Surgical treatment of calcaneal fractures with bioabsorbable screws

Abstract

There is no consensus for the best surgical treatment of intra-articular calcaneal fractures. Bioabsorbable implants have been recommended for the treatment of some fractures. The aim of this study was to estimate the outcome and complications of surgical treatment of calcaneal fractures using bioabsorbable screws. We retrospectively reviewed 58 patients who underwent surgical treatment using bioabsorbable screws. The minimum follow-up was 15 months (mean, 23 months; range, 15-32 months). Fifty-five of 58 patients healed without additional complications. The mean adjusted American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 73.6 ± 22.4, the mean foot function index score was 23.9 ± 7.1, and the mean calcaneal fracture scoring system score was 77.2 ± 8.5. One patient had a superficial wound infection which healed after irrigation and debridement without removal of the implant. Two patients had consistent effusion from the wound for two weeks which healed after drainage and elastic dressing. We identified no evidence of soft tissue irritation or other complications directly attributed to the bioabsorbable screws. Our observations indicate that bioabsorbable screws provide sufficient stabilisation to allow for calcaneal fracture union with the advantage of no implant removal needed.

Figures

Fig. 1

a Preoperative lateral X-ray shows the destroyed Boehler's angle and compressed joint of calcaneus. b Postoperative lateral X-ray shows the restored Boehler's angle and joint of calcaneus. Circles indicate the positions of bioabsorbable screws. c Preoperative coronal CT shows the widening calcaneus. d Postoperative coronal CT shows restored calcaneal width; Arrows show the positions of bioabsorbable screws. e Lateral X-ray shows the healed calcaneus at one year