Introduction:
Management of comminuted calcaneal fractures is controversial, and multiple factors, including fracture pattern and severity, soft-tissue integrity, medical co-morbidities, and lifestyle issues, influence the decision-making process. In an effort to minimize complications related to soft tissue lesions, a minimally invasive technique was developed that combines percutaneous reduction of the joint, restoration of the calcaneus shape (hindfoot) and subtalar joint debridement for primary arthrodesis.
Method:
A minimally invasive technique was used in an experimental series of four patients with a comminuted calcaneal fracture Sanders type III and IV. All patients were operated on within 8-10 days of injury. Complications were recorded and pre-op, post-op and final follow-up radiographs analysed.
Results:
Four patients were included, 2 with Sanders III and 2 with Sanders IV fractures. Radiologic follow-up showed no loss of height the calcaneum. Fusion across the arthrodesis site was radiographically evident in all patients between 8 and 12 weeks. No wound complications or infection were observed. Using the AOFAS score, the results were good in three cases and excellent in one case. 3 patients returned to their professional activity within 6 months and 1 was retired.
Conclusion:
We found this minimally invasive technique with primary fusion of the subtalar joint an effective and safe treatment option in selected patients with comminuted fractures of the calcaneum. These preliminary results justify future use of this technique.