"Smile" incision: an approach for open reduction and internal fixation of calcaneal fractures.
METHODS
A consecutive group of 73 patients (77 calcaneal fractures) treated with open reduction and internal fixation through a smile-shaped lateral approach to the hindfoot were reviewed retrospectively. Inclusion criteria were a closed displaced intra-articular fracture of the calcaneus, no compartment syndrome, and adequate followup. Followup ranged from 4 months to 4 years.


RESULTS
One patient had a deep wound infection that required removal of hardware and intravenous antibiotics. No deep dehiscence or flap necrosis occurred. Superficial dehiscence occurred in three patients (4%) and superficial necrosis was seen in nine patients (12%); all resolved with continued casting to protect the wound. Six patients (8%) complained of numbness or pain in the sural nerve distribution. No symptomatic neuromas were seen. Reflex sympathetic dystrophy occurred in three patients (4%); all resolved with sympathetic blocks. Only one patient required an additional procedure for treatment of a wound-related problem or infection.


CONCLUSIONS
The "smile" incision provides good fracture exposure for reduction without added morbidity.
Wiley
William B
WB
Department of Orthopaedics, Summa Health System, Akron, OH 44320, USA.
Norberg
Jon D
JD
Klonk
Christopher J
CJ
Alexander
Ian J
IJ
D002111:Calcaneus / Q000293:injuries* / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects