Intra-articular calcaneus fractures are high-energy injuries that can result in significant functional loss and morbidity. The management of displaced intra-articular calcaneus fractures is controversial as studies have shown advantages and disadvantages of both nonoperative care and surgical intervention.
When surgery is performed, a traditional approach using an extensile L-shaped lateral incision with lateral plating has been associated with high rates (up to 40%) of wound-healing problems and superficial and deep infection. Wound complications can result in reoperation, plastic surgical intervention and amputation in severe cases. The vascular supply of the lateral hindfoot relies upon the lateral calcaneal branch of the peroneal artery, which is susceptible to injury during an extensile L-shaped approach.
Less-invasive surgical techniques for calcaneus fracture fixation have been developed in recent years to optimize the benefits of surgery while lowering the complication risks. The goal is to obtain anatomic fracture reduction and stabilization with minimal soft-tissue dissection. Early results have shown lower complication rates with these techniques with good clinical and radiographic outcomes in certain fracture patterns and patient cohort.