Percutaneous fixation of Calcaneum fractures.

ABSTRACT

Introduction: Displaced intra-articular calcaneum fractures require reduction and internal fixation for favourable long term results. Open procedures are more prone to complications regarding wound healing. Percutaneous fixation offers a middle pathway in treating simpler variety of displaced calcaneal fractures. Material and Methods: Over a two year period 22 cases of Essex-Lopresti tongue type displaced calcaneum fractures were treated using percutaneous screw fixation following closed reduction techniques were reviewed. Clinical outcome was evaluated by standardized physical examination using AOFAS ankle & hindfoot scores and radiographs of both injured and uninjured feet for comparative purposes. Results: Fall from height was the commonest cause of injury. The average time from injury to operation was 2 days. All patients went on to complete union. There was significant improvement of the Bohler and Gissane angles following reduction as well as maintenance of heel height and breadth. The mean AOFAS score was 84 indicating a good result. There was loss of reduction as evaluated on x-rays in follow-up in14 % patients. The rate of infection was 9% and rate of implant removal was 5%. No cases of peroneal tendon dysfunction were found. Conclusion: For simple displaced intra-articular Essex-Lopresti tongue type fractures of the calcaneum percutaneous fixation techniques give reliable good results without significant complications.