Minimally Invasive Reduction And Percutaneous Fixation Compare With Open Reduction And Internal Plate Fixation Management In The Treatment Of Displaced Intra-Atricular Calcaneal Fractures

Objective: The aim of this study was to assess the clinical, radiographic,and functional outcomes of patients in whom displaced intra-articular calcanealfractures were treated with percutaneous fxation compared with those afteropen reduction and internal fixation management.Method: Patients at our trauma centers were randomized to minimallyinvasive reduction and percutaneous fixation or open reduction and internalfixation care. A standard protocol, involving a lateral approach and rigidinternal fixation, was used for operative care. All fractures were classified, andthe quality of the reduction was measured. Postoperative complications wererecorded. During follow-up, pain, functional outcome, range of motion wereevaluated with the use of the American Orthopaedic Foot&Ankle Society(AOFAS) score，Creighton-Nebraska score(CNS), and Zwipp Foot score (ZFS).Results: Between October2009and December2011,30patients with acalcaneal fracture were treated. Of those patients,21with21displacedintra-articular calcaneal fractures were enrolled in the study. Twenty-firstpatients (100%) were followed and assessed for a minimum of two months anda maximum of twenty eight months of follow-up. The outcomes afterminimally invasive reduction and percutaneous fxation treatment were notfound to be significant different from those after open reduction and internalfixation treatment; At a mean follow-up time of eight months，the score on theAOFAS was85.80and84.18, respectively (p=0.319), the score on Creighton-Nebraska score was81.20and82.00, respectively (p=0.787) andthe score on Zwipp Foot score was6.00and6.36, respectively(p=0.473).Conclusion: The functional results after minimally invasive reduction andpercutaneous fixation care of Sanders II，III displaced intra-articular calcanealfractures were equivalent to those after open reduction and internal fixation.However, the outcomes of postoperative complications and the days ofhospitalization were significantly better in the percutaneous fixation group. Weconsider the technique of minimally invasive reduction and percutaneousfixation to be an excellent option for the treatment of displaced intra-articularcalcaneal fractures in selected patients.