Evaluation of patients submitted to minimally invasive surgery (suprafibular access) for treatment of calcaneal fractures

Abstract

Objective: To evaluate the functional results of the treatment of calcaneal fractures using the minimally invasive approach, focusing on the rate of complications involving the soft tissues. Methods: From 2006 to 2010, 27 intraarticular calcaneal fractures were treated by the minimally invasive technique. Sanders’ tomographic classification was used in the preoperative evaluation. The surgical access route was the lateral economic, with minimum fixation, focusing on the talocalcaneal joint, without causing dislocation of the soft tissues, with fixation only with wires and screws, and without the use of a plate or graft. For the clinical-functional evaluation, the functional scale of the American Orthopaedic Foot & Ankle Society (AOFAS) was used. The initial and subsequent pre- and postoperative radiographs were evaluated, checking the Böhler and Gissane angles. Results: The radiological values obtained were normalized in 100% of cases, with only one patient having a radiographic result considered unsatisfactory; 50.1% of the patients presented good clinical results. The AOFAS functional scale presented a mean score of 71 points (ranging from 60 to 90). The mean postoperative Böhler angle was 18° and the Gissane angle was 88°. No patient presented infection in the region of the surgical wound during our follow-up. No complications affecting the soft tissues were observed. There were no skin complications or infections; five cases presented residual pain; and post-traumatic arthritis was observed in two cases. Conclusion: The study demonstrated satisfactory clinical-functional results, with improvements and a low rate of complications.