Open Reduction using Lateral Approach in Displaced Intra-articular Fracture of Calcaneus

Purpose : This study was designed to investigate the usefulness of lateral approach for accurate reduction and rigid internal fixation in comminuted intra-articular fractures of calcaneus. Material and Method : Twenty patients(21 cases) who had intra-articular fracture of calcaneus and underwent an open reduction and internal fixation using lateral approach were enrolled. Using Essex-Lopresti classification, all cases were intra-articular fracture, which joint depression type was 17 cases and 4 of severe comminuted tongue type. We compared the preoperative and postoperative change of B o h l e r ’ s angle and clinical results were analyzed using Paley and Halls evaluation protocol and scoring system. Results : The average B ohler’ s angle was restored from 2.8 to 25.1 after operations and clinical results classified 4 well, 12 good, 4 fair, 1 poor cases. Postoperative complications were 2 cases of wound dehiscence, 1 of infection and one had sural nerve injury. Late complications included 3 cases of limitation of motion of ankle that disturb usual activity, 3 of sustained pain and 2 of traumatic arthritis and 2 cases had 2 complications at the same patients. Conclusion : The lateral approach is valuable for the comminuted intra-articular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint, and also with little morbidity of neurovascular injury. Abstract .. ..