Management of Intra-Articular Calcaneal Fractures: Clinical Results of Reduction Technique Using a Bone Spreader

The purpose of the present study was to examine the clinical results of surgery for intra-articular calcaneal fractures using a calcaneal locking plate and a bone spreader as a reduction tool. Ten patients with intra-articular calcaneal fractures were treated. An extended lateral approach was used. The reduction of the intra-articular fragments of the posterior facet was temporarily held using a bone spreader and Kirschner wires. Internal fixation was achieved with a locking calcaneal plate. Bohler's angle and Preiss' angle were assessed on the day of injury and the day of the final follow-up examination. The step off and gap of the posterior facet were assessed on the day of injury and the first week after surgery. The functional outcome was evaluated using the American Orthopaedic Foot and Ankle Society ankle hindfoot scale score. The mean Bohler's angle ranged from 2.1 degrees 11.0 degrees to 30.4 degrees +/- 5.0 degrees (p < .0001), the mean Preiss' angle ranged from 23.5 degrees +/- 4.5 degrees to 15.5 degrees +/- 2.9 degrees (p < .0001), the mean step off ranged from 4.0 +/- 1.9 mm to 0.1 +/- 0.2 mm (p =.0002), and the mean gap ranged from 2.6 1.0 mm to 1.2 +/- 0.6 mm (p =.0035). The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score was 89.2 (range 85 to 100) at a mean of 14.3 months after surgery. Our results suggest that a locking calcaneal plate can be used to restore and reduce an intra-articular calcaneal fracture and achieve good clinical results. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.