Introduction and Objectives: Our aim was to study the clinical and work-related results of minimally invasive athrodesis in the treatment of severe calcaneus fractures.

Materials and Methods: A total of 50 fractures (42 patients) with intraarticular calcaneus fractures were treated by means of a minimally invasive primary arthrodesis using the VIRA^® (Biomet, Valencia, Spain) system with a minimum follow-up of 12 months and a mean follow-up of 21 months. Mean age was 41 years of age. Eight procedures were bilateral and 3 open. According to Sanders classification 74% were type IV. We performed a prospective study with clinical and radiographic assessment (AOFAS scale) 12 months after surgery.

Results: The mean AOFAS score was 76.6 points (SD: 13.97): 26% were very good, 62% good and 12% fair to poor. There was no statistical variation of AOFAS in Sanders type of fracture, whether or not the lesion was bilateral and whether or not there was an associated lesion. We found an association (p=0.06) between the AOFAS score and the previous health status of the patient. Böhler’s angle improved slightly, although significantly (p=0.05), and there was seen to be correspondence with the postoperative AOFAS scale. Subtalar arthrodesis was achieved in 48 cases (96%) at 3 months.

Discussion and Conclusions: Primary arthrodesis using minimally invasive systems is a valid option for the surgical treatment of severe fractures of the calcaneus. It provides good clinical and radiological outcomes with minimally aggressive surgery and a low complication rate.

Introduction and Objectives: In distal avulsion of the biceps, the treatment of choice is re-attachment of the tendon. The aim of this study is to compare both surgical techniques.

Materials and Methods: Between September 2004 and February 2007, 22 consecutive patients with distal biceps rupture were randomly assigned to one of the 2 treatment groups. In group A, 11 patients underwent tendon reattachment with an Endobutton^® through a single anterior incision and in group B, 11 patients underwent tendon reattachment by means of a procedure using 2 bioabsorbable Panaloc^® harpoons placed through a double anterior and posterior approach. Mean age and interval between rupture and surgery were similar in both groups.

Results: Mean operation time was 44 minutes in group A and 65 minutes in group B. There were no complications in group A. Two patients in group B suffered transient neurapraxia of the posterior interosseous nerve and 2 presented heterotopic ossification. At 12 months there were no significant differences in the Mayo Elbow Performance Score, mobility, time of return to work or strength.

Discussion and Conclusions: Although both groups had similar functional results, anterior repair using an Endobutton must be considered the technique of choice for distal biceps avulsions because of the shorter operation time and less morbidity.