Reduction of calcaneal fractures by the McReynolds medial approach technique and its experimental basis

Most calcaneal fractures are of the joint depression type or the tongue type, both of which are amenable to reduction by the medial approach technique. This procedure is based on the principle of restoring the medial wall of the calcaneus, which must be done from the medial side. An accurate reduction produces stability, restores length and height, and partially restores width. The joint depression- or tongue-type fragment is reduced to restore the articular surface of the posterior facet. Many of these fractures can be reduced from the medial side. However, if necessary, a lateral incision should also be made for accurate replacement of these fragments. The final restoration of calcaneal width is accomplished by reducing the lateral bulge of the tuberosity by applying direct pressure over the lateral heel. This deformity, which produces morbidity, must be completely reduced. The medial approach technique offers an opportunity to reduce each of the deformities of the depressed calcaneal fracture. The method is recommended.