الفهرس 
Relevant Anatomy of HindfootOnly 14 pages are availabe for public view
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Abstract
Despite the relative prevalence of intra-articular calcaneal fractures, definitive management is controversial.
After the first percutaneous operation by the German surgeon Westhues in 1934, a considerable number of percutaneous and minimally invasive open techniques have been used to treat calcaneal fractures
Based on several studies with percutaneous techniques, Rammelt et al(Rammelt et al., 2004) concluded in 2004 that percutaneous fixation of displaced calcaneus fractures produces good to excellent results in properly selected patients with less severe fracture patterns and that the quality of joint reduction should be directly visualized to avoid problems in subtalar joint motion.
Twenty-two (22) percutaneous fixation of calcaneal fractures in 20 patients were included in this study. This study was done at Banha university hospital and Mataraya teaching hospital between July 2019 and January 2020.These patients were followed up for at least 8 months post-operatively. This study included closed intra-articular calcaneal fractures type II , III and IV in adult patients and excluded open, extra-articular, type I fractures.
The mean age was 36.45 ± 11.213 (range from 19 to 59) years old.. 18 patients (90%) were males and 2 females (10%). 13 patients (65%) were broken on the right side and 5 (25%) patients on the left side. There were 2 patients (10%) of bilateral involvement.
The mean pre-operative Böhler’s angle was 14.08 ± 2.4390 (range 9 -17 o) and the mean post-operative Böhler’s angle was 26.15 ± 4.187 (range 18 – 33 o).. This means improvement of Böhler’s angle after fixation achieved in 14 fractures (63.6%) and not achieved in 8 fractures (36.4%).
The mean pre-operative Gissane angle was 151.14 ± 14.2640 (range 1480-1800 ) and the mean post-operative Gissane angle was 136.32 ± 15.2550 (range 1350-1530 ). This means improvement of Gissane angle after fixation in 12 patients (52.2%) and not achieved in 10 patients (47.8%).
The mean pre-operative Sarrafian angle was 40.50 ± 7. 769 (range 300 -480 ) and the mean post-operative Sarrafian angle was 55.32 ± 8.5550 (range 470-640 ). This means improvement of Sarrafian angle after fixation in 9 patients (43.5%) and not achieved in 13 patients (56.5%). That meant improvement of Böhler’s, Gissane and Sarrafian angles after fixation.
Eighteen patients (90%) started weight bearing at 12 weeks while two patients (10%) started weight bearing at 16 weeks.
Regarding complications, only one patient developed superficial wound infection treated by daily dressing and antibiotics for one week. Only two patients developed calcaneo-cuboid pain relieved by selective steroid injection. Only one patient developed tarsal tunnel syndrome and refused surgical release. Two patients developed subtalar joint pain relieved by xylocaine injection.
The results at the end of this study were satisfactory in 86.3% of patients and unsatisfactory in 13.6% of patients according to AOFAS score.