title: Current management options for displaced intra-articular calcaneal fractures: Non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. A contemporary review.
abstract: BACKGROUND
  Management of Displaced Intra-articular Calcaneal Fractures (DIACFs) continues to be technically demanding. The literature has not been definitive in its guidance for surgeons dealing with these injuries. Recent publications have further added to the lack of clarity. This review is intended to summarise the present state of knowledge, and provide some genuine guidance for clinicians.
  
  
  OBJECTIVE
  To review previous research, focussing on articles published within the last fifteen years, and summarise the findings to aid surgeons in managing DIACFs with choosing best management for patients.
  
  
  METHODS
  We reviewed the best evidence and literature, focussing on articles published within the last fifteen years, and summarised findings into workable recommendations. Variables of (1) patient, (2) the associated soft tissue injury and (3) the fracture characteristics were used to aid surgeons in choosing the best of the available options for each patient that presents with a DIACF.
  Management of DIACFs can best be divided into four broad categories: (i) non-operative management, (ii) open reduction and internal fixation, (iii) minimally invasive reduction and fixation, and (iv) primary subtalar arthrodesis. The evolution of the literature would suggest orthopaedic surgeons managing calcaneus fractures should have an expert's knowledge, surgical expertise and the latest techniques to cover these four options, to tailor the treatment of DIACFs to the individual patient.
authors: Department of Orthopaedics, University of Otago, Christchurch Hospital, Riccarton Avenue, Christchurch 4710, New Zealand. Electronic address: jonnysharr@yahoo.co.nz.
authors: P J
authors: PJ
authors: Sharr
authors: Department of Orthopaedics, University of Calgary, Foothills Hospital, 1403 29 St NW, Calgary, AB, Canada T2N 2T9.
authors: M M
authors: MM
authors: Mangupli
authors: Department of Orthopaedics, University of Bristol, Southmead Hospital Southmead Way, Avon, Bristol BS10 5NB, United Kingdom.
authors: I G
authors: IG
authors: Winson
authors: Department of Orthopaedics, University of Calgary, Foothills Hospital, 1403 29 St NW, Calgary, AB, Canada T2N 2T9.
authors: R E
authors: RE
authors: Buckley
mesh_terms: D001174:Arthrodesis; D002111:Calcaneus / Q000293:injuries*; D018409:Foot Injuries / Q000628:therapy*; D005593:Fracture Fixation, Internal; D006801:Humans; D057072:Intra-Articular Fractures / Q000628:therapy*; D019060:Minimally Invasive Surgical Procedures; D013380:Subtalar Joint / Q000293:injuries / Q000601:surgery
keywords: Calcaneus; Fracture; Fracture management; Intra-articular; Minimally invasive; Primary subtalar arthrodesis; Review article