A Percutaneous Technique for Reduction and Internal Fixation of Displaced Intra-Articular Calcaneal Fractures

Introduction

A retrospective cohort study demonstrated that, in comparison with open reduction and internal fixation through an extensile lateral approach, our percutaneous technique for reduction and internal fixation of displaced intra-articular calcaneal fractures decreases the rate of complications and achieves and maintains extra-articular fracture reductions just as well.

Step 1 Patient Positioning and Imaging

Position the patient correctly to obtain excellent fluoroscopic views, which are key to the procedure.

Step 2 Fracture Reduction

The techniques for reducing and fixing joint depression and tongue-type calcaneal fractures differ and will be described separately.

Step 3 Screw Fixation

Identify screw entry points and paths using fluoroscopic images, and confirm the final positions with c-arm imaging.

Step 4 Postoperative Management

Apply a splint; then obtain postoperative images to confirm fracture reduction and screw placement.

Results & Preop/Postop Images

The results of percutaneous reduction of displaced intra-articular calcaneal fractures in seventy-nine patients with a total of eighty-three fractures were compared with those obtained by another surgeon using the extensile lateral approach.

What to Watch For

IndicationsContraindicationsPitfalls & Challenges.

Case report: successful treatment of acute exertional paraspinal compartment syndrome with hyperbaric oxygen therapy

An NCAA football player developed an acute paraspinal compartment syndrome after a weight-lifting strain. The patient presented with myonecrosis (CK up to 77,400 U/L), and myoglobinuria. Treatment consisted of forced diuresis and six sessions in the hyperbaric oxygen chamber.