Open reduction and internal fixation of type II intra-articular calcaneus fractures.

Open reduction and internal fixation of 23 type II calcaneus fractures in 21 patients was performed using a standard extended lateral approach. Average follow-up was 26 months (range, 12-47 months). The Creighton-Nebraska Health Foundation Assessment Score for Fractures of the Calcaneus was used to evaluate fractures. The average score was 91.4 (range, 80-100), which represented an excellent result. A series of 10 type II fractures treated with closed methods was also evaluated using the same evaluation methods. The average score was 70 (range, 60-84), which represented a fair result. There was a clear statistically significant superiority with type II calcaneus fractures treated with open reduction and internal fixation (P < 0.0001). We recommend type I calcaneus fractures (nondisplaced) be treated with closed methods, and type II calcaneus fractures (displaced) be treated with open reduction and internal fixation.