C-NAIL - a new implant for minimally-invasive treatment of intraarticular calcaneal fractures

摘要

The treatment of dislocated intra-articular fractures of calcaneus gives a lot of debates between the orthopaedic surgeons. Minimally-invasive techniques beside offering good reduction of the fracture have lesser complications and for this reason tend to replace the open procedures. In this paper, we want to describe a new method of minimally-invasive technique used in the treatment of intra-articular calcaneal fractures and internal fixation with C-NAIL. The nail offers the possibility to insert up to seven screws into the calcaneus: two sustentacular screws, three latero-medial screws into the tuberosity and anterior process and 2 supero-inferior into the tuberosity. The first step of the procedure is the closed reduction of the calcaneal tuberosity to the sustentacular fragment and open reduction and internal fixation of the posterior facet through a 3-cm long incision made below the apex of the lateral malleolus. Second step in the insertion of the nail via a minimal incision just below the insertion of the Achille tendon. The nail and the screws creates an angularly stable fixation; the main stability is obtained by inserting the two screws into the sustentaculum.