[Treatment of complex calcaneal fractures with external fixator and limited internal fixation]

To study the clinical effects of the adjustable external fixation combined with the limited internal fixation such as ordinary screws, Kirschner wire fixation for the treatment of complex calcaneal fractures (Sanders III, IV).

From January 2003 to June 2008, 27 patients 36 feet (19 feet in the left and 17 feet in the right) with calcaneal fractures of Sanders III and IV (the age ranged from 17 to 65 years, mean 37 years)were treated with external fixator combined with ordinary screws and Kirschner wire fixation. All the patients were undergone X-ray and CT examinations and classified by Crosby-Fitzgibbons-Sanders. The changes of the Böhler and Gissane angles were analyzed by X-ray. The functional of the feet was assessed by ZHANG Tie-liang calcaneal fractures scoring system.

Thirty-two feet were followed up for 11 to 24 months, with an average of 13 months. The Böhler and Gissane angles changed from average (8.0 +/- 7.3) degree and (130.5 +/- 10.5) degree, back to postoperative (29.6 +/- 7.4) degree and (122.5 +/- 8.6) degree. According to ZHANG Tie-liang scoring system, the result was excellent in 17 feet, good in 8 feet,fair in 5 feet and not satisfied with 2 feet. Three feet with wound infection or skin flap necrosis were healed after vacuum sealing drainage or wound dressing.

The combination of external fixator and limited internal fixation is an effective treatment for complex calcaneal fractures with few complications and good functional recovery.