• Oper Orthop Traumatol · Apr 2019

    Review

    Minimally invasive internal fixation of calcaneal fractures or subtalar joint arthrodesis using the Calcanail®.

    • M Saß, R Rotter, and T Mittlmeier.
    • Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Germany. marko.sass@med.uni-rostock.de.
    • Oper Orthop Traumatol. 2019 Apr 1; 31 (2): 149-164.

    ObjectiveA minimally invasive technique to prevent soft tissue problems using a calcaneal nail (Calcanail®, FH Orthopedics, Heimsbrunn, France) for calcaneal fractures or in subtalar joint arthrodesis is described.IndicationsDisplaced extra-articular calcaneal fractures involving the tuberosity fragment and in displaced intra-articular calcaneal fractures with impression and/or displacement of the subtalar joint surface. Subtalar joint arthrodesis for posttraumatic subtalar osteoarthritis.ContraindicationsSeverely displaced fractures type Sanders IV with the purpose of internal fixation; peripheral calcaneal fractures; general contraindications for operative treatment.Surgical TechniqueMinimally invasive reduction of calcaneal fractures using a special distractor and a graft pusher through a calcaneal working channel. Fixation performed via the insertion of the Calcanail® and the two locking screws, optional additional screws. Subtalar joint arthrodesis with a Calcanail® used with optional three locking screws to fix the talus and calcaneus creating an angular stable construct.Postoperative ManagementMobilization and restricted weight-bearing for 6 weeks in the patient's own shoes after fracture fixation or in a walker after arthrodesis.ResultsPreliminary results of 69 cases from three surgical centers have already been published. From 2013-2017, the technique was used in 48 of our own patients (42 calcaneal fracture reduction and fixation; 6 for subtalar joint arthrodesis). Mean postoperative hospital stay was 7 days for fracture reduction without any need of additional operations. During follow-up, 6 implant removals and 2 secondary subtalar fusions were noticed. All 6 cases of subtalar joint arthrodesis were planned in posttraumatic subtalar osteoarthritis.

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