Management of Open Calcaneal Fractures with Medial Wounds by One-Stage Sequential Reduction and Frame Structure...

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Reconstructive Surgery

Background:

• Open calcaneal fractures present complex challenges in management.
• Medial wound involvement necessitates careful surgical planning.
• Traditional approaches may involve multiple stages and significant soft tissue disruption.

Purpose of the Study:

• To evaluate the clinical outcomes of open calcaneal fractures with medial wounds treated with a one-stage management protocol.
• To assess the efficacy of early modern wound care, sequential reduction, and percutaneous Kirschner wire fixation.

Main Methods:

• Nineteen patients with Gustilo and Anderson type-II and IIIA open calcaneal fractures were treated.
• A one-stage protocol included irrigation, debridement, sequential reduction, percutaneous Kirschner wire fixation, and vacuum-assisted closure (VAC).
• Radiographic parameters (Bohler, Gissane angles) and functional scores (Paley and Hall, AOFAS, Maryland Foot Score, VAS) were assessed.

Main Results:

• Significant improvements in Bohler and Gissane angles were observed postoperatively (P < 0.05).
• Superficial infections and wound dehiscence occurred but were successfully managed.
• Most patients achieved good to fair functional outcomes with low visual analogue scale (VAS) pain scores; severe complications were avoided.

Conclusions:

• One-stage management is a viable option for open calcaneal fractures with medial wounds.
• This approach facilitates direct restoration of calcaneal morphology with minimal soft tissue compromise.
• Functional outcomes appear comparable to existing literature, supporting its clinical utility.