• Felipe López-Oliva, Tomás Sánchez-Lorente, Adela Fuentes-Sanz, Francisco Forriol, and Yolanda Aldomar-Sanz.
• Department of Orthopaedic Surgery, Fundación Jiménez Diaz, Madrid, Spain. flopezoliva@hotmail.es
• Injury. 2012 Dec 1;43 Suppl 2:S73-8.

PurposeTo study the results of reconstruction and primary fusion in worker's compensation intraarticular calcaneus fractures.Patients And MethodsWe carried out a prospective study of 169 acute intraarticular calcaneus fractures treated by reconstruction and primary fusion with the minimally invasive Vira® system, in severe calcaneus fractures. The evaluation was performed by clinical, radiological and biomechanical analysis.ResultsAOFAS score averaged 77.26 points at the end of follow up. Forty-two cases (24.9%) obtained excellent results, 108 (63.9%) good, 12 (7.1%) mild and 7 (4.1%) poor. The improvement in Börder's angle after surgery was significant (p = 0.05) and this did not vary during the follow up. Subtalar arthrodesis was achieved in all cases and only three cases needed bone grafting. Five major post-surgical complications were observed, and one deep infection in a case of open Gustilo Grade III fracture. In the kinetic study, the support time of the operated foot was lower than that of the contralateral foot (p<0.21). The axial force of the heel contact and the single limb support of the operated foot reduced the toe-off axial forces. In the foot with arthrodesis the posterior forces increased (p <0.01). The pressures were lower in the region of the heel and the mid-foot and in the external part of the forefoot, and increased in the big toe.ConclusionsCalcaneal workplace injuries are challenging to treat. Primary subtalar fusion with a minimally invasive method allows rapid recovery for these patients with a satisfactory clinical, functional and radiological outcome.Copyright © 2012 Elsevier Ltd. All rights reserved.

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