We describe a new technique for reduction and percutaneous osteosynthesis of displaced posterior facet fractures of the calcaneus which appears to overcome the problems encountered with other percutaneous methods described for this type of surgery. The method relies on the use of traction which allows automatic reduction of the greater tubercle.
The patient is installed on an orthopedic traction table. Pin traction provides anatomic reduction of the posterior articular surface and restitution of Böhler's angle under fluorosocopic and arthroscopic control. We used this technique in thirteen patients with fifteen displaced posterior facet fractures of the calcaneus. Mean patient age was 50.4 years. Mean follow-up was twenty months.
We did not have any cutaneous or infectious complications in this small series. In the majority of the cases, the overall functional and physical results were excellent or good. The mean Böhler's angle was 27°, corresponding to 83% correction compared with the healthy side.
These preliminary results are encouraging. We were able to restitute calcaneus anatomy, shorten hospital stay, and avoid all skin complications. Indications for this percutaneous technique could be widened. It is a valid alternative to open treatment of posterior facet fractures of the calcaneus.
© 2004 Elsevier Masson SAS. Tous droits réservés.