[Value of a direct approach to the calcaneum]

The authors describe an approach to the calcaneus: the incision follows the Achilles tendon and curves anteriorly between the lateral and plantar skin of the foot. The subtalar joint is opened using a Müller distractor, with one pin in the tibia and the other in the calcaneus. Sixty-one crush fractures of the thalamus were treated using this approach. There were 6 cases with skin problems; in 4 cases the skin necrosis was limited. This approach is useful in all cases: it provides excellent exposure of the subtalar joint, making a precise reduction of the fracture possible. When a distractor is used, varus of the calcaneus should first be reduced.