G Mattiassich1,2,3, W Litzlbauer4, M Ponschab4,5, R Ortmaier6, C Rodemund4. 1. Unfallkrankenhaus Linz, Lehrkrankenhaus der Paracelsus Medizinischen Universität Salzburg und der Medizinischen Universität Wien, Garnisonstrasse 7, 4010, Linz, Österreich. georg.mattiassich@gmx.at. 2. Ludwig-Boltzmann Institut für experimentelle und klinische Traumaforschung, Wien, Österreich. georg.mattiassich@gmx.at. 3. Abteilung für Orthopädie, Krankenhaus der Barmherzigen Schwestern Linz, Linz, Österreich. georg.mattiassich@gmx.at. 4. Unfallkrankenhaus Linz, Lehrkrankenhaus der Paracelsus Medizinischen Universität Salzburg und der Medizinischen Universität Wien, Garnisonstrasse 7, 4010, Linz, Österreich. 5. Ludwig-Boltzmann Institut für experimentelle und klinische Traumaforschung, Wien, Österreich. 6. Abteilung für Orthopädie, Krankenhaus der Barmherzigen Schwestern Linz, Linz, Österreich.
Abstract
OBJECTIVE: Open treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications. INDICATIONS: Calcaneal fractures with malalignment/comminution >1-2 mm; broadening, varus alignment of the calcaneal length axis or shortening; emergency surgery for open fractures or compartment syndrome. CONTRAINDICATIONS: Local or general contraindications. SURGICAL TECHNIQUE: Standardised positioning; restoration of length/axis with 2‑point distractor under fluoroscopic control. Fragment reduction via small incisions. Fixation with 7.3 mm cannulated screws and 4.0 mm sustentaculum screws. POSTOPERATIVE MANAGEMENT: Cast-free and no weight bearing for 6 weeks; then weight bearing in a heel off-loading shoe for another 6 weeks with physiotherapy; if needed postoperative cast until soft tissue consolidation. RESULTS: Of 212 calcaneal fractures, 182 were treated with this technique. Wound healing complication rate was 2.7%; 4.7% of patients required secondary arthrodesis of the subtalar joint.
OBJECTIVE: Open treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications. INDICATIONS: Calcaneal fractures with malalignment/comminution >1-2 mm; broadening, varus alignment of the calcaneal length axis or shortening; emergency surgery for open fractures or compartment syndrome. CONTRAINDICATIONS: Local or general contraindications. SURGICAL TECHNIQUE: Standardised positioning; restoration of length/axis with 2‑point distractor under fluoroscopic control. Fragment reduction via small incisions. Fixation with 7.3 mm cannulated screws and 4.0 mm sustentaculum screws. POSTOPERATIVE MANAGEMENT: Cast-free and no weight bearing for 6 weeks; then weight bearing in a heel off-loading shoe for another 6 weeks with physiotherapy; if needed postoperative cast until soft tissue consolidation. RESULTS: Of 212 calcaneal fractures, 182 were treated with this technique. Wound healing complication rate was 2.7%; 4.7% of patients required secondary arthrodesis of the subtalar joint.