Percutaneous reduction and fixation of intraarticular calcaneal fractures: a series with 2-year follow-up

Abstract

Background: Fractures of the calcaneus may occur with high-energy trauma. The gold standard management of fractures extending to the posterior facet is open reduction and plate fixation, but soft-tissue complications are frequent. The aim of this study was to evaluate the results of percutaneous reduction and fixation of intraarticular calcaneal fractures. Our hypothesis was that percutaneous fixation of Sanders type ΙΙ or ΙΙΙ articular calcaneal fractures provides good functional results with few complications. Methods: Between January 2014 and June 2017, 20 patients with intraarticular fractures of the calcaneus (30 feet) were treated with closed reduction and percutaneous fixation. The mean age of the patients was 30 yr (range 18–50 yr). All patients were assessed by radiographs and CT before and after surgery. Clinical and functional outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Hind Foot Score. A P-value <0.05 was considered statistically significant. Results: The mean follow-up period was 24.4±7.1 mo (18–30 mo). The postoperative mean AOFAS score was 88±4.7 points. There were statistically significant improvements in the postoperative means of both the Böhler and Gissane angles. Persistent postoperative pain was encountered in one patient, and another had a completely resolved mild superficial infection without major skin complications or deep infection. Conclusions: Percutaneous reduction and fixation of Sanders type ΙΙ and ΙΙΙ intra-articular calcaneal fractures had satisfactory clinical and radiographic results with minimal infection and soft-tissue morbidity.