title: The outcome of super-cutaneous locked plate fixation with percutaneous reduction of displaced intra-articular calcaneal fractures.
abstract: BACKGROUND
  Supercutaneous (external) fixation with locking plate is utilized for fixation of long bone fractures. One retrospective study for open reduction and supercutaneous fixation of the calcaneus is reported. We prospectively evaluated the use of this method of fixation combined with percutaneous reduction.
  
  
  METHODS
  Between January 2014 and June 2015, 32 displaced calcaneus fractures in 30 patients were stabilized with percutaneous reduction and super-cutaneous fixation. They were 24 males and six females. The mean age was 37.9±5.7 years (21-55). All cases were closed. The time to surgery, complications, radiographic alignment, and time to radiographic union were recorded. Clinical results at the final follow-up were assessed by evaluating Bohler's angles for the radiographic alignment, and the system of the American Orthopedic Foot and Ankle Society (AOFAS) for the functional outcome.
  
  
  RESULTS
  According to the Sanders' classification, two cases were type II, 17 cases were type III and 13 cases were type IV. The preoperative average Bohler's angle was 10.57°±4.8. The postoperative X-ray films demonstrated that the average Bohler's angle improved to 29.07°±5.9 (p<0.001). At the time of radiologic healing (about 3 months), the plates and screws were removed under general anesthesia. The average follow-up was 13.2 months (11-18). Four cases (type IV) showed mal-union and heel pain. According to (AOFAS) rating, the fine score was 87.1±17.1 points.
  
  
  CONCLUSIONS
  Super-cutaneous fixation with percutaneous reduction of calcaneal fracture is an effective method in type II and III and can be effective with type IV but with less favorable results.
authors.affiliation: Kasr Al-Ainy School of Medicine, Faculty of Medicine, Cairo University, Egypt. Electronic address: ehabede@hotmail.com.
authors.forename: Ihab I
authors.initials: II
authors.lastname: El-Desouky
authors.affiliation: Kasr Al-Ainy School of Medicine, Faculty of Medicine, Cairo University, Egypt. Electronic address: wissam.abusenna@kasralainy.edu.eg.
authors.forename: Wissam
authors.initials: W
authors.lastname: Abu Senna
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D020878:Device Removal; D004534:Egypt; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult
keywords: Calcaneus; Locked plate; Percutaneous reduction; Supercutaneous fixation