[Intra-articular calcaneal fractures]
J Kocis1, J Stoklas, S Kalandra
1Klinika traumatologie LF MU v Urazové Nemocnici Brno. jankocis@seznam.cz
Summary
This study shows that treating intra-articular calcaneal fractures with an extended lateral approach and internal fixation yields excellent outcomes. Accurate reduction of the posterior subtalar joint is key for successful healing and good clinical results.
Area of Science:
- Orthopedic surgery
- Traumatology
- Skeletal reconstruction
Background:
- Intra-articular calcaneal fractures are complex injuries often resulting from high-energy trauma.
- The extended lateral approach offers direct visualization for surgical management.
- Optimal treatment strategies are crucial for restoring function and minimizing long-term morbidity.
Purpose of the Study:
- To evaluate the outcomes of treating intra-articular calcaneal fractures using an extended lateral approach and internal osteosynthesis.
- To assess the efficacy of this surgical technique in achieving bony union and functional recovery.
Main Methods:
- Retrospective evaluation of 32 male patients (average age 41.7 years) with intra-articular calcaneal fractures treated between 2001 and 2003.
- Surgical treatment involved osteosynthesis with a plate via an extended lateral approach, with autologous or allogenous bone grafting in select cases.
- Fracture classification utilized the Sanders system; postoperative assessment included radiographs, Böhler angle measurement, and the Kerr rating system.
Main Results:
- Excellent (36%), very good (44%), and good (17%) outcomes were reported, with only 3% poor results.
- Postoperative Böhler angle averaged +28.5 degrees, with all patients achieving bone union and no cases of pseudoarthrosis.
- Complications included one late purulent infection and one early hematoma requiring revision; metal removal averaged 13 months postoperatively.
Conclusions:
- The extended lateral approach combined with internal osteosynthesis provides effective treatment for intra-articular calcaneal fractures.
- Achieving precise reduction of the posterior subtalar joint is critical for favorable clinical outcomes, especially in Sanders II and III type fractures.
- Treatment success is influenced by fracture type, soft tissue condition, patient factors, and surgeon expertise.
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