"Smile" incision: an approach for open reduction and internal fixation of calcaneal fractures.

Foot Ankle Int 2005 Aug;26(8):590-2

Department of Orthopaedics, Summa Health System, Akron, OH 44320, USA.

Materials: A consecutive group of 73 patients (77 calcaneal fractures) treated with open reduction and internal fixation through a smile-shaped lateral approach to the hindfoot were reviewed retrospectively. Inclusion criteria were a closed displaced intra-articular fracture of the calcaneus, no compartment syndrome, and adequate followup. Followup ranged from 4 months to 4 years.

Results: One patient had a deep wound infection that required removal of hardware and intravenous antibiotics. No deep dehiscence or flap necrosis occurred. Superficial dehiscence occurred in three patients (4%) and superficial necrosis was seen in nine patients (12%); all resolved with continued casting to protect the wound. Six patients (8%) complained of numbness or pain in the sural nerve distribution. No symptomatic neuromas were seen. Reflex sympathetic dystrophy occurred in three patients (4%); all resolved with sympathetic blocks. Only one patient required an additional procedure for treatment of a wound-related problem or infection.

Conclusion: The "smile" incision provides good fracture exposure for reduction without added morbidity.

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http://dx.doi.org/10.1177/107110070502600802DOI Listing
August 2005
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