The posterolateral approach for calcaneal fractures

Dror Lakstein*, Alexander Bermant, Evgeny Shoihetman, David Hendel, Zeev Feldbrin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Conventionally, the extended lateral approach (ELA) served as the standard extensile approach for intraarticular calcaneal fracture fixation. However, this approach has a high rate of wound complications. The purpose of this study was to describe an alternative approach, the posteriorlateral approach (PLA) and compare it to the ELA regarding soft tissue complications and functional outcome. Materials and Methods: 32 patients operated through PLA and 66 patients treated through ELA were included in this retrospective study. Major and minor soft tissue complications up to 3 months postoperatively were recorded. Eighteen patients of the PLA group and 32 patients of the ELA group were available for 1-year functional outcome assessment with the American Foot and Ankle Score (AOFAS) score. Results: The PLA group had no major complications requiring surgical intervention. Six patients (19%) had minor wound complications. The ELA group had 8 (12%) major complications and 9 (14%) minor complications. There were no significant differences in AOFAS scores at 1-year followup. PLA is a safe and efficient approach for open reduction and internal fixation of displaced intraarticular calcaneal fractures. Conclusion: In selected cases when fracture comminution and displacement may not be adequately treated through a less invasive approach, it is a good alternative with less concern about wound complications as in ELA.

Original languageEnglish
Pages (from-to)239-243
Number of pages5
JournalIndian Journal of Orthopaedics
Issue number3
StatePublished - 1 May 2018


  • Approach
  • calcaneum
  • fracture
  • wound complications


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