Limited Approaches to Calcaneal Fractures

Abstract

Purpose of review: To review literature published in the last 3 years related to minimally invasive approaches to calcaneal fracture fixation.

Recent findings: Numerous randomized control trials, cohort studies, and meta-analyses have been done in the last 3 years comparing surgical treatment of calcaneus fractures. These studies indicate minimally invasive procedures decrease wound complication rates and achieve similar radiographic and clinical outcomes to open reduction internal fixation. In comparing different surgical treatment methods to non-operative treatment, operative management has increased complication rates but may lead to better functional outcomes in certain patient populations. Optimal treatment for displaced intra-articular calcaneus fractures continues to be debated. Current literature would suggest that the decision to operate be based on patient and fracture characteristics and surgeon capabilities. Minimally invasive techniques aim to improve patient reported outcomes and quality of life while decreasing complications and offer another option for surgeons in the treatment of displaced intra-articular calcaneal fractures.

Keywords: Calcaneus; Intra-articular fracture; Minimally invasive procedure; Percutaneous; Sinus tarsi.

Fig. 1

A femoral distractor is placed on the lateral side. You are able to gain length as well as correct varus deformity with the femoral distractor. A large Vaber clamp is placed to reduce the facet fragments

Fig. 2

a Lateral calcaneal view 12 weeks after percutaneous reduction and fixation with 4.5 mm cannulated screws for a Sanders III fracture. b Axial heel view 12 weeks after percutaneous reduction and fixation for a Sanders III fracture

Fig. 3

a Lateral calcaneal view 10 weeks after sinus tarsi approach with locked plating and 4.5 mm cannulated screw for a Sanders II fracture. b Axial heel view 10 weeks after fixation via sinus tarsi approach for a Sanders II fracture