Abstract
Category: Hindfoot, Trauma Introduction/Purpose: Surgical treatment of displaced intraarticular calcaneal fractures using a standard lateral extended approach for plate fixation is frequently complicated by wound healing complications and infections. This prospective matched- pairs analysis evaluates the new minimally-invasive calcaneal interlocking nailing technique in terms of reduction capacities, complication rates and functional outcome compared to standard locking plate fixation. Methods: 40 feet (20 feet/group; mean patient age 53 years, range 27-78) with displaced intraarticular calcaneal fractures were either treated with a calcaneal locking nail (LN) or locking plate (LP) and observed clinically and radiologically after 1.6 years. Follow-up included CT-based radiological assessment of reduction and functional evaluation according to the AOFAS Ankle- Hindfoot- Score and Foot Function Index (FFI). Results: Time for surgery did not differ between both groups (LN 93 min vs. LP 96 min). Inpatient treatment time was significantly reduced in the LN group (7.6 days vs. LP 11 days). Postoperative and follow-up radiographic imaging revealed adequate restoration of the calcaneal body in both groups. The remaining defect of the posterior facet was significantly smaller in the LN group (0.7 mm vs. LP 1.6 mm). The mean AOFAS Score was slightly better for the LN group with 71.6 points vs. 66.1 points (LP). In analogy, the FFI revealed better results for the LN group (27.3 points) than the LP group (30.8 points). No intraoperative complications but two postoperative infections with wound healing complications were observed in the LP group. Conclusion: The new calcaneal interlocking nail shows promising results in terms of reduction capacities and safety. Postoperative infection complications were reduced whilst superior function was found applying the minimum-invasive interlocking nailing technique compared with standard locking plate fixation via a lateral extended approach.
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