Introduction
Intra-articular calcaneous fracture is one of the most aggravating fractures if not properly managed. Open reduction and internal fixation are associated with high incidence of postoperative soft-tissue complication. Closed reduction and percutaneous fixation had a high incidence of postoperative subtalar osteoarthritis due to an improper reduction of the articular surface, and therefore the mini approach was used for restoring the articular surface and for fixing the fracture by K-wires.
Patients and methods
A total of 22 patients with 27 intra-articular calcaneous fractures from March 2009 to July 2012 were treated at Menoufia University Hospital. All patients were treated with the miniapproach and percutaneous K-wire fixation for intra-articular calcaneous fractures. The patient sample included 15 males and seven females. In 14 patients, the fractures were caused by falling from heights, whereas in eight patients the cause was road traffic accidents. Five patients had bilateral fractures. According to Sander’s Classification, 13 fractures were of type II, 10 were type III, and four were type VI.
Results
The average age was 29 years with a range of 21–55 years. The mean follow-up period was 16 months with a range of 12–36 months. The average union period of fractures was 12 weeks, ranging from 10 to 16 weeks. Seven patients had wedge fracture of the dorsolumbar spine but without neurological manifestation. The average operative time was 53 min with a range of 37–109 min. The clinical results according to the Maryland foot score revealed 21 (78%) cases with satisfactory scores (eight excellent and 13 good) and six cases (22%) with unsatisfactory results (four moderate and two poor).
Conclusion
Percutaneous treatment of fracture calcaneous minimizes soft-tissue complications and postoperative scar formation, which improves functional outcome. The miniapproach for elevation of depressed posterior facet restores joint congruity and decreases late subtalar arthritis.