Summary:
Open repositioning and internal fixation of intraarticular calcaneal fractures has become a standard surgical method, however, concerns
over its feared complications, including, in particular, secondary wound healing followed by osteomyelitis, continue fo be discussed.
The aim of this study is to inform the surgical public about the surgical method.
From February 2004 to September 2005, 26 intraarticular calcaneal fractures in 22 patients were operated using open repositioning
and internal cast fixation. In four cases, the fracture was bilateral. The patients were indicated for the procedure based on the
Sanders CT classification. The procedure included extensive L-shaped lateral approach (Seattle), anaemization, minimization of soft
tissue disruption, and was followed by spongioplasty. In isolated dislocated sustentacular fractures, osteosynthesis through a medial
approach was completed, using screws. Post-operatively, the extremity was not fixated and early rehabilitation was initiated.
In majority of the operated patients, the skin cover healed per primam. In 3 patients, the wound healed per secundam intentionem.
Complete fracture healing was x-ray confirmed in all patients. No signs of the osteosynthetic material release or of pronounced signs
of subtalar arthrosis or of a foot arch collapse were present. No deep defects or other serious postoperative complications were recorded.
The follow-up period lasted for 6-22 months and goes on. The patients followed for over a year period have no symptoms, they
fully wightbear the operated extremity and they have returned to their original professions.
Open repositioning and internal stable cast fixation is recommended as a standard treatment method in these fractures.
Key words:
intraarticular calcaneal fractures – calcaneal cast – osteosynthesis
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