title: Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation.
abstract: BACKGROUND
  Fractures of the calcaneus are among the most challenging for the orthopaedic surgeon. The treatment of the intra-articular calcaneum fracture remains controversial due to complications and complexity of surgical anatomy. Treatment of calcaneal fracture ranges from non-operative treatment to operative. We present intraarticular fracture of calcaneus treated by combined percutaneous and minimal internal fixation.
  
  
  METHODS
  All cases evaluated either by X-ray or CT scan. All fractures were sanders two or three type evaluated by CT scan and either joint depression or tongue type fracture by X-ray. Lateral approach was used, posterior facet was exposed, reduced and fixed with one 4 mm canulated cancellous screws and 2 axial pins percutaneously from tuberosity. Clinical evaluation of the outcomes was done by modified Rowe Score.
  
  
  RESULTS
  Out of 22 patients, 14 were male and 8 cases were female. Average age of the patients was 30.5 yrs (15-63 yrs). Mode of the injury was RTA in 6 cases and fall from height in 16 cases. There was no soft tissue problem in any patient. All fractures united without secondary displacement in an average of 8 weeks. Average duration of follow up was 26 months (6-37 months). Average Modified Rowe Score was 80 (Range 55-95). Ten patients had excellent, 10 had good and 2 had satisfactory outcome.
  
  
  CONCLUSIONS
  Intra-articular fracture of the calcaneus can be well managed by minimal opening at the fracture and fixation by single cancellous screw and 2 axial k-wires, so minimizes complications and results in comparable outcomes.
authors.affiliation: Department of Orthopaedics, Institute of Medicine, Tribhuwan University Teaching Hospital, Kathmandu, Nepal. drajun@ gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Lamichhane
authors.forename: D
authors.initials: D
authors.lastname: Mahara
mesh_terms: D000293:Adolescent; D000328:Adult; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult