Calcaneus bone intra-articular fracture treatment by the closed reduction and percutaneous fixation with cannulated screw method in high-risk patients: A pilot trial

OBJECTIVE: Debate surrounding the methods for optimal treatment of calcaneal fractures is controversial. One method, closed reduction and percutaneous fixation, can restore the height, width, length and shape of the hindfoot by restoring the orientation of the calcaneal posterior facet. The aim of this study was to evaluate the treatment of intra-articular fractures of the Calcaneus bone with this method, especially in patients unsuitable for open reduction surgery.

METHOD: 49 patients with intra-articular fractures underwent closed reduction and percutaneous fixation surgery between 2014 and 2016 in Taleghani Hospital. After 12 months of follow up, pain, functional outcome, range of motion, and change in footwear were evaluated with the use of the criteria from the American Orthopedic Foot and Ankle Society (AOFAS). Bohler’s and Gissane’s angles were recorded before and after surgery, and 12 months later. A visual analog scale (VAS) was recorded for the patient, along with their return to employment status, and post-operative infection status.

RESULT: Out of 49 patients, 42 were male and 7 were female. All cases demonstrated bony union, with an average Bohler’s angle of 25.92 ± 7.93 and Gissane’s angle of 115.39 ± 11.24. At the 12 months’ follow-up, the mean values of the AOFAS score were 73.3 ± 7.08. The changes in Bohler’s angle, VAS and AOFAS score did not differ significantly between patients with blister and without blister, and also between the smokers and nonsmokers sub-groups. Neither deep infection nor osteomyelitis was seen.

CONCLUSION: Closed reduction and percutaneous fixation of calcaneus fractures using cannulated screws can be a safe and effective method for treating calcaneus fractures.