The surgical procedure for comminuted calcaneal fracture includes incision, reduction, internal fixation and suturing of the incision.
Comminuted calcaneal fractures often involve the subtalar joint surface, so they need to be treated surgically. Generally, the surgery requires hospitalization and relevant examinations to assess the conditions and risks of the surgery and to determine the surgical plan.
The conventional surgical procedure usually uses an “L” shaped incision up to the bone surface, separating the soft tissues along the bone cortex, revealing the subtalar joint surface and the heel and dice joints, resetting the fracture under direct visualization, and using Kirschner’s pin to temporize the fracture if necessary, and then selecting the appropriate size of the heel plate for internal fixation of the fracture after resetting, and then pulling out the Kirschner’s pin.
Intraoperative C-arm fluoroscopy is also needed to ensure that the fracture is well repositioned and the plate screws are in position. Finally, the incision is rinsed and the instruments and dressings are counted without error and then the incision is closed layer by layer. In order to avoid infection caused by bleeding and formation of hematoma in the wound, the incision also needs to be prevented from drainage tubes or draining skin pieces.
As the fracture is comminuted, the operation process may be longer, but generally under anesthesia, the patient will not have obvious pain, should relax and actively prepare for the operation and postoperative rehabilitation.