Dr. Amr Salem El Sayed Mohamed ElGazzar :: Publications:

: Minimally invasive approaches became an alternative to the extensile lateral approach used for treatment of displaced intra-articular calcaneal fractures to reduce the high rates of soft tissue complications. The aim of the study was to evaluate the outcomes of minimally invasive approach for treatment of displaced intra-articular calcaneal fracture using a mini-plate through sinus tarsi approach and percutaneous screws. Patients & Methods: During the period from January 2015 to June 2016, 69 patients including 58 males and 11 females with intra-articular fracture calcaneus were treated in Benha University and insurance hospitals by minimally invasive approach using a mini-plate and percutaneous screws. The mean age was 30.9 (ranged 15 to 45) years. The affected sides were right in 54 patients and 15 with left side. There were 17 smoker patients, 5 diabetic patients, and no open fractures. The mean preoperative delay was 8.2 (ranged 5 to 11) days. There were 47 patients with intra-articular fracture sander type II and 22 patients with intra-articular fracture Sander type III. The mean follow up period was 36.2 (ranged 28 to 39) months. Results: Fracture healing occurred after a mean of 9.8 months. The Böhler’s angle improved from a preoperative mean of 5±2 degrees to a mean of 25±4 degrees postoperatively with a mean of 28±4 degrees for the contralateral side. The Gissane angle improved from 147±5 degrees preoperatively to 135±2 degrees postoperatively with a mean of 133±2 degrees for the contralateral side. The median visual analogue scale (VAS) for pain became 1 (range, 0 to 3) postoperatively. The mean hindfoot score of American orthopedic foot and ankle society (AOFAS) became 83±4 postoperatively. Four patients underwent to subtalar arthrodesis during follow up period with only two patients treated from superficial wound infection by intravenous antibiotics. Conclusion: Treatment of displaced intra-articular calcaneal fractures by minimally invasive sinus tarsi approach with percutaneous cannulated screws is an effective method for achieving articular reduction, early range of motion and preventing wound complications and malalignment. Level of evidence: level IV, retrospective case series.