Functional Assessment of Calcaneal Fructures Fixed Minimally Invasive: Comparing between Screws and Wires Technique

Abstract Background: The goal of therapy for calcaneal fractures is the elimination of pain and restoration of normal foot shape and walking ability. The occurrence of wound complications is a serious concern in treating calcaneal fractures. Aim of Study: The purpose of the present study was to describe and evaluate the functional outcome of a modified minimally invasive technique for the treatment of intra-articular fractures of the calcaneus. Patients and Methods: A prospective randomized study was conducted on 40 patients who had recent calcaneal fractures. Twenty patients undergo minimally invasive fixation through sinus tarsiby cancellous K wires and twenty patients undergo fixation by cancellous screws. The patients were operated on and followed-up at Cairo University in the screws group and El-Haram Hospital in the K.wire group during the period between March 2014 and April 2016. Results: In the current study regarding follow-up, the duration of follow-up ranged between 6 months and 18 months. Functional assessment was done in our series using the scoring system of the American Foot and Ankle Society Scale for fractures of the calcaneus. This scoring system was recom-mended by Kitaoka et al. [1], For Pain (40 points), Activity (10 points), Range of motion (14 points), walking distance (5 points), walking surface (5 points), gait abnormality (8 points), Ankle stability (8 points), and Alignment (10 points). The maximum score was 100 points, the result was rated excellent if the score was 90 points or more, good if it was 80 to 89, fair if it was 65 to 79, and poor if it was 64 or less. Conclusion: We concluded that this minimally invasive technique permitsre building of the articular surface of the posterior facet resulting in decrease drisk of infection and hared wear failure. It is an excellent option for the treatment of displaced intra-articular calcaneal fractures in selected patients despite the frequent need for screw removal following fracture-healing with the advantage of the threaded screws over smooth wires in the preservation of reduction till union as smooth wires biomechanically not designed to distract a collapsed bone as screw.