Percutaneous Fixation of Displaced Calcaneal Fracture

Abstract

Purpose: To review the techniques and outcomes of percutaneous fixation, with the modified Essex-Lopresti technique, in isolated, displaced tongue-type calcaneal fractures. Methods: This is a retrospective review of 24 patients who received percutaneous calcaneal screw fixation in our hospital, from April 2003 to June 2009. One patient had bilateral fixation performed. All patients had a serial of X-rays of the injured foot, which included anteroposterior, axial, lateral, and Broden’s views. Preoperative and post-operative Bohler’s and Gissane’s angles were measured. The patients’ conditions were continuously assessed in serial follow-ups, and the Maryland Foot Score was used to evaluate the clinical outcome. Results: Bohler’s and Gissane’s angles were fully restored in 13 and 17 out of 25 fractures, respectively. The mean duration of post-operative hospital stay was 4 days. There were no major post-operative complications. Sixteen patients were able to resume their original jobs. The Maryland Foot Score rated 13 out of 25 injured limbs (52%) as excellent, 9 (36%) as good, and 3 (12%) as fair. There were no patients rated as poor. The three patients with fair results complained of pain and stiffness at the subtalar joint. Conclusion: Percutaneous fixation of displaced tongue-type calcaneal fractures is an effective treatment with acceptable clinical outcome, short hospital stay, minimal skin complications, and quick recovery.

Keywords

• percutaneous fixation
• calcaneum
• fracture