A Novel Minimally Invasive Reduction Technique by Balloon and Distractor for Intra-Articular Calcaneal Fractures: A Report of 2 Cases

Abstract

Treatment of displaced intra-articular fractures of the calcaneus remains a challenge for the orthopaedic surgeon. Conservative therapy is known to produce functional impairment. Surgical approach is plagued by soft-tissue complications and insufficient fracture reduction. We describe a minimally invasive technique that will hopefully improve these issues. We want to present our first experience through two cases. The first was a 46-year-old man who presented with a Sanders type IIBC calcaneal fracture, and the second was a 86-year-old woman with a type IIIBC calcaneal fracture. We introduced 2 Schanz screws in the talus and the calcaneus. After distraction, we introduced an inflatable balloon inside the calcaneus. By inflating the balloon, the articular surface was reduced by lifting it up. Then bone cement was injected in order to maintain the reduction. Additional screw fixation was used in the young patient. Postoperative imaging showed good congruence of the subtalar joint without leakage of cement, for the two cases. After 2 months, the patients had no pain and were without soft-tissue complications. We advocate this technique to perform a minimally invasive reduction and fixation of intra-articular calcaneal fractures because it preserves soft-tissues and provides good clinical results with early weight-bearing.

Open reduction and Kirschner wire fixation method using a cylindrical block of unidirectional porous β-tricalcium phosphate for tongue-shaped calcaneal fracture: Report of three cases

“…I don't know if it's better to fill (many artificial bones of various shapes) the whole depression or just one artificial bone, but considering the medical economy, I think it's better to treat it at a lower cost. In recent years, there have been reports of the use of balloons to reduce depressions and the use of liquid-based artificial bones [ 16 ], which may lead to calcaneal fracture treatment that does not use implants [ 17 , 18 ]. Perhaps in the future, a minimally invasive treatment for intra-articular calcaneal fractures that does not use implants may be developed.…”

Study of Mechanical Behavior in Epiphyseal Fracture Treated by Reduction and Cement Injection: No Immediate Post-Operative Weight-Bearing but Only Passive and Active Mobilization Should be Advised

“…Its initial use allowed for the sealing of joint prostheses ( Smith, 2005 ). Since 1984, new fields of use have emerged with a standalone application in the field of traumatology in the spine, and since 2010, in different anatomical localizations (calcaneus and tibial plateau) ( Vendeuvre et al, 2013 ; Smith, 2005 ; Prod’homme et al, 2018 ). This new approach allows minimally invasive management, reducing postoperative complications and immobilization time.…”