Minimally Invasive Reduction and Fixation of Displaced Calcaneal Fractures: Surgical Technique and Radiographic Analysis

SLR- February 2014- Douglas L. Croff

Reference:  Arastu M; Sheehan B; Buckley R. Minimally Invasive Reduction and Fixation of Displaced Calcaneal Fractures: Surgical Technique and Radiographic Analysis. International Orthopaedics. 2013 Dec 17 Epub.  

 

Scientific Literature Review

Reviewed by: Douglas L.Croff, DPM

Residency Program: Detroit Medical Center

Podiatric Relevance: Displaced calcaneal fractures are often associated with complications related to patients’ co-morbidities. Patients with medical histories including smoking, peripheral vascular disease, and diabetes are at higher risk to develop complications. The technique described in this article is an additional approach that can be considered with higher risk patients undergoing surgical correction for this potentially severe fracture.
 

Methods: Thirty-one patients with displaced intra-articular calcaneal fractures were treated with minimally invasive reduction and fixation using threaded K wires and Steinmann pins.

Results: The mean follow up was 14.9 months with all fractures healed at final follow up. The only complication was one superficial wound infection. The mean increase of Bohlers angle was 16 degrees (mean 22.1 deg) from time of injury to complete healing. There was a mean increase in length of 3mm (mean 84.1mm) from time of injury to complete healing.
 

Conclusions: This technique may be considered for patients at increased risk of post-operative complications due to comorbidities and those not suitable for the traditional lateral extensile approach. The minimally invasive approach advantages include shorter operating time, less exposure to anesthesia, lower post-operative infection risk, and an increase in Bohlers angle.