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Three-step closed reduction and percutaneous screw fixation: A reliable and reproducible protocol in managing displaced intra-articular calcaneal fractures

  • Author Footnotes
    1 These authors contributed equally to this work.
    Cheng Long
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Orthopaedics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, China

    Department of Orthopaedics, Shengli Orthopaedic Hospital, 2 Chenxi Road, Yiyang 413501, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    Kaihu Li
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Orthopaedics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, China
    Search for articles by this author
  • Jianxi Zhu
    Affiliations
    Department of Orthopaedics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, China
    Search for articles by this author
  • Hongbin Liu
    Affiliations
    Department of Orthopaedics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, China
    Search for articles by this author
  • Yong Zhu
    Correspondence
    Corresponding author.
    Affiliations
    Department of Orthopaedics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha 410008, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
Published:February 08, 2022DOI:https://doi.org/10.1016/j.injury.2022.02.017

      Abstract

      Background

      For displaced intra-articular calcaneal fractures (DIACFs), the less invasive surgical techniques vary widely. Herein, the study is to introduce a novel, reliable and reproducible protocol of three-step closed reduction (distracting, elevating, and clamping) and percutaneous screw fixation for DIACFs.

      Methods

      This retrospective study included 32 patients with 33 DIACFs treated by the abovementioned surgical procedures with an average follow-up of 17.7 months. Postoperative outcomes were evaluated by complications, radiographs, and functional scores.

      Results

      There were no incision complications. Postoperative Böhler's angle, height, and width were significantly recovered with p < 0.001. Especially, mean postoperative subtalar incongruity was 0.5 ± 0.5 mm. The average values of Maryland Foot Score (MFS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score were 93.6 ± 5.9, 91.7 ± 6.7, respectively. The average scores of short form-36 (SF-36) and visual analog scale (VAS) were 89.9 ± 10.4 and 3.1 ± 1.6, respectively. Further subgroup analysis showed that the functional scores were comparable among different fracture types according to either Sanders or Essex-Lopresti classification.

      Conclusion

      We consider the three-step reduction (distracting, elevating and clamping) and percutaneous screw fixation to be a reliable and reproducible protocol for the treatment of DIACFs.

      Keywords

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