An innovated treatment for intra-articular fracture of calcaneus.

ABSTRACT

An innovated composite treatment for intra-articular fracture of the calcaneus has been developed. A Steinmann's pin is introduced into the calcaneus percutaneously to release the impaction of the fragments and to lift the compressed subtalar joint facet, which forms a potential cavity in the calcaneal body facilitating restoration of Bohler's angle and correction of widening of the calcaneus by manual reduction. A new type external fixation device, the calcaneus fixation boot, is used to substitute for the traditional plaster immobilization. The boot can exert continuous centripetal pressure on both sides of the calcaneus to control transverse displacement and to maintain the normal height of the heel. The patient is allowed to do functional exercises 24 hours after reduction with the aid of the spring stepping roller, which not only helps dissipate swelling in the early stage but also remold the articular facet. Biomechanical determination showed that the power of triceps surae muscles returned to nearly normal in 4-5 weeks. The patients were allowed to bear weight with crutches in 6-7 weeks. In this series, 94 (87.8%) of 107 cases with an average follow-up period of 2 years and 9 months attained excellent and good results.