[Experiences with closed screw placement in intra-articular fractures of the calcaneus. Surgical technique and outcome].

For the closed treatment of an intraarticular fracture of the heel bone it is essential to know the 3D shape of the bone, the various types of fractures and to get skilled in reduction under an image intensifier. In our hospital we have made a comparison of 34 fractures treated with a plate and 94 treated with screws. The evaluation was made by the scores based on Merle d'Aubigne and clinical and radiological findings. The method of closed reduction and fixation with screws is easier, less dangerous for the patient and, compared to the open fixation, the results are the same or even better (good and excellent: 79.7%). As a result of gentle treatment of the soft tissues and the early reposition, the wound healing complications decreased to 2.1% compared to the 14% healing problems connected to open plating. Furthermore, cancellous grafting was necessary within the first group.