Medium-term outcome after mini-open reduction and transarticular Kirschner wire fixation for displaced fractures of calcaneus

Abstract

Background The management of calcaneal fractures has been a controversial topic. Open reduction and internal fixation is associated with a high incidence of postoperative soft tissue complications. Minimally invasive open reduction and internal fixation by K-wires through a minimally invasive sinus tarsi approach is a valid therapeutic line of treatment that guarantees stability and anatomic fracture reduction with minimal complications. The aim of our study is to evaluate the outcome of mini-open reduction and transarticular percutaneous K-wire fixation of displaced intraarticular calcaneal fractures. Patients and methods This prospective case series study was conducted on 220 (156 men and 64 women) patients with intraarticular calcaneal fractures, who were managed by mini-open reduction and fixation via multiple transarticular K-wires. Mean age was 40 years. Mean follow-up period was 57 months. The following variables were assessed: preoperative and postoperative Bohler angle, angle of Gissane, calcaneal height, and Maryland Foot Score. Results Patients were operated on within a mean time of 3 days of injury. All fractures healed after an average of 10 weeks. There were 14 cases of pin-tract infection. The Maryland Foot Score rated 142 (64.5%) patients as excellent, 59 (27%) as good, and 19 (8.5%) as fair. There was significant improvement in Bohler angle, calcaneal height, and calcaneal width. Patients returned to the routine daily activities after an average time of 4 months. Conclusion We believe mini-open reduction and transarticular percutaneous K-wire fixation is an effective treatment method for cases of displaced intraarticular calcaneal fractures.