Clinical Study of Management of Intra-Articular Calcaneum Fracture by Essex Lopresti / Wetheus Reduction Technique and It's Outcome.

Background: Calcaneal fractures remain one of the most challenging problems for orthopedic surgeons. Calcaneal fractures accounts for 2% of all fractures. They account for 60% of tarsal injuries. Open reduction and internal xation with k-wires, lag screws and plates is treatment of choice for intra articular calcaneal fractures. However, plate xation requires a relatively large incision and extensive soft tissue dissection, which increase the risk of postoperative complications such as wound edge necrosis and infections. We were interested in determining whether reduction, bone grafting and plate xation by a small incision can reduce soft tissue complications. We hypothesize minimally invasive treatment of calcaneal fractures would increase patient satisfaction and lower the incidence of complications. Therefore, we are trying to perform a prospective study to measure the outcomes of one of the minimally invasive techniques known as Essex Lopresti technique by using Steinman pins. From January 2023 to December 2023, 20 pa Methods: tients (three women, 17 men) with comminuted calcaneus fractures (Sander's classication type III and Essex-Lopresti classication joint- depression type fracture) were included. Plain lms were obtained preoperatively in all patients. The operation was performed within three days post-injury, and patients were not allowed to bearweight until three months postoperatively. During this period, the patients were educated on how to perform bed exercises for joints above the surgical site, including muscle strengthening and body conditioning. Early active range of motion exercises for the ankle and forefoot began 3 to 6 weeks postoperatively. All patients were followed up regularly. The results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and Böhler's angle of the calcaneus. After an Results: average follow-up of two years, none of the patients required further surgery or experienced soft tissue complications. The clinical results were rated good to excellent on the AOFAS scale in 80% of the cases (16 of 20 patients), and most patients had pain relief and returned to their former daily activities at the same level as before the injury. A modied Essex-Lopresti procedure with percutaneous calcaneoplasty app Conclusion: ears to be a safe and effective procedure to treat comminuted calcaneal fractures with acceptable functional results. Long-term outcomes and additional cases using this technique are required to support our conclusion.