Surgical treatment of intraarticular calcaneous fractures of sanders' types II and III. Systematic review

OBJECTIVE: This paper aims to identify the most effective surgical technique for intraarticular calcaneal fractures of Sanders' types II and III. METHODS: Systematic review of comparative randomized clinical trials on surgical treatment of the intraarticular fractures of the calcaneus (Sanders types II and III) that used the questionnaire of the American Orthopaedic Foot and Ankle Society. The studies were identified and retrieved in the following databases - LILACS, MEDLINE/PubMed, Cochrane Library, SciELO, EMBASE, Science Direct, Scopus, Journals@Ovid, ISI Web of Knowledge, Evidence Based Medicine, besides consulting the references of studies accessed. The keywords used Boolean logic (AND and OR): "calcaneus fracture, calcaneous, calcaneal; surgical treatment, management; open reduction, minimally invasive, percutaneous reduction; internal fixation, external fixation. RESULTS: We identified only three randomized comparative trials. Each study compared a different technique (external fixation, percutaneous fixation with Kirchner wires and cannulated screws fixation) to the open reduction with internal fixation using plate and screws (considered the standard technique). CONCLUSION: Comparing the series, percutaneous fixation using Kirschner wires presented the best results, however, evidence is insufficient to assert superiority of this treatment in comparison with other surgical techniques.