Calcaneous interlocking nail treatment for calcaneous fracture: a multiple center retrospective study

Area of Science:

• Orthopedic surgery
• Traumatology
• Minimally invasive surgical techniques

Background:

• Minimally invasive treatments for calcaneus fractures offer comparable outcomes with fewer complications than traditional methods.
• Technical challenges and lack of adequate reduction tools have limited the widespread adoption of minimally invasive techniques for calcaneus fractures.
• A novel calcaneus interlocking nail system has been developed to address these limitations, enabling effective and minimally invasive reduction and fixation.

Purpose of the Study:

• To evaluate the efficacy and outcomes of a newly developed calcaneus interlocking nail system for treating calcaneus fractures.
• To assess intraoperative variables and patient outcomes following minimally invasive fixation using the calcaneus interlocking nail system.
• To compare the results with existing literature on calcaneus fracture treatment.

Main Methods:

• A retrospective analysis of 59 patients with calcaneus fractures treated with calcaneus interlocking nails across 7 institutions (October 2020 - May 2021).
• Data collected included patient demographics, fracture characteristics (Sanders classification), and intraoperative variables (surgery time, blood loss, incision length, fluoroscopy time).
• Outcomes assessed included complication rates, Visual Analog Scale (VAS) pain scores, and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores at 12-month follow-up.

Main Results:

• The study included 59 patients (54 male, 5 female; average age 47.5 years) with various Sanders fracture types (I-IV).
• Average surgery time was 131.9 minutes, with an average blood loss of 36.9 ml and an average incision length of 3.5 cm.
• Postoperative VAS scores averaged 2.4, and 12-month AOFAS scores averaged 93.3. Only one superficial infection (1.7% complication rate) was reported, with all patients showing good functional outcomes.

Conclusions:

• The calcaneus interlocking nail system provides satisfactory reduction and fixation for calcaneus fractures, including complex Sanders type IV fractures.
• The system facilitates minimally invasive surgery with good functional outcomes and a low complication rate.
• The calcaneus interlocking nail system represents a viable alternative for minimally invasive calcaneus fracture fixation.