A Percutaneous Technique for Reduction and Internal Fixation of Displaced Intra-Articular Calcaneal Fractures

Abstract

INTRODUCTION A retrospective cohort study demonstrated that, in comparison with open reduction and internal fixation through an extensile lateral approach, our percutaneous technique for reduction and internal fixation of displaced intra-articular calcaneal fractures decreases the rate of complications and achieves and maintains extra-articular fracture reductions just as well. STEP 1 PATIENT POSITIONING AND IMAGING Position the patient correctly to obtain excellent fluoroscopic views, which are key to the procedure. STEP 2 FRACTURE REDUCTION The techniques for reducing and fixing joint depression and tongue-type calcaneal fractures differ and will be described separately. STEP 3 SCREW FIXATION Identify screw entry points and paths using fluoroscopic images, and confirm the final positions with c-arm imaging. STEP 4 POSTOPERATIVE MANAGEMENT Apply a splint; then obtain postoperative images to confirm fracture reduction and screw placement. RESULTS & PREOP/POSTOP IMAGES The results of percutaneous reduction of displaced intra-articular calcaneal fractures in seventy-nine patients with a total of eighty-three fractures were compared with those obtained by another surgeon using the extensile lateral approach. WHAT TO WATCH FOR IndicationsContraindicationsPitfalls & Challenges.