Closed reduction of displaced intra-articular calcaneal fractures using ilizarov frame

Abstract

Background: Treatment of displaced intra-articular calcaneal fractures (DIACFs) is still controversial. Aim: The objective of our study was to assess the capability of using Ilizarov frame as a minimally invasive technique to improve foot function and restore calcaneal length, height, width, and Bohler's angle in patients with DIACFs. Patients and Methods: We retrospectively reviewed forty patients (mean age, 25.4 ± 9.6 years, a mean follow-up of 44.9 ± 6.9 months) with 48 closed DIACFs who underwent indirect reduction and external fixation using Ilizarov technique. We applied distraction technique through the mechanical axis of the leg and through the foot axis. The drop wire technique was used to restore depressed subtalar fragments. Bone graft was not used. Results: We achieved good alignment in all cases except four feet who had varus deformity. The mean American Orthopaedic Foot and Ankle Society score was 84.6 ± 5. Superficial pin tract infection occurred in 7 feet. Skin pressure necrosis was seen in 3 feet. Statistically, all radiological measures were improved and significantly different from those measured preoperatively. Conclusion: Closed reduction of DIACFs using Ilizarov frame provides a good functional foot outcome with a low risk of postoperative complications. It also has the capability of restoring normal anatomy of the calcaneus.