title: Heel displaced intra-articular fractures treated with mini-calcaneal external fixator.
abstract: BACKGROUND
  Treatment of displaced heel fractures is controversial; however, ORIF is widely described in the literature to be the gold-standard. Percutaneous reduction and monolateral external fixation is gaining increasing attention because it provides a good and stable reduction, and minimises soft tissue complications due to open surgery, such as deep infections and delays in wound healing. The aim of this study was to show that the new Orthofix Calcaneal Minifixator (six pins) provides a greater stability than the four-pin version to enable a better and more stable reduction, an earlier weight-bearing (30 days) and improved functional outcomes.
  
  
  METHODS
  A series of 69 consecutive closed heel intraarticular displaced fractures treated with the new Orthofix Calcaneal Minifixator were evaluated. Patients were assessed clinically with the Maryland Foot Score and radiologically with standard radiographs.
  
  
  RESULTS
  The clinical results at follow-up were excellent in 37 cases (53.6%), good in 27 (39.2%), fair in two (2.9%) and poor in three (4.3%). The mean preoperative Böhler's angle was 5.2˚ (range 0-18˚) and the mean postoperative value was 28.5˚ (range 16-38˚).
  
  
  CONCLUSIONS
  The excellent functional outcomes were despite some radiological images of imperfect posterior facet anatomical reduction and seemed to correlate with the use of a good and stable minimally-invasive surgical technique. This technique enabled early weight-bearing, minimised complications, respected the delicate biology of this anatomical site and restored the good heel volume and Böhler angle.
authors.affiliation: Orthopaedics and Traumatology Department, "Vito Fazzi Hospital", Lecce, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corina
authors.affiliation: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Mori
authors.affiliation: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Italy. Electronic address: dott.gvicenti@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Vicenti
authors.affiliation: Orthopaedics and Traumatology Department, "Az Unita'Sanitaria Locale TA 1", Castellaneta, TA, Italy.
authors.forename: V N
authors.initials: VN
authors.lastname: Galante
authors.affiliation: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Conserva
authors.affiliation: Orthopaedics and Traumatology Department, "Hospital Santissima Annunziata", Taranto, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Speciale
authors.affiliation: Orthopaedics and Traumatology Department, "Hospital Santissima Annunziata", Taranto, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Scialpi
authors.affiliation: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Abate
authors.affiliation: Orthopaedics and Traumatology Department, "Miulli Hospital", Acquaviva delle Fonti, Bari, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Tartaglia
authors.affiliation: Orthopaedics and Traumatology Department, "Di Venere Hospital", Bari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Caiaffa
authors.affiliation: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Moretti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D020878:Device Removal; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: External fixation; Heel fractures; Sanders classification