Minimally invasive reposition of intraarticular calcaneal fractures: a case report

Calcaneal fracture is a most common bony injury of the hindfoot. In constitutes 60% of foot fractures and 1-2% of all fractures. According to current literature 75% of these fractures involve articular surfaces, which makes them especially difficult to treat. Intraarticular fractures often result in permanent disability impairing foot function and ambulation, sometimes due to inadequate treatment method. According to literature, in developed countries open reduction and internal plate fixation is standard treatment of intraarticular calcaneal fractures. This treatment poses a risk of impaired wound healing and is appropriate for selected group of patients without additional risk factors. Other patients are treated with minimally invasive methods. Proponents of minimally invasive techniques apply distraction, which makes most intraarticular calcaneal fractures amenable to this method.

This paper presents a minimally invasive treatment technique for intraarticular (depression type according to Essex-Lopresti, IIA accordind to Sanders) calcaneal fracture in 63-years old man. External fixator (Monotube) is used for intraoperative distraction. Posterior facet is reduced with additional maneuvers.

With this technique we were able to reduce posterior faced, correct varus alignment and restore Böhler's angle. With restoration of shape of calcaneal bone optimal functional result can be expected. At six moths follow-up very good result was observed.