Minimally invasive internal fixation of calcaneal fractures or subtalar joint arthrodesis using the Calcanail®.

Abstract

Aminimally invasive technique to prevent soft tissue problems using acalcaneal nail (Calcanail®, FH Orthopedics, Heimsbrunn, France) for calcaneal fractures or in subtalar joint arthrodesis is described. Displaced extra-articular calcaneal fractures involving the tuberosity fragment and in displaced intra-articular calcaneal fractures with impression and/or displacement of the subtalar joint surface. Subtalar joint arthrodesis for posttraumatic subtalar osteoarthritis. Severely displaced fractures type Sanders IV with the purpose of internal fixation; peripheral calcaneal fractures; general contraindications for operative treatment. Minimally invasive reduction of calcaneal fractures using aspecial distractor and agraft pusher through acalcaneal working channel. Fixation performed via the insertion of the Calcanail® and the two locking screws, optional additional screws. Subtalar joint arthrodesis with aCalcanail® used with optional three locking screws to fix the talus and calcaneus creating an angular stable construct. Mobilization and restricted weight-bearing for 6weeks in the patient's own shoes after fracture fixation or in awalker after arthrodesis. Preliminary results of 69cases from three surgical centers have already been published. From 2013-2017, the technique was used in 48of our own patients (42 calcaneal fracture reduction and fixation; 6for subtalar joint arthrodesis). Mean postoperative hospital stay was 7days for fracture reduction without any need of additional operations. During follow-up, 6 implant removals and 2 secondary subtalar fusions were noticed. All 6cases of subtalar joint arthrodesis were planned in posttraumatic subtalar osteoarthritis.