Between June 1996 and April 2002, 56 patients underwent closed reduction and percutaneous fixation of calcaneal fractures. Of the 39 men and 17 woman, five were lost to follow-up. The patients’ mean age was 38 years (17 to 64). Four had bilateral procedures.

Using the AOFAS Ankle and Hindfoot Scale (AHS) and Visual Analogue Pain Scale (VAPS), we assessed patients preoperatively and at 6 and 12-monthly intervals. Clinical examination was undertaken preoperatively and postoperatively at 2-week, 6-week, 3-month, 6-month and 12-monthly intervals. Except at two weeks, radiographs included weight-bearing axial and lateral views at all intervals. Follow-up was for a mean period of 42 months (12 to 72). The mean time to union was 10.2 weeks (8 to 14).

The AHS improved from 34 preoperatively to 85 at the most recent follow-up. The VAPS improved from 9.1 preoperatively to 2.2 at three years. The satisfaction rate was 86%. Functional results depended on the quality of the reduction of the posterior facet and the severity of the initial injury. Complications included a 5% sural nerve injury and a 3% peroneal tendinopathy. No wound complications were encountered.

In selected cases, closed reduction and internal fixation of calcaneal fractures may produce results similar to those of conventional open reduction and internal fixation, with fewer complications. This technique is best performed within 24 to 72 hours of injury.

Twenty-four patients with 26 symptomatic recurrences of deformity after previous hallux valgus procedures were included in this study. Exclusion criteria were hallux metatarsophalangeal joint fusion, Keller/Mayo procedures, insulin-dependent diabetes, previous ankle or subtalar fusions, peripheral vascular disease or peripheral neuropathy. An AAOS Foot and Ankle Outcomes Data Collection questionnaire, a Visual Analogue Pain Scale (VAPS), and the AOFAS Hallux Metatarsopha-langeal Interphalangeal Scale (HMIS) were administered preoperatively, at six months and then annually. Weight-bearing radiographs were taken preoperatively, at 6 weeks, 3 months, 6 months and 12 months. The mean follow-up was 21.6 months (6 to 36).

At final follow-up, the mean HMIS scores increased from 47.5 to 87.8 and the mean VAPS improved from 6.2 to 1.3. The mean hallux valgus angle improved from 37° to 14° and the mean intermetatarsal angle improved from 18° to 7°. In 77%, patients were very satisfied, in 4% satisfied, and in 19% somewhat satisfied.There were no cases of hallux varus. Complications included three nonunions, all of which occurred in smokers, and two superficial wound infections.

In appropriately selected patients, the Lapidus procedure is a reliable and effective alternative for failed hallux valgus surgery.