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A Minimally Invasive, Dual-incision (Medial and Lateral) Approach

An Alternative Technique for Reduction and Fixation of Intra-Articular Calcaneus Fractures

Neary, Kaitlin C., MD*; Daws, Snow B., MD; Dunaway, Linda J., APRN; Kaiser, Cody, BS§; Lundeen, Gregory A., MD, MPH∥,¶,#

Techniques in Foot & Ankle Surgery: December 2018 - Volume 17 - Issue 4 - p 194–203
doi: 10.1097/BTF.0000000000000209
CME Article

Calcaneus fractures are severe injuries that historically have been associated with poor outcomes and debilitating consequences. To maximize functional outcome, the literature in favor of operative management encourages anatomic reduction and alignment of displaced, intra-articular calcaneus fractures, while minimizing risk to soft tissues. Because of the increased risk of soft tissue complications with extensile approaches, minimally invasive techniques have continued to gain popularity. The current technique aims to describe a minimally invasive approach to calcaneus fractures through a dual-incision, lateral (sinus tarsi) and medial, approach. This approach facilitates anatomic reduction of the calcaneal tubercle to restore calcaneal tuberosity height and length, thus facilitating anatomic reduction of the posterior facet and realignment of the anterior calcaneus while minimizing risk of soft tissue complications. The authors’ results support this technique and we recommend it as a safe and effective method for open reduction and internal fixation of displaced, intra-articular calcaneal fractures.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.

*Orthopedic Surgeon, St. Lukes Department of Orthopaedic Surgery, Boise, ID

Orthopedic Surgeon, Novant Health Orthopedics & Sports Medicine, Winston-Salem, NC

Nurse Practitioner, Reno Orthopedic Clinic

§Medical Student, University of Nevada

Orthopedic Surgeon, Reno Orthopedic Clinic

#Orthopedic Surgeon, University of Nevada, Reno, NV

Orthopedic Surgeon, Department of Orthopaedics, UC Davis, Davis, CA

G.A.L.: Consultant—Stryker; Editorial Board—Techniques in Foot and Ankle Surgery. Foot and Ankle International; Board Member—Musculoskeletal Organization for Research and Education; Received funding/support from: Smith and Nephew, Arthrex, Stryker. The remaining authors declare no conflict of interest.

Address correspondence and reprint requests to Gregory A. Lundeen, MD, MPH, Reno Orthopaedic Clinic, 555 N Arlington Avenue, Reno, NV 89503. E-mail: renofootmd@gmail.com.

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