title: "Smile" incision: an approach for open reduction and internal fixation of calcaneal fractures.
abstract: 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.
authors.affiliation: Department of Orthopaedics, Summa Health System, Akron, OH 44320, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Wiley
authors.forename: Jon D
authors.initials: JD
authors.lastname: Norberg
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Klonk
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Alexander
mesh_terms: 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