displaced intra-articular calcaneal fractures
Emre Baca, Alican Koluman
Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
Keywords: Calcaneal fracture, intra-articular fracture, minimally invasive surgery, percutaneous fixation.
Objectives: This study aims to review the results of surgically treated displaced intra-articular calcaneal fractures with a fast, less complicated, and modified percutaneous technique.
Patients and methods: This retrospective study included 114 patients (86 males, 28 females; mean age 39 years; range, 16 to 66 years) admitted to our clinic for calcaneal fractures between May 2012 and June 2016 and operated using closed reduction and percutaneous fixation with two crossed Schanz pins. Trauma type, additional injuries, medical comorbidities, pre- and postoperative period, duration of operation, time to bone healing, complications, postoperative functional and radiological results were evaluated.
Results: The increase in the postoperative Bohler’s angle measurements was statistically significant compared to preoperative values (p=0.001; p<0.01). According to Sanders classification, seven feet (5.3%) were type II, 76 feet (57.57%) were type III, and 49 feet (37.12%) were type IV. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 80.4 (range, 47 to 92). According to Sanders classification, the mean AOFAS scores were 81.25 for type II, 81.88 for type III, and 80.19 for type IV. Mean duration of operation was 8±1.5 minutes.
Conclusion: Modified percutaneous fixation can give good results, even when open reduction is contraindicated. Maintaining the alignment and elevating the depressed intraarticular fragment may be sufficient for good mid-term results without anatomic reduction.