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A Percutaneous Technique for Reduction and Internal Fixation of Displaced Intra-Articular Calcaneal Fractures
J L Marsh1, J S Boyer1, J Sullivan1
1Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for J.L. Marsh: j-marsh@uiowa.edu.
Introduction:
A retrospective cohort study demonstrated that, in comparison with open reduction and internal fixation through an extensile lateral approach, our percutaneous technique for reduction and internal fixation of displaced intra-articular calcaneal fractures decreases the rate of complications and achieves and maintains extra-articular fracture reductions just as well.
Step 1 Patient Positioning And Imaging:
Position the patient correctly to obtain excellent fluoroscopic views, which are key to the procedure.
Step 2 Fracture Reduction:
The techniques for reducing and fixing joint depression and tongue-type calcaneal fractures differ and will be described separately.
Step 3 Screw Fixation:
Identify screw entry points and paths using fluoroscopic images, and confirm the final positions with c-arm imaging.
Step 4 Postoperative Management:
Apply a splint; then obtain postoperative images to confirm fracture reduction and screw placement.
Results & Preop/Postop Images:
The results of percutaneous reduction of displaced intra-articular calcaneal fractures in seventy-nine patients with a total of eighty-three fractures were compared with those obtained by another surgeon using the extensile lateral approach.
What To Watch For:
IndicationsContraindicationsPitfalls & Challenges.
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