Features of External Rod-Controlled Fixation in Calcaneal Fractures

Abstract

A device for transosseous osteosynthesis of rod type and a technique of external fixation have been developed, which will allow to provide with high degree of efficiency a positive clinical result of reposition of all types of intra−articular calcaneus fractures. The proposed device, based on the apparatus Ilizarov details, as well as technique of osteosynthesis have their own peculiarities, namely the technical ability to use a removable repotent node to perform the reposition of all types of calcaneus fractures. We have used the modified method of closed one−moment instrumental reposition. Own practical experience and observations allowed us, depending on the nature of the destruction of posterior articular facet and types of its displacement, to assert the possibility of using a closed one−time instrumental reposition. The essence consists in distraction surgery, where the main mechanism of indirect reposition is the effect of tensile forces in a certain sequence on surrounding fracture of damaged ligaments, i.e. so−called the effect of ligamentotaxis. According to this method, 6 surgical procedures were performed. In all cases, the use of the proposed device intraoperative repositioning of the posterior articular surface of the heel bone and restoration of the Böhler's angle were considered satisfactory, even with significant destruction. Technical capabilities enables the conclusion about recommending this for surgical treatment of intra−articular fractures of a heel bone. It is advisable to continue research in the specified patient category to confirm the effectiveness of new, minimally invasive surgical intervention. Further improvement and implementation of surgery of intra−articular fractures of calcaneus will improve both the medium and long−term results. Key words: calcaneus, fractures, transosseous osteosynthesis.