Evaluation of the result of articular facet reduction and intraoperative distraction for sanders type iv calcaneal fracture n polytraumatized patients

Abstract

Aim: The aim of this study is to evaluate the results of combined repositioning – open repositioning of the depressed articular facet combined with intraoperative two-vector distraction of the calcaneus with a new external fixation distraction apparatus and osteosynthesis with a calcaneal plate with angular stability of a Sanders IV type fracture. Materials and Methods: This study evaluates the results of sequential two-vector distraction with a repositioning apparatus for open reduction and internal fixation (ORIF) of a Sanders IV calcaneal fracture. The method was applied in the treatment of 25 patients with polytrauma with 30 Sanders IV calcaneal fractures treated in Astana multiprofile hospital No. 1 and National Scientific Centre of Traumatology. 1 and National Scientific Centre of Traumatology and Orthopaedics named after academician N.D. Batpenov (Republic of Kazakhstan) from 2018 to 2022. Results: At final examination, the values of Bohler angle, Gissane, posterior articular facet tilt, width, height, and length of the calcaneus were significantly higher (p<0.001) preoperative values and were identical to postoperative values. Conclusions: The mean VAS pain score was 2.14 (standard deviation 1.08 and range 1.5-5.5). The mean clinical outcome score on the AOFAS was 92.8 points (SD 5.7, range 74-97). Two-vector distraction of the calcaneus with external fixation apparatus in ORIF of Sanders IV type intra-articular fracture is an effective method of repositioning a three-dimensional deformity of the calcaneus.