Closed reduction and percutaneous cannulated screws fixation of displaced intra-articular calcaneus fractures

BackgroundDisplaced intra-articular calcaneal fractures remain a therapeutic challenge due to fracture complexity and different treatment options. One of the adverse effects of operative treatment is secondary damage to soft tissues. To avoid soft tissue complications, several less invasive procedures have been introduced. The most frequently used minimally invasive technique is closed reduction of fracture and percutaneous cannulated screws fixation.MethodThis study evaluates the medium-term outcome of a new technique of percutaneous treatment in 60 cases operated in Al-Razi orthopedic hospital in Kuwait in the period from 2007 to 2009. The described technique applies the principle of closed manipulation with new reduction method using a medial subperiosteal tunnel to manipulate the fragments. The technique involves new method of distribution of screws required to fix the fracture.ResultsAccording to the American Orthopedic Foot and Ankle Society Hind foot Score, 38.3% of all cases (22 cases) had excellent results, 41% good (25 cases), fair results in 15% (9 cases), and poor results in 5% (4 cases). The overall satisfactory results (excellent and good) were 79.3%.ConclusionThe technique is suitable for most types of intra-articular fractures especially in patients with compromised soft tissues in which open reduction and internal fixation is contraindicated.