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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 11, 1474-1479.
doi: 10.1302/0301-620X.88B11.17759  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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External fixation for displaced intra-articular fractures of the calcaneum

B. Magnan, MD, Orthopaedic Surgeon1; R. Bortolazzi, MD, Orthopaedic Surgeon1; A. Marangon, MD, Orthopaedic Surgeon1; M. Marino, MD, Orthopaedic Surgeon1; C. Dall’Oca, MD, Orthopaedic Surgeon1; and P. Bartolozzi, MD, Professor1

1 Department of Orthopaedics, University of Verona, Policlinico "G. B. Rossi", Piazzale Lodonco Amtomio Scuro 10, 37134 Verona, Italy.

Correspondence should be sent to Dr B. Magnan; e-mail: brunomagnan{at}virgilio.it

A minimally-invasive procedure using percutaneous reduction and external fixation can be carried out for Sanders’ type II, III and IV fractures of the os calcis. We have treated 54 consecutive closed displaced fractures of the calcaneum involving the articular surface in 52 patients with the Orthofix Calcaneal Mini-Fixator. Patients were followed up for a mean of 49 months (27 to 94) and assessed clinically with the Maryland Foot Score and radiologically with radiographs and CT scans, evaluated according to the Score Analysis of Verona. The clinical results at follow-up were excellent or good in 49 cases (90.7%), fair in two (3.7%) and poor in three (5.6%). The mean pre-operative Böhler’s angle was 6.98° (5.95° to 19.86°), whereas after surgery the mean value was 21.94° (12.58° to 31.30°) (p < 0.01). Excellent results on CT scanning were demonstrated in 24 cases (44.4%), good in 25 (46.3%), fair in three (5.6%) and poor in two (3.7%). Transient local osteoporosis was observed in ten patients (18.5%), superficial pin track infection in three (5.6%), and three patients (5.6%) showed thalamic displacement following unadvised early weight-bearing.

The clinical results appear to be comparable with those obtainable with open reduction and internal fixation, with the advantages of reduced risk using a minimally-invasive technique.




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Symptomatic nonunion after fracture of the calcaneum: DEMOGRAPHICS AND TREATMENT
J Bone Joint Surg Br, September 1, 2007; 89-B(9): 1218 - 1224.
[Abstract] [Full Text] [PDF]


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