Two-pin Posterior Tuberosity to Medial Wall Reduction Technique in Calcaneal Fracture Using Sinus Tarsi Approach

Abstract

Introduction: The purpose of this study was to describe a novel technique in the surgical treatment of displaced intra-articular calcaneal fractures using 2 Schanz pins to reduce the posterior tuberosity to the medial wall (constant fragment) and correcting the varus malalignment while using the sinus tarsi approach. Materials and Methods: Twelve patients with calcaneal fractures Sanders type 2 and 3 underwent surgical fixation using this technique at our center from January 2021 to September 2021. One Schanz pin was inserted into the constant fragment and another one was inserted into the posterior tuberosity from lateral to medial. By holding the 2 pins the fracture fragments were first disengaged by applying a distraction force. The heel was then brought out of varus by a combination of maneuvres. The posterior calcaneal tuberosity pin was pushed medially and then the 2 pins were held together with one hand. The ankle was then dorsiflexed to lock the reduction. Harris heel views were taken to ensure reduction. Results: The mean Bohler angle improved from 7.5 degrees preoperatively to 29 degrees postoperatively. The mean Visual Analog Scale was 2.3 out of 10 at 6 months’ follow-up. None of the patients had wound complications, sural nerve neuropraxia, or revision surgery due to malreduction. Discussion: The 2-pin posterior tuberosity to medial wall reduction technique in calcaneal fractures using the sinus tarsi approach is a useful maneuver that can be used by orthopedic surgeons to correct the varus malalignment which is a frequent problem in calcaneal fracture fixation.