Minimally invasive percutaneous fixation of displaced intra-articular calcaneal fractures: Surgical technique and case series from a major trauma centre.

Authors

Ashwin Bhadresha, Iris Kwok, Harry Hodgson, Islam Abdelrahman, Nadeem Mushtaq, Naveethan Sivanadarajah

Published in

Foot (Edinburgh, Scotland). Volume 68. Pages 102285. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

Displaced intra-articular calcaneal fractures (DIACFs) managed with open reduction internal fixation through extensile lateral or sinus tarsi approaches are associated with a high rate of soft tissue complications. We present the technique of minimally invasive percutaneous fixation of DIACFs and the early outcomes from a major trauma centre.
This was a retrospective case series from a single major trauma centre between 2021 and 2024. Seventeen DIACFs in 13 patients were followed up for a mean of 14 months (range, 12-16 months). The mean age was 41 years (range, 18-60 years). Two out of 17 fractures were open injuries. There were seven Sanders type 2 and ten Sanders type 3 fractures. Simple tongue-type fractures were excluded. Fracture reduction was performed using a Schanz pin, combined with the 'Essex-Lopresti manoeuvre' and manual correction of varus and shortening. Fixation was with at least three 6.5 mm partially-threaded cancellous screws. Patients were immobilised in a below knee backslab for 6-weeks post-operatively. Radiological parameters (Böhler's angle, calcaneal height and width), the Kerr-Atkins score, VAS pain score, and any re-operations or complications were recorded.
At final follow-up, the mean Kerr-Atkins score was 67 and the mean VAS pain score was 3.4. The average time from injury to surgery was 6.9 days (range, 3-21). All patients were mobilising unaided, and only 2 patients required orthotic footwear. One patient had a re-operation due to a late-declaring necrotic eschar. Mean Böhler's angle increased from 14.9° to 26.8° (p < 0.0001). The mean calcaneal height increased from 38.7 mm to 45.4 mm (p < 0.0001). No patients had developed clinical or radiological subtalar arthritis during the study period.
In our case series, we have demonstrated that minimally invasive percutaneous fixation of DIACFs is a safe procedure, with a very low complication rate. Early functional and radiological outcomes are excellent, with all patients mobilising unaided, and most were able to wear normal footwear with a plantigrade, shoeable foot.

PMID:
42468064
Bibliographic data and abstract were imported from PubMed on 18 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.