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. 2012 May;22(4):345-349.
doi: 10.1007/s00590-012-0968-1. Epub 2012 Mar 13.

Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail(®)

Mario Goldzak, Thomas Mittlmeier, Patrick Simon

Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail(®)

Mario Goldzak et al. Eur J Orthop Surg Traumatol. 2012 May.

Abstract

Although open reduction and internal fixation is considered the best method for treating displaced articular fractures of the calcaneus, lateral approach is at high risk for wound healing complications. For this reason, the authors developed a posterior approach and a new implant to perform both intrafocal reduction and internal fixation. The aim of this technical note is to describe this method of treatment for displaced articular fractures of the calcaneus, which offered the following advantages: (a) the creation of a working channel that provides also a significant bone autograft, (b) the intrafocal reduction of the displaced articular surface, (c) the insertion of a locking nail that maintains the reduced articular surface at the right height, (d) the possibility to switch from an ORIF to a reconstruction arthrodesis with the same approach and instrumentation in case of severely damaged posterior facet.

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Figures

Fig. 1
Fig. 1
Insertion of the first K wire in the calcaneal tuberosity (a lateral view; b retrotibial view)
Fig. 2
Fig. 2
This cadaveric view shows the caspar distractor inserted on the talar and calcaneal pins and the direction of the hollow reamer (red arrow) (colour figure online)
Fig. 3
Fig. 3
The cylinder of autograft provided by the hollow reamer
Fig. 4
Fig. 4
Direct intrafocal reduction by mean of pushers or spatula. White arrows show the pins on which the Caspar device is inserted
Fig. 5
Fig. 5
The implant Calcanail. The picture shows the teeth at the tip of the nail, the windows for anchorage of the graft, the holes for locking screws, and the cap
Fig. 6
Fig. 6
On this operative view are shown the Caspar distractor, the handle of the nail with the sleeves for the insertion of the locking screws
Fig. 7
Fig. 7
Preoperative and postoperative views of a calcaneal fracture in a 21-year-old woman. a Preoperative lateral view, b preoperative retrotibial view, c, d tridimensional preoperative CT, e postoperative lateral view, f postoperative retrotibial view
See this image and copyright information in PMC

References

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