Background
Minimally invasive treatments for calcaneous fractures have the same outcomes and fewer complications. However, they are technically demanding, and there are a lack reduction tools. To overcome these problems, a calcaneous interlock nail system was developed that can make reduction and fixation minimally invasive and effective. We retrospectively studied the calcaneous fracture variables intraoperatively and followed up to evaluate the outcomes of patients treated with the interlock nail system.
Methods
All patients in 7 institutions between January 2020 and May 2021 who had calcaneous fractures treated with interlock nails were retrospectively analyzed. The patient characteristics, including age, sex, injury mechanism, Sanders type classification, smoking status, and diabetes, were recorded. The interlock calcaneous nail and standard surgical technique were introduced. The intraoperative variables, including days waiting for surgery, surgery time, blood loss, incision length, and fluoroscopy time, were recorded. The outcomes of complications, AOFAS scores and VAS scores were recorded.
Results
Fifty-nine patients were involved in this study; 54 were male; 5 were female; and they had an average age of 47.5 ± 9.2 years (range 25–70). Two of these fractures were Sanders type I, 28 of these fractures were Sanders type II, 27 of these fractures were Sanders type III, and 2 of these were Sanders type IV. The surgery time was 131.9 ± 50.5 (30–240) minutes on average. The blood loss was 36.9 ± 41.1 (1-250). The average incision length was 3.5 ± 1.8 (1–8) cm; 57 were sinus tarsi incisions; and 2 were closed fixations without incisions. The average fluoroscopy time was 12.3 ± 3.6 (10–25) seconds during the surgery. The VAS score of patients on the day after surgery was 2.4 ± 0.7 (1–3). The AOFAS ankle-hindfoot score in patients who had a follow-up of at 12 months was 93.3 ± 3.6(85–99). During the follow-up, all patients’ functional outcomes were good. One patient had a superficial infection. The rate of complications of the 59 patients was 1.7% (1/59).
Conclusions
The calcaneous interlock nail system can have satisfactory reduction and fixation in calcaneous fractures, even in Sanders type IV. The outcomes of follow-up showed good function. The interlock nail could be an alternative method for minimally invasive calcaneous fracture fixation.