الفهرس 
Normal values of calcaneal anglesOnly 14 pages are availabe for public view
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Abstract
Calcaneus fractures are rare but potentially debilitating injuries. Their management remains controversial; a moderate consensus tends toward Sanders computerized tomography (CT) classification, Angle of Gissane, the Böhler angle and calcaneal width measurement as useful diagnostic and management tools.
The fundamental purpose of calcaneal fractures surgical management is to reestablish the volume of the calcaneus and the alignment of the hindfoot to allow a good functional result even if the subtalar is very often rigid.
Open reduction and internal fixation through the extended lateral approach allows excellent visualization and direct reduction of the articular surface; however, it has been reported to be associated with a high incidence of soft tissue complications. Recently, Different minimally invasive techniques have been reported and achieved satisfactory outcomes, including percutaneous Kirschner wires (K-wires) or Steinman pins, percutaneous cannulated or solid screws, external fixators, and percutaneous plates.
Twenty-four (24) percutaneous fixation of calcaneal fractures in 24 patients were included in this study. This study was done at El Menoufia University hospitals and Mansoura general hospital between December 2020 and June 2021.
These patients were followed up for at least 6 months post-operatively. This study included closed intraarticular calcaneal fractures type II and III in adult patients and excluded open, extra-articular, type I and IV fractures.
Summary
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The maximum age incidence in this study was from 31-46 (50.6%) and the least age incidence was from 49-60 (49.4%), The youngest patient was 31years old and the eldest was 60 years old. Nineteen patients were males and only five females showing male predominance. Fourteen patients were affected on the right side and ten patients were affected on the left side. Only 5 patients had associated injuries which included: fracture spine in 2 patients, upper limb fracture in 1 patient, abdominal injury in 1 patient and pulmonary injury in 1 patient.
The predominant mechanism of injury was fall from height and landing on the heel in 16 patients (66.7%). The other mechanism was the road traffic accident in 8patients (33.3%). All fractures were classified using Sander’s Classification for fracture of calcaneus. Of the 24 calcaneal fractures 15 calcaneal fractures were Type II and 9 calcaneal fractures were Type III. In the k- wires group the mean pre-operative Bohler’s angle was 18.08±1.92, in the cannulated screws group was 19.42±0.90 and the mean post-operative Bohler’s angle was 28.83±1.34 and 29.75±0.96 respectively. Restoration of normal range Bohler angle was achieved in 24patients (100%). In the k-wires group the mean pre-operative Gissane angle was 160.50±3.58, in the cannulated screws group was 159.58±2.57 and the mean post-operative Gissane angle was 142.17±1.69 and 141.50±1.17 respectively. Restoration of normal range Gissane angle was achieved in 24 patients (100%).
Twenty-one patients (21) (87.5%) started weight bearing at 12 weeks while three patients (12.5%) started weight bearing at 16 weeks, only one patient developed pin tract infection treated by daily dressing and antibiotics for one week. Only two patients developed calcaneo-cuboid arthritis relieved by selective steroid injection. Only two patients developed malunion with subtalar joint pain relieved by xylocaine injection, only one patient developed k-wires loosening with painful nonunion.
Summary
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In the current study, the excellent and good results were considered satisfactory while the poor and fair results were considered unsatisfactory. The final results at the end of this study were satisfactory in 91.6% of patients and unsatisfactory in 8.4% of patients according to Maryland foot score.