Minimally Invasive Technique for Treatment of Calcaneal Fractures

Document Type : Original Research Papers

Authors

1 Department of Orthopaedic Surgery Faculty of Medicine Benha University

2 Professor of Orthopaedic Surgery Faculty of Medicine Benha University

3 Assistant Professor of Orthopaedic Surgery Faculty of Medicine Benha University

Abstract

Background: Aims: To evaluate the use short lateral subtalar approach with screw fixation in treatment of displaced calcaneal fractures using clinical and radiological evaluation. Patients and methods; The study was conducted on 27 patients with 30 fracture calcaneus from January 2019 till June 2022 including patients with intra-articular fractures of the calcaneus presenting to Banha University Hospitals and El-Mataria Teaching Hospital, treated by Limited open reduction and internal fixation via subtalar approach. Mean age for patients was 35.3 years. 28 fractures were classified as joint depression fractures and 2 were classified as tongue type fractures. There were 19 fractures classified as Sanders II and 11 fractures were classified as Sanders III. All patients were managed by limited open approach and direct reduction of the articular surface followed by indirect reduction and percutaneous fixation of the extraarticular part guided by fluoroscopy. Results; The mean AOFAS ankle/ hindfoot score was 91.73 and the mean Maryland foot score was 95.09. Complications included superficial wound infection in two cases and sural nerve dysthesia in one case which was treated conservatively. Complex regional pain syndrome (CRPS) in four cases, all responded well to physiotherapy and pregabalin. Tenderness at screw site in five cases .The time elapsing between the trauma and operation was found to correlate significantly to AOFAS ankle / hindfoot score and Maryland foot score. Conclusion: Minimally Invasive Techniques for Treatment of Calcaneal Fracture, sanders type II,III through limited lateral subtalar approach using screw fixation is an effective, safe, and reproducible method of treatment.

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