Calcaneal fractures treatment with locking nail: is it an option?

Abstract

Surgical treatment of calcaneal fractures continues to be a challenge for surgeons owing to the high risk of complications. The aims of this study were to analyze the results of percutaneous locking nail fixation, including radiologic and functional outcomes, complications, time to surgery and to hospital discharge. This is a retrospective study, that assessed calcaneal fractures treated with a percutaneous locking nail (Calcanail, FH Orthopedics). The fractures were classified according to Sanders. Pain, function and range of motion were evaluated at final follow up, according to the visual analogue scale (VAS), the foot and Ankle Outcome Score (FAOS) and the American Orthopaedic Foot and Ankle Society Ankle-Hind foot Score (AOFAS-AHS), respectively. Between July 2016 and May 2018, 12 patients and 13 fractures were identified. The mean time to surgical procedure was 10.5 days, with 1 day of hospital stay. The average AOFAS and FAOS scores were 87.8 and 79.2% respectively, at a mean final follow-up of 16 months, and the mean VAS was 1.83/10. Böhler and Gissane angles improved from 18º and 132º to 28º and 122º respectively. The mean improve of calcaneal height was 0.5 cm. The mean time to return to daily activity level was 3.3 months and to work 4 months. 8% of the patients had complications severe enough to require a new intervention, and we had no skin complications. Percutaneous calcaneal fracture fixation with locking nail appears to be an effective and reliable procedure. It is a surgical option in selected patients.