Standardized treatment of intra-articular calcaneal fractures using an oblique lateral incision and no bone graft.
BACKGROUND
The purpose of this study was to evaluate our protocol with the modified skin incision without bone graft in the treatment of intra-articular calcaneal fractures in a consecutive series.


METHODS
Thirty-three displaced intra-articular calcaneal fractures operatively treated by a single surgeon were evaluated. Each fracture was managed according to a standardized protocol that included an oblique lateral incision and stable internal fixation, without supplemental bone graft. Fractures were classified according to two accepted criteria. Patients were evaluated with serial clinical and radiographic examinations. Final evaluation was made after at least a 2-year follow-up and was determined by the use of a functional outcome assessment questionnaire.


RESULTS
Anatomic or near anatomic reductions were obtained in 97% of cases. All fractures healed without loss of initial reduction or collapse. Excellent or good results were achieved in 88% of non-worker's compensation patients and 27% of worker's compensation patients. Fractures with anatomic reductions were more likely to achieve a good or excellent result. Ninety-two percent of patients returned to the workforce. Complications included one superficial wound infection and five cases of peroneal tendinitis requiring hardware removal. One patient underwent subtalar fusion secondary to painful posttraumatic arthritis.


CONCLUSIONS
The open reduction and internal fixation using our standardized protocol is an effective method of treatment for intra-articular calcaneal fractures.
Geel
C W
CW
Department of Orthopedics, State University of New York, Upstate Medical University, Syracuse, New York, USA.
Flemister
A S
AS
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D001864:Bone Wires; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D002985:Clinical Protocols; D004651:Employment; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D016896:Treatment Outcome; D014942:Workers' Compensation