Intra-articular calcaneal fractures. Current concepts.

Intra-articular fractures of the calcaneus should be treated like any other fractures of major weight-bearing joints. Technology has advanced significantly in the evaluation of such complex pathology. Surgical instrumentation is now available to address any fracture classification. In the past, this had been a problem, as maintenance of the anatomic reduction, rigid internal/dynamic external fixation, and early mobilization may not have been attainable. The two remaining major variables are the mechanism of injury and its force that creates the fracture in combination with a very complex intra-articular anatomical structure. There will always be some morbidity in complex and serious fractures, but at least a more favorable outcome may be attainable with application of the current concepts discussed in this text. Finally, the most crucial factor when dealing with this trauma is the skill of the surgeon, which includes his or her decision-making, preoperative planning, surgical acumen, atraumatic technique, experience, and training and postoperative management of possible complications.