Balloon reduction and cement fixation in intra-articular calcaneal fractures: a percutaneous approach to intra-articular calcaneal fractures

The management of calcaneal fractures remains challenging and often controversial. Open reduction and internal fixation with a lateral plate has been established as a standard therapy for displaced articular fractures. However, accurate subtalar joint reduction, while mandatory, is difficult to achieve, requires an extensive lateral approach, and clinical results may not be up to the difficulty of the task. We present a treatment using a percutaneous approach and local balloon reduction followed by polymethyl-metacrylate fixation. This technique was used in four patients presenting articular subtalar fractures with displacement. Reduction was achieved in all cases using a posterior trans-osseous percutaneous approach. Bony fusion with conservation of the subtalar articular reduction was achieved in all cases. We present all cases with a detailed report of outcome. Clinical outcome after at least three years of follow-up suggests that this technique may be promising and may be used in cases with closed fractures as a primary reduction and fixation tool.