Percutaneous & Minimal Internal Fixation of Displaced Intraarticular Calcaneal Fractures

Hwang, Deuk Soo; Lee, June Kyu; Oh, Hong Rok; Lee, Seung Jin

Abstract

A displaced intraarticular fracture of the calcaneus is difficult to reduction and to restore its function, and its management still remains controversies. Treatment recomendation ranges from conservative to operative method using percutaneous pins, bone grafting and open reduction with internal or external flxators. We analysed retrospectively 24 displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation of intraarticular fracture of posterior facet in whole 48 cases(36 person) calcaneal fractures between January 1990 to April 1996 at the Department of Orthopaedic Surgery, Chungnam National University Hospital. A single Ollier approach was used in all cases. And we did not add any bone graft on the defected portion of calcaneal fractures. The technique and the result were as follows ; 1. An approach to the sinus tarsi with only Oiliers small lateral incision made an offer a good field for open reduction to the displaced posterior facet of calcaneus and diminishes the risk of lateral soft tissue problems. 2. Even only minimal internal fixation of thalamic joint fragment and percutaneous axial pin fixation of the body is enough to prevent the calcaneal redisplacement and provides enough stability to permit functional aftercare(early exercise and weight bearing) with a good result. 3. The Bohler angle is technically difficult to restoration to normal range of angle in our minimal operative method. 4. A bone graft is an alternative and is not necessary. We proposed our experience obtained in 24 cases as a good method ofr treatment of displaced intraarticular calcaneal fracture, especially in joint depressioin type and tongue type without severe comminution.