ABSTRACT
This is a prospective cohort study to evaluate the results of open reduction through an extensile lateral approach and internal fixation with calcaneal tentacle plate as surgical treatment of the displaced intra-articular calcaneal fracture. The extended lateral approach accounts for low incidence of complication. After suitable interval to improve the soft tissue status, this series recommend to take the cases for surgery between 14 to 21 days from the time of injury. Wound dehiscence is the common complication, which can be minimized by raising cutaneous-subcutaneous flap during incision. Prevention of collapse is mainly by the rigid fixation & perfect anatomical plating and delayed weight bearing. Bone grafting is needed for severely comminuted cases. We systematically obtained anatomical reduction, whatever the Sanders type. This reconstruction and subtalar joint congruence, essential for a good result. Post operative subtalar joint incongruence may lead to early subtalar arthritis, which can be managed with subtalar arthrodesis. Osteosynthesis of type II calcaneal fractures give excellent result compared to other fracture patterns. In case of contraindication relating to age, associated pathology such as diabetes or arteriopathy, or psychiatric disturbance, we advise plaster cast immobilization for relatively congruent fractures, and closed percutaneous pinning or screwing for more displaced and incongruent fracture. Proper pre-operative planning, rigid fixation with calcaneal tentacle plate and adequate screws through extensile lateral approach, anatomical reduction to achieve subtalar joint congruency, using bone grafts in comminuted fractures, early post op rehabilitation, delayed weight bearing will give good results in case of displaced intra articular calcaneal fracture K