Treatment of Sanders II、III Calcaneal Fractures with Closed Reduction and Percutaneous Screw Fixation

Objective To evaluate the results of the treatment of Sanders Ⅱ、Ⅲ Calcaneal Fractures with Closed Reduction and Percutaneous Screw Fixation.Methods From January 2008 to September 2011,25 cases(28 feet) of Sanders Ⅱ、Ⅲ Calcaneal Fractures were treated with Closed Reduction and Percutaneous Screw Fixations,19 were males and 6 were females,aged 20 to 65 years(37.8 years on average).19 patients were type Ⅱ ang were type Ⅲ by Sanders classification respectively.Postoperative infections were recorded.During follow-up,pain,functional outcome,range of motion,and change in footwear were evaluated with the use of the American Orthopaedic Foot Ankle Society(AOFAS) score.Results We reviewed the cases of 25 patients who had a combined total of 28 displaced intra-articular calcaneal fractures and a follow-up period of 8 to 18 months(mean 11.2 months).Three wound infections occurred,two of which were superficial and one of which was deep.All cases showed clinical healing during 9 to 16 weeks(mean 10.6 weeks).There were no failure of internal fixationin.The Bhler's,Gissane's angle,calcaneal width and height were reduced close to normal anatomic structure in X-ray.According to AOFAS Hindfoo score,the operation results were excellent in 16 feet,good in 9,and poor in 3.The AOFAS Hindfoot Score averaged 88.7.The overall satisfactory results(excellent and good) were 89.29%.At the time of follow-up,subtalar arthrodesis had been performed in three patients.Conclusion Percutaneous screw fixation of calcaneal fractures(Sanders Ⅱ,Ⅲ) is associated with minimal soft tissue traumatization and low complication rates.It allows early rehabilitation and excellent results with proper patient selection.The procedure is suitable for most types of intra-articular fractures especially in patients with compromised soft tissues in which open reduction and internal fixation is contraindicated.