Background
Calcaneal fracture is a topic in orthopedic fracture care that has been heavily debated over the past decades. The aim of the current study was to assess the results of minimally invasive open reduction and percutaneous fixation of intra-articular calcaneal fractures.
Patients and methods
Twenty-four calcaneal fractures in 21 patients were prospectively included in the current study. There were 15 males and six females, with a mean age of 34.8 years. A limited sinus tarsi approach was used in elevation of the depressed posterior facet, followed by fixation with one or two 4 mm cancellous screws. Fixation was completed by using one or two cannulated 4 mm partially threaded screws. Then two or more fully threaded cancellous screws were inserted percutaneously from the tuberosity along the calcaneus.
Results
The average duration of follow-up was 39 months (range: 24–41 months). According to the American orthopaedic foot and ankle score at final follow-up, 20.8% of all cases had excellent results, 66.7% had good results, 12.5% had fair results, and there were no poor results. The satisfactory results (excellent and good) were 87%, with the mean American orthopaedic foot and ankle score for hind foot being 84.95 points. The average postoperative visual analog scale for pain is 1.55 in Sanders type II group, 2.55 in Sanders type III group, and 3.75 in Sanders type IV group, with a significant statistical correlation between fracture type and postoperative pain (<0.00001). The average satisfaction score for Sanders type II group was 7.44, 7 in Sanders type III group, and 6.75 in type IV.
Conclusion
Limited open reduction and percutaneous screw fixation yielded good results as the classic extended approach, with the advantage of far less soft tissue complications, less operative time, and less hospital stay.