Treatment of calcaneal fracture with calcaneal reduction forceps and external fixation

Abstract Background:The optimal treatment of displaced intra-articular calcaneal fractures remains controversial.Conservative treatment has been proven to be ineffective for these fractures. Usually,surgical treatment methods include open reduction and internal fixation, arthroscopic-assisted reduction,balloon dilatation and plasty.However,there is no consensus on which methods are more effective.This paper reports the clinical effect of the minimally invasive treatment of calcaneal fractures by closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation. Method:The clinical data of 16 patients,including 14 males and 2 females,with a unilateral calcaneal fracture were analysed retrospectively.The Bohler angle,Gissane angle,and calcaneal width, height and length were measured before and after the operation.The ankle function was evaluated according to the AOFAS score at 6 and 12 months after the operation. Result:The average Bohler angle was 16.7 before the operation and 25.8 after correction; the average angle at the final follow-up was 25.2. The average Gissane angle before and after the operation was 103.6 and 120.9, respectively; the average angle measured at the final follow-up was 119.6. The average calcaneal width before and after the operation was 39.5 mm and 35.2 mm, respectively; the average width measured at the final follow-up was 36.5 mm. The average height before and after the operation was 46.9 mm and 48.5 mm; the average height measured at the final follow-up was 48.9 mm.The average length before and after the operation was 67.5 mm and 71.2 mm, respectively; the average length measured at the final follow-up was 70.9 mm. The average AOFAS score was 60.1 at 6 months after the operation and 80.6 at 12 months after the operation, which was significantly higher than the average AOFAS score at 6 months after the operation (P < 0.001).At the final follow-up, the AOFAS score was excellent, good, moderate,and poor in 11 cases, 3 cases,1 case and 1 case,respectively,with a rate of excellent and good scores of 87.5%. Conclusion:The application of closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation is effective for the treatment of displaced calcaneal fractures, with a simple procedure, minimal trauma, fewer skin and soft tissue complications, and satisfactory clinical results.