• Oper Orthop Traumatol · Apr 2017

    Review

    [Minimally invasive treatment of intra-articular calcaneal fractures with the 2‑point distractor].

    • G Mattiassich, W Litzlbauer, M Ponschab, R Ortmaier, and C Rodemund.
    • Unfallkrankenhaus Linz, Lehrkrankenhaus der Paracelsus Medizinischen Universität Salzburg und der Medizinischen Universität Wien, Garnisonstrasse 7, 4010, Linz, Österreich. georg.mattiassich@gmx.at.
    • Oper Orthop Traumatol. 2017 Apr 1; 29 (2): 149-162.

    ObjectiveOpen treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications.IndicationsCalcaneal fractures with malalignment/comminution >1-2 mm; broadening, varus alignment of the calcaneal length axis or shortening; emergency surgery for open fractures or compartment syndrome.ContraindicationsLocal or general contraindications.Surgical TechniqueStandardised positioning; restoration of length/axis with 2‑point distractor under fluoroscopic control. Fragment reduction via small incisions. Fixation with 7.3 mm cannulated screws and 4.0 mm sustentaculum screws.Postoperative ManagementCast-free and no weight bearing for 6 weeks; then weight bearing in a heel off-loading shoe for another 6 weeks with physiotherapy; if needed postoperative cast until soft tissue consolidation.ResultsOf 212 calcaneal fractures, 182 were treated with this technique. Wound healing complication rate was 2.7%; 4.7% of patients required secondary arthrodesis of the subtalar joint.

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