A Prospective Study on Radiological and Functional Outcome of Displaced Tongue Type Intra-Articular Calcaneal Fractures Treated by Percutaneous Screw Fixation

A Development of the Essex-Lopresti Maneuver: Minimally Invasive Reduction and Fixation of Tongue-Type Calcaneal Fractures via a Single Incision

Tongue-type calcaneal fractures are a subset of displaced intraarticular calcaneal fractures. A reduction maneuver for this fracture pattern was described by Essex-Lopresti. The aim of this article is to describe a modification of this technique that allows reduction and fixation of tongue-type calcaneal fractures via a single, minimally invasive incision. We retrospectively reviewed all patients undergoing fixation utilizing this technique at our institution. We identified 13 fractures in 12 patients with a median follow-up of 12 months. Median Böhler angle was 3.5° preoperatively and 26.5° at final follow-up. The median AOFAS (American Orthopaedic Foot and Ankle Society) hindfoot score was 78. There were no complications or further surgeries in this series. We believe that reduction and fixation of tongue-type calcaneal fractures using this minimally invasive technique is safe and reliable and avoids the potential soft tissue problems of fixation with more extensive incisions.Levels of Clinical Evidence: Level IV.