Evaluation of results of displaced calcaneal fractures by open reduction and internal fixation by calcaneal plate fixation (Sinus tarsi approach).

Background: The operative treatment of displaced intraarticular calcaneal fractures has been a controversial topic. Soft tissue conditions and concomitant disease must be considered in these patients. The minimally invasive sinus tarsi approach is a valid therapeutic solution that guarantees stability, anatomic reduction of the fracture and soft tissue preservation. Objectives: The foremost objectives in such cases are to restore the congruity of the posterior facet and the subtalar joint, to restore the height of the calcaneus, to re-establish the integrity of calcaneocuboid joint and to avoid any deformity. Material and Methods: Twenty closed calcaneal fractures in 15 patients were treated with open reduction and internal fixation using the sinus tarsi approach (including fixation with cannulated screws). All fractures healed by the time of final follow-up at 12 months. Results: The time to union judged both clinically and radiographically, averaged 3 months. Mean Maryland foot scores were: 95 in type II; 91 in type III; and 83 in type IV fractures. Conclusion: Advantages offered by this new approach include a less invasive incision while still permitting good visualization and anatomic reduction of articular surfaces and with few complications.