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Treatment of Calcaneal Fractures with Closed Reduction and the Endobutton-Assisted Technique

Short-Term Analysis

Halil Atmaca Department of Orthopaedics and Traumatology, Akdeniz University, School of Medicine, Antalya, Turkey.

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Kaya Memisoglu Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Kocaeli, Turkey.

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Tuncay Baran Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Kocaeli, Turkey.

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Cumhur Cevdet Kesemenli Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Kocaeli, Turkey.

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Background

Closed reduction and percutaneous pinning, open reduction and internal fixation, and primary arthrodesis are procedures used in the surgical treatment of calcaneal fractures. This study presents short-term clinical and radiologic results of patients with calcaneal fractures treated by closed indirect reduction with Endobutton-assisted minimally invasive osteosynthesis.

Methods

Twenty-one feet of 18 patients (four women and 14 men) with calcaneal fractures were retrospectively analyzed. Böhler and Gissane angles were measured from the preoperative, postoperative, and latest follow-up lateral radiographs of the feet. American Orthopaedic Foot and Ankle Society (AOFAS) scores were used for the 6-month and latest follow-up clinical assessments.

Results

The mean preoperative Böhler angle of 17.1° was corrected to a mean of 20.4° postoperatively. The mean value of this angle measured at the time of latest follow-up was 21.3°. The mean preoperative and postoperative Gissane angles were 116° and 117.8°, respectively. The mean value of this angle measured at the time of latest follow-up was 117.4°. The mean 6-month postoperative AOFAS score was 59.8 points. The mean AOFAS score at the time of latest follow-up (79.1 points) was significantly higher than the mean score 6 months postoperatively (P < .001). Regarding the latest follow-up AOFAS scores, four were poor, four were moderate, ten were good, and three were excellent.

Conclusions

With a low learning curve and satisfactory clinical outcomes, this technique can be used in acute, edematous cases with soft-tissue injuries to avoid calcaneal enlargement, infection, and soft-tissue problems.

Corresponding author: Halil Atmaca, MD, Department of Orthopaedics and Traumatology, Akdeniz University, School of Medicine, Dumlupinar Ave, 07058, Konyaaltı-Antalya, Turkey. (E-mail: drhalilatmaca@hotmail.com)