Importance of assistant intra-operative medial distraction technique for intraarticular calcaneus fractures

To report the clinical efficacy of open reduction and internal fixation (ORIF) assisted by medial distraction for intra-articular calcaneus fractures. From September 2010 to November 2013, 151 patients with intra-articular calcaneus fractures were treated at our department by ORIF. They were 95 men and 56 women, 18 to 69 years of age. According to the Sanders classification, there were 24 cases of type II, 76 ones of type III and 51 ones of type IV. Medial distraction was used in 27 cases but not in 124 ones. The 2 groups were compatible, without significant differences in preoperative general data (p > 0.05). The two groups were compared in intraoperative indexes and follow-up radiological data. The mean duration of surgery in the distraction group (71.6 ±18.3 minutes) was significantly shorter than that in the non-distraction group (80.4±20.7 minutes), and the varus angle in the distraction group (5.3° ± 4.4°) was significantly smaller than that in the non-distraction group (10.6° ± 6.5°) (p < 0.05). There were no significant differences between the 2 groups in intraoperative bleeding, postoperative drainage, hospital stay, bone union time, follow-up duration, American Orthopaedic Foot & Ankle Society score, Böhler angle, Gissane angle, calcaneal axis, calcaneal horizontal length, tuberosity height, hillock calcaneal height, calcaneal width, or talar inclination angle (p > 0.05). ORIF assisted by medial distraction technique is effective for intra-articular calcaneal fractures, especially in correcting the calcaneal axis.