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Calcaneal fractures: indirect reduction and external fixation
William C McGarvey1, Michael W Burris, Thomas O Clanton
1Michael.W.Burris@uth.tmc.edu
Foot & Ankle International
|July 18, 2006
Summary
Indirect reduction with Ilizarov external fixation offers a viable surgical option for displaced intra-articular calcaneal fractures, showing promising results, especially in open fractures.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Skeletal Reconstruction
Background:
- Displaced intra-articular calcaneal fractures traditionally treated with surgical fixation.
- Evaluating indirect reduction using Ilizarov external fixation as an alternative surgical approach.
Purpose of the Study:
- To assess the efficacy of indirect reduction with Ilizarov external fixation for calcaneal fractures (Sanders types II-IV).
Main Methods:
- 33 calcaneal fractures in 31 patients treated with circular external fixation and limited plantar incision.
- Fracture assessment via CT scans; patient outcomes evaluated using AOFAS hindfoot scores.
- Follow-up duration ranged from 6 months to 4 years.
Main Results:
- Average AOFAS score was 66, improving to 74 with longer follow-up and 77 for isolated fractures.
- Open fractures showed no deep infections with early debridement and soft-tissue coverage.
- 11 complications noted: 9 superficial pin track infections, 1 superficial skin necrosis, 1 deep infection in a high-risk patient.
Conclusions:
- Indirect reduction and external fixation is a viable surgical alternative for intra-articular calcaneal fractures.
- Favorable outcomes observed in open fractures with concurrent soft-tissue reconstruction.
- Advantages include minimal invasiveness and early weight-bearing; disadvantages involve technical challenges and potential need for secondary surgery.