[Operative reduction of comminuted fractures of the heel-bone and its results]

Severe comminuted fractures of the heel-bone involving the joint, which have to be classified according to Böhler into group V-VIII, are treated by a modified form of the so-called raising operation of Palmer. 27 patients (= 14,3%) had bilateral heel-bone fractures. The posterior subtalar supporting plate is raised under image-amplifier control, the defect cavity is filled with spongiosa, and the result of reposition is fixed with Kirschner wires laid under the skin. Functional treatment may begin a few days later; loading is generally possible after ten to twelve weeks, when the metal parts have been removed and the fracture has consolidated. Sixteen patients (= 8,5%) do not need orthopedic instruments, 132 patients (= 69,9%) are provided with arch-supports, and 41 (= 69,9%) with orthopedic footwear.