INTRAMEDULLARY LOCKED NAILING (CALCANAIL) FOR DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES: EARLY OUTCOMES FROM A SINGLE UK CENTRE

Background Intra-articular calcaneal fractures are complex fractures, but closed reduction and internal fixation (CRIF) is a minimally invasive alternative for treatment. Calcanail® Intramedullary technique aims to restore alignment whilst protecting the soft tissues associated with the standard lateral approach. We report our early experience from a UK trauma unit Methods A retrospective analysis of 24 consecutive displaced intra- articular fractures treated by a single surgeon. Baseline demographics included age, sex, comorbidity, smoking, Sanders classification, Bohler's angles and MOXFQ scores. Results 14 Males and 10 Females with mean age of 57 (SD 15.6) The all-cause revision rate was 12% (n=3) at a median of 154 months. The aseptic revision rate was 8 % at a median of 154 months. 3 had surgery for removal of symptomatic metalwork with 1 had subtalar fusion for post traumatic arthritis. Secondary outcomes included Mean Bohler's angle improving substantially from 18.6° pre-operatively to 35.5° post-operatively (P<0.001), representing a mean correction of 16.9°. Overall, 88% of patients achieved a postoperative Bohler's angle greater than 20°, indicating a satisfactory radiographic reduction. Postoperative Functional MOXFQ score was 58.8. Conclusion Survivorship in our unit using CALCAnail ® was excellent with an all-cause revision rate of 12% and aseptic revision rate of 8 % at median of 154 months. Calcanail effectively restores anatomical relationships around the subtalar joint, evidenced by improved radiographic and functional outcomes whilst also utilising a minimally invasive approach protecting the vital soft tissue envelop which often is a concern with complex calcaneal fractures.