Minimally invasive calcaneal fracture fixation by using two-point distractor - A Prospective Observational Cohort Study.

Introduction: A displaced fracture of calcaneum is serious and disabling injury. Treatment options have evolved from conservative to open surgical alternatives and include a variety of minimally invasive techniques also. We hypothesise that minimally invasive surgery of calcaneal fractures by using a distractor achieves a good clinical and functional outcome with minimum wound complications. Aims and objectives: The aim of our study was to assess the functional outcome of minimally invasive surgery in the management of calcaneal fractures and the subsequent complication rate in the management of displaced intra-articular fractures. Methods: Between April 2018 and March 2021, patients with unilateral or bilateral closed calcaneal fractures, treated operatively with minimally invasive technique using distractor were included in the study. 64 patients with 60 calcaneal fractures were included in the study. Pre operatively CT scan evaluation was done and fractures were classified as per Sander's classification. Only type II and type III were included in the study. Pre operatively both Bohler's and Gissane's angles were measured. Maryland foot and ankle score was used for evaluation and effectiveness of intervention. Results: The average operative time in our study was 45± 11.2 minutes. No major wound complications were reported in our study. Screw prominence was seen in three patients. Complex regional pain syndrome was seen in seven of our patients. Both Gissane and Bohlers angles were restored in 94% of our patients. Maryland foot and ankle score was excellent in 20 % (11) of patients, Good in 60% (33), Fair in 15% and Poor in 5%. Conclusion:We concluded that management of calcaneal fractures with the use of distractor helps to restore the articular congruity of subtalar joint with minimum soft tissue complications. [ABSTRACT FROM AUTHOR]