Comparative study on three surgical techniques for intra-articular calcaneal fractures: open reduction with internal fixation using a plate, external fixation and minimally invasive surgery.
OBJECTIVE
To evaluate, compare and identify the surgical technique with best results for treating intra-articular calcaneal fractures, taking into account postoperative outcomes, complications and scoring in the Aofas questionnaire.


METHODS
This was a retrospective study on 54 patients with fractures of the calcaneus who underwent surgery between 2002 and 2012 by means of the following techniques: (1) open reduction with extended L-shaped lateral incision and fixation with double-H plate of 3.5 mm; (2) open reduction with minimal incision lateral approach and percutaneous fixation with wires and screws; and (3) open reduction with minimal incision lateral approach and fixation with adjustable monoplanar external fixator.


RESULTS
Patients treated using a lateral approach, with fixation using a plate had a mean Aofas score of 76 points; those treated through a minimal incision lateral approach with screw and wire fixation had a mean score of 71 points; and those treated through a minimal incision lateral approach with an external fixator had a mean score of 75 points. The three surgical techniques were shown to be effective for treating intra-articular calcaneal fractures, without any evidence that any of the techniques being superior.


CONCLUSIONS
Intra-articular calcaneal fractures are complex and their treatment should be individualized based on patient characteristics, type of fracture and the surgeon's experience with the surgical technique chosen.
Hospital e Maternidade Celso Pierro, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
Missa
M
Takasaka
Hospital e Maternidade Celso Pierro, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
Cintia Kelly
CK
Bittar
Hospital e Maternidade Celso Pierro, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
Fernando Saddi
FS
Mennucci
Hospital e Maternidade Celso Pierro, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
Carlos Augusto
CA
de Mattos
Hospital e Maternidade Celso Pierro, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
José Luís Amim
JL
Zabeu
Calcaneus/injuries; Calcaneus/surgery; Comparative study