Virtual Conference
Constantinos Chaniotakis

Constantinos Chaniotakis

General Hospital of Heraklion Venizeleio, Greece

Title: Intraarticular Calcaneus fractures percutaneous fixation. Clinical and radiographic results of the method


Calcaneal fractures are relatively common and they represent the 1% to 2% of all fractures. In unstable fractures there are conflicting views regarding the method of treatment due to the increased percentage of complications after open reduction and internal osteosynthesis. The use of percutaneous fixation is progressively rising. The purpose of this study is the description of the technique and the functional results from its use to a case series of patients who were treated in our department.
Materials and methods
We present five patients with a mean age 34,6 years were treated using a percutaneous method. Among surgical technique the patient is applied in the lateral decubitus position. Under fluoroscopy the fracture is reduced by traction and a valgus directed force to the tuberosity, in order to restore the length and to correct the varus deformity. A small incision over the lateral wall is performed and a periosteal elevator is introduced under the subtalar joint with scope to reduce the depressed fragment.  Finally, one or two screws 4.0mm are applied from the lateral wall pointing to the sustentaculum tali and two 6,5mm screws are applied from the calcaneal tuberosity directed to the calcaneocuboid joint.
Functional and radiographic result is reported with a minimum follow up of twelve months. Our results show that the sooner time between 5-7 days  (Boehler's angle of 100 to 200  and AOFASCORE between 85-97) to operate the fracture show  a better radiographic and clinical outcomes than when fracture operated more than ten days.
Percutaneous fixation of the calcaneal fractures offer exceptional functional outcome, provided that it is performed early (five to seven days post injury) and a near anatomical reduction is achieved. Otherwise, open reduction is suggested.