The Operative Reduction of Intra-articular Calcaneal Fractures

In the past the evaluation of treatment modalities of calcaneal fractures has been fraught with the lack of well-designed, randomized clinical studies. As a result, surgeons treating these injuries were typically polarized when deciding between a surgical or nonsurgical approach to management. Among the many technical reasons for the frank dichotomy of treatment preferences were the difficulty in anatomical restoration, the relatively poor surgical access to the calcaneus, the limited internal fixation devices available for stabilization, and the difficulty in comprehensive radiographic imaging. Furthermore, the lack of complete understanding of the mechanism of sequential bony failure complicated the surgical exercise. The lack of standardized protocols for surgical treatment also lended to the controversy.