Percutaneous Fixation of Displaced Calcaneal Fracture

Abstract

Purpose To review the techniques and outcomes of percutaneous fixation, with the modified Essex-Lopresti technique, in isolated, displaced tongue-type calcaneal fractures. Methods This is a retrospective review of 24 patients who received percutaneous calcaneal screw fixation in our hospital, from April 2003 to June 2009. One patient had bilateral fixation performed. All patients had a serial of X-rays of the injured foot, which included anteroposterior, axial, lateral, and Broden’s views. Preoperative and post-operative Bohler’s and Gissane’s angles were measured. The patients’ conditions were continuously assessed in serial follow-ups, and the Maryland Foot Score was used to evaluate the clinical outcome. Results Bohler’s and Gissane’s angles were fully restored in 13 and 17 out of 25 fractures, respectively. The mean duration of post-operative hospital stay was 4 days. There were no major post-operative complications. Sixteen patients were able to resume their original jobs. The Maryland Foot Score rated 13 out of 25 injured limbs (52%) as excellent, 9 (36%) as good, and 3 (12%) as fair. There were no patients rated as poor. The three patients with fair results complained of pain and stiffness at the subtalar joint. Conclusion Percutaneous fixation of displaced tongue-type calcaneal fractures is an effective treatment with acceptable clinical outcome, short hospital stay, minimal skin complications, and quick recovery.