Steinmann pin retractor: An auxiliary reduction equipment for the minimally invasive treatment of calcaneal fractures

Abstract

A minimally invasive approach has been widely used for the treatment of calcaneal fractures, however, its downside in exposing the calcaneal body, affects fracture reduction. We used a Steinmann pin retractor mentioned in our previous case series study to solve this issue. To further evaluate the efficacy of this reduction technique, and elucidate its mechanism, we compared it with the control groups in this study. Between March 2017 and November 2020, 52 patients were included in this retrospective comparative study. 20 patients were included in the S-S group (Steinmann pin retractor with internal fixation via the sinus tarsi approach), 17 patients were included in the S group (internal fixation via sinus tarsi approach), and 15 patients were included in the L group (internal fixation via L-shaped approach). Patients in each group were operated on by a distinctly skilled surgeon who is specialized in one of the specified surgeries mentioned above. All patients received positive postoperative radiological and clinical evaluations. The patients were followed up for at least 6 months postoperatively. At the last S-S group follow-up, the VAS value (0.29 ± 0.46) improved compared to the L group. The AOFAS (American Orthopedic Foot and Ankle Society) Ankle-Hindfoot score (94.38 ± 5.05) also improved significantly compared to the S and L groups. The Böhler angle (32.34 ± 3.56°), width (36.48 ± 3.91 mm), and height (88.87 ± 4.12 mm) of the calcaneal improved (34.38 ± 18.50°, –10.13 ± 6.98 mm, 8.75 ± 4.82 mm) compared to the preoperative state, the S and L groups. These parameters (the Böhler angle: 31.76 ± 3.37°, width: 36.47 ± 3.72 mm, height: 87.23 ± 3.83 mm) were maintained at the last follow-up. Steinmann pin retractor effected a sound reduction. It also manifested radiological and clinical advantages over the S and L protocols. By reason of the aforementioned, it could be recommended as useful reduction equipment for the minimally invasive treatment of calcaneal fractures.