The Posterolateral Approach for Calcaneal Fractures

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Foot and ankle surgery

Background:

• The extended lateral approach (ELA) is the traditional method for intraarticular calcaneal fracture fixation.
• ELA is associated with a high incidence of wound complications.
• The posteriorlateral approach (PLA) is proposed as an alternative surgical technique.

Purpose of the Study:

• To describe the posteriorlateral approach (PLA) for calcaneal fractures.
• To compare PLA with the extended lateral approach (ELA) regarding soft tissue complications.
• To evaluate functional outcomes after PLA versus ELA for calcaneal fractures.

Main Methods:

• Retrospective study comparing 32 patients treated with PLA and 66 patients treated with ELA.
• Soft tissue complications (major and minor) were recorded up to 3 months postoperatively.
• Functional outcomes were assessed at 1-year using the American Foot and Ankle Score (AOFAS).

Main Results:

• The PLA group experienced no major complications requiring surgical intervention; 19% had minor wound issues.
• The ELA group had 12% major and 14% minor complications.
• No significant differences in 1-year AOFAS scores were observed between the PLA and ELA groups.

Conclusions:

• The posteriorlateral approach (PLA) is a safe and effective alternative for open reduction and internal fixation of displaced intraarticular calcaneal fractures.
• PLA offers a viable option with reduced concern for wound complications compared to ELA.
• PLA is particularly suitable for selected cases where fracture comminution and displacement necessitate a less invasive approach.