Pierluigi Mastri, Alessandro Cerone, Mariano Giuseppe Di Salvatore, Antonio Medici, Vittorio Calvisi
Fractures of the calcaneus represent a significant challenge for the orthopedic surgeon. The use of external fixators dedicated to the calcaneus has allowed in recent years a simpler and more intuitive approach to these fractures. The aim of our study is to review the literature to understand the state of the art of this surgical approach. Was conducted a literature review in PubMed, EMBASE and Google Scholar with the keywords “Fracture” “Calcaneus” “External fixation”. 35 articles were reviewed by 3 authors. The exclusion criteria were: studies with less than 20 patients, articles published before 2000, and minimum follow up of 15 months. 267 FE-treated fractures were included. Of the 267 fractures, according to the Sanders classification, 1.26% were type I, 36.6% type II, 50.47% type III and 11.67% type IV. In the follow-up, 165 patients had excellent (> 90), 99 good (> 75), 27 good (> 50) and 16 poor (<50) Maryland Score. The mean pre-operative Bohler angle was 5.3 °, with a post-surgical mean of 24.11°. Internal fixation in calcaneus fractures has poor clinical outcome and is recommended to be performed by expert surgeon. The data that emerged from the review highlight how the FE of the calcaneus is an effective method with limited post-surgical complications. FE of the calcaneus seems to be an effective treatment method, it allows the reduction of complications and allows to obtain excellent functional results, resulting in a safe and easily reproducible surgical strategy.
