Management of calcaneal fractures using the Ilizarov external fixator

Twenty five intra-articular fractures of the calcaneus in 25 patients were reduced through a minimal incision and fixed with an Ilizarov external fixator. The average age of patients was 38.6 years (range: 17 to 62 years). According to the Sanders CT classification, 10 (40%) were type II, 9 (36%) type III, and 6 (24%) type IV. The average follow-up was 30 months (range: 24-40 months). According to the AOFAS scale for ankle and hind foot there were 6 (24%) excellent, 11 (44%) good, 6 (24%) fair, and two (8%) poor results. The average score was 68 with a range of 48 to 92. The average length of the treatment period with the fixator was 9.7 weeks (range, 8 to 12 weeks). Radiological assessment revealed reduction malalignment < 5 degrees in 22 cases and > 10 degrees in 3 cases. The calcaneal width averaged 112% of the contralateral side. The calcaneal height was restored to 92% of the normal side, the mean (+/- SD) Böhler angle was changed from 11 degrees +/- 9 degrees preoperatively to 24 degrees +/- 5 degrees postoperatively. The most common complication was superficial skin infection at wire insertion sites. The results with this technique in a small number of non randomised cases with an average follow-up of 2.5 years seem to indicate that it could be a good alternative to traditional methods for management of intraarticular calcaneus fractures, with fewer secondary problems.