EVALUATING THE EFFICACY OF MINIMALLY INVASIVE APPROACH IN THE MANAGEMENT OF CALCANEAL FRACTURE
Main Article Content
Keywords
Calcaneal fractures, Minimally invasive surgery, Subtalar approach, Screw fixation, Functional outcomes
Abstract
Objectives
This study explores the effectiveness of a minimally invasive approach, with short lateral subtalar incision combined with screw fixation for managing displaced intra-articular calcaneal fractures. The objective was to evaluate both clinical outcomes and radiographic healing.
Study design: Prospective study
Place of Study and Duration of study: This study conducted at Emirates Health Services Saqr Hospital, United Arab Emirates from January 2024 to January 2025.
Methods
A total of 40 patients with intra-articular calcaneal fractures were included in this study. All patients underwent limited open reduction and internal fixation using a short lateral subtalar approach. The average age of patients was 35 years, among the fractures treated, 28 were of the joint depression type and 12 were tongue-type. According to the Sanders classification, 24 were Type II and 16 were Type III. Direct reduction was performed for the articular surface, while the extra articular portion was managed indirectly and stabilized percutaneously under fluoroscopic guidance.
Results
All patients were followed for an average of 13.3 months. Functional outcomes were promising, with a mean AOFAS ankle-hindfoot score of 91.7 and an average Maryland foot score of 95.1. Postoperative complications were minimal. Two patients developed superficial wound infections, and one experienced transient sural nerve dysesthesia, both resolved with conservative treatment. Four patients were diagnosed with complex regional pain syndrome (CRPS), which responded well to physiotherapy and pregabalin. Five individuals reported tenderness at the screw site, leading to elective screw removal. A notable finding was the positive correlation between earlier surgical intervention and improved functional scores.
Conclusion
The limited lateral subtalar approach combined with screw fixation appears to be a safe, effective, and reproducible method for treating Sanders Type II and III calcaneal fractures, offering solid clinical and radiologic outcomes with minimal complication rates.
References
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Abdelbagy Handous
Abdelbagy Handous, Consultant Orthopedic, Head of Department, Emirates Health Services Saqr
Hospital, United Arab Emirates
Niaz Hussain Keerio
Niaz Hussain Keerio, Specialist Orthopedic, Emirates Health Services Saqr Hospital, United Arab Emirates
Goud Deng
Goud Deng, Specialist Orthopedic, Emirates Health Services Saqr Hospital, United Arab Emirates
Mamoun Al Dokhi
Mamoun Al Dokhi, Specialist Orthopedic, Madinat Zayed hospital Abu Dhabi, United Arab Emirates